Higher Education and Types In Nursing
Types of Doctoral Education
Doctoral education in nursing includes two general types of programs offering distinctly different types of degrees. The basic differentiation is between research-focused and practice-focused programs.
Research Focused
Research-focused doctoral programs comprise the majority of programs. They are designed to prepare the graduate for a lifetime of scholarship and research. Research-focused doctoral programs offering either the academic doctorate (Doctor of Philosophy-PhD) or the professional Doctor of Nursing Science-DNS, DSN, or DNSC) degree; one research-focused program offers the EdD.
Practice Focused
Practice-focused doctoral programs, which are fewer in number, are designed to prepare the nurse for leadership in practice and for specialized advanced practice and administrative roles. The degree titles that are currently offered by practice focused programs include the Doctor of Nursing (ND), and the Doctor of Nursing Practice (DNP or DrNP ); one practice focused program awards the DNS.
Currently, over 88 institutions offer doctoral programs
in nursing and several (7 currently) offer both a research-focused and a
practice-focused program. Six programs are offered jointly or collaboratively
between two or more institutions.
Curricular Differences
Over three fourths of existing programs offer the academic doctorate, reflecting the trend in research-oriented programs to offer the PhD rather than the professional degree, because the PhD is universally recognized and accepted and enjoys considerable prestige, particularly in academia.
Curricula for programs leading to research-focused doctorates typically contain a core of required courses addressing nursing theory, methodology, theory development strategies, and various aspects of research methodology and statistics.
qAdditionally, students usually are required to develop substantive expertise in a specialized area of nursing knowledge and research by selecting courses in nursing and related disciplines (cognates), becoming involved in hands-on research related experiences such as research residencies or practical and research assistant ships, and conducting major independent research protect and writing the dissertation.
Research Focused Curriculum
Typically, half or more of the credits focus on research methodology and actual conduct of research.
On the average, full-time students complete their doctoral study in 4 years: 2 years to complete the course work and an additional 2 years to complete the dissertation. Although the degree title is different, research focused programs leading to the professional doctorate (DNS, DNS, DSN) have curricula that are quite similar to the academic doctoral programs.
Theoretically programs offering the DNS are more likely to emphasize research that is applied and relates directly to clinical, administrative, or policy-related practice and leadership.
In addition to research preparation , curricula for such programs often include practicum experiences designed to develop a high level of research expertise in a specialized area of nursing practice.
The required dissertation is often
applied in nature. Graduates of research-focused programs are most likely to
assume faculty positions upon graduation, but increasingly are being employed
as researchers in clinical environments.
Most Wanted Type
An important trend in nursing is the rapid increase in practice-focused doctoral programs. Although they are not new to nursing, practice-focused doctoral programs have received renewed interest as a viable alternative to the academic doctorate for individuals who wish to attain the highest level of expertise in clinical practice.
The curricula differ considerably from those of the research-focused programs, with the major differences being that they typically have fewer credits addressing research and do not require a dissertation.
Areas of content that are common to virtually all of the practice-focused doctoral programs include: the scientific underpinnings for practice; advanced practice in a given specialty area of nursing; organization and system leadership, change strategies and quality improvement; analytical methodologies related to the evaluation of practice and the accrual and application of evidence for practice; use of technology and information; development, application and evaluation of health policy; and interdisciplinary collaboration.
In addition, programs provide the basis for advanced specialized expertise in at least one area of nursing practice.
A dissertation is generally not required; however, most programs include a practice-related project and a residency experience. Some practice focused doctoral programs limit their specialty areas to those concerned with the direct care of patients as implemented in advanced practice nursing roles (ie, nurse practitioner, nurse midwife, nurse anesthetist, clinical nurse specialist), while others also include specialty preparation in administration or executive practice.
There are several different points of entry into practice-focused doctoral programs; some require students to enter with some specialty preparation at the master's level and others permit post-baccalaureate entry.
In all cases, graduates are expected to provide
visionary leadership in the practice arena as advanced practice nurses, program
managers and evaluators, and nursing service administrators. Graduates of
practice- focused doctoral programs frequently assume positions clinical
educators in schools of nursing.
Historical Perspectives
Historically, doctoral nursing education began at Teachers College, Columbia University, and at New York University in the 1920s. After a 30-year hiatus during which no new programs were opened, interest in doctoral education was rekindled; by the end of the 1970s, a total of 18 programs had been initiated.
During the 1980s the number of programs more than doubled, and with the rapid increase in programs and enrollments came concern about maintaining high quality. The American Association of Colleges of Nursing took a leadership role in developing indicators of quality regarding student and faculty qualifications, curriculum content, administrative patterns, and support resources.
During the 1990s, ideas about the nature of scholarship and doctoral education were refined as the emphasis on establishing and maintaining quality continued. Emphasis expanded from the tools of scholarship to increasingly addressing the growing body of substantive nursing knowledge.
The disproportionate focus on process
changed to greater emphasis on the content that constitutes the input to and
products of the scientific process.
In addition to the growing interest in practice-focused doctoral programs, an important trend is that increasingly students are being encouraged to progress as quickly as possible toward the terminal degree.
Fueled in part by a growing faculty shortage and the need to produce more doctoral graduates, programs are increasingly streamlining progression between tween degree levels and eliminating work experience as a prerequisite to admission. As a result, the profile of the "typical" doctoral student is changing.
The average age of doctoral nursing students is
gradually decreasing, and students often enter doctoral study from clinical as
well as academic backgrounds.
Future Of Doctoral Education
Doctoral education continues to be an arena of excitement and innovation in nursing education. The need for doctoral graduates continues to escalate, yet the challenge to maintain quality in the face of rapid change is of paramount concern.
For individuals, the
doctorate is the pinnacle of attainment in nursing education, and for
institutions it is the pinnacle of academic attainment. The virtually universal
acceptance of the doctorate as the terminal degree signifies nursing's status
as a true academic discipline.
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