History of Doctoral Education In Nursing Discipline

Afza.Malik GDA

 Need of Doctoral Education for Nurses and Its Development

History of Doctoral Education In Nursing Discipline

Development the Doctoral Discipline of Nursing ,Evolving Doctoral Programs in Nursing Education,DNS and Equivalence to PhD,Understanding Doctoral Preparation in Nursing Education,Requirement of Nurses with DNP,DNP Programs in Nursing ,DNP and Nurse Educator.

Development the Doctoral Discipline of Nursing 

    Doctoral education for nurses has existed since the 1920s. Doctoral programs originally prepared nurses for administrative and teaching roles. The first program was offered in 1924 at Teachers College, Columbia University, where nurses received an educational doctorate (EdD). Nurses received EdDs because the nursing profession had not developed its own doctoral programs, these doctorates were accessible through programs that offered part time study, and the programs discriminated less against women as compared to programs in other fields (Bullough & Bullough, 1984). 

    It was not until the latter part of the 20th century that doctoral programs in nursing developed. They developed out of recognition that the nursing profession needed its own research and theoretical basis. As a result, doctoral programs in nursing dramatically increased, and offered nurses the opportunity to conduct research and develop theory within their own discipline.

Evolving Doctoral Programs in Nursing Education

    The PhD (doctorate of philosophy) in nursing is often referred to as the “gold standard” for adequate doctoral preparation because it ensures nurses are competent to conduct research, which develops nursing knowledge and theory (Kirkman, Thompson, Watson, & Stewart, 2007 ). Despite the merit of the PhD, in the 1960s Boston University challenged it by beginning the DNSc, or the clinical doctorate. Many thought this doctorate would prepare nurses for doctoral level work in clinical practice, rather than research and theory (Loomis, Willard, & Cohen, 2007). 

DNS and Equivalence to PhD

    Regardless of its original intent, over time, studies indicated that the DNSc (also known as the DNS or DSN), in many respects, is equivalent to the PhD (Loomis et al., 2007). Another challenge to the PhD occurred in the 1970s when Margaret Newman of New York University advocated for the ND (Nursing Doctorate) program. Similar to the DNSc, with the noted exception that the ND also prepares individuals for basic licensure as a registered nurse, she believed an ND would prepare nurses just as medical schools repair physicians for application of advanced knowledge in clinical practice. 

    The first ND began program in 1979 at Case Western Reserve University in Cleveland, Ohio. This evolution of doctoral programs has essentially created two pathways for doctoral education in nursing, one that is Research oriented and another that is practice oriented.

Understanding Doctoral Preparation in Nursing Education 

    Doctoral programs are entering a new and progressive era. The DNP (doctorate of nursing practice), proposed by the American Association of Colleges of Nursing (AACN, 2007a) to become the terminal degree for advanced practice nursing by 2015, is the newest doctorate focusing on advanced preparation in clinical practice. It is comparable to practice doctorates in fields such as pharmacy and physical therapy. 

    The DNP provides advanced preparation in scientific foundations of nursing practice , leadership, evidence based practice, healthcare technologies, healthcare policy, interprofessional collaboration, clinical prevention and population based healthcare, and advanced nursing practice in specialty areas (AACN , 2006c). A great deal of controversy has surrounded the development of the DNP. Those supporting it suggest it offers improved formal preparation for advanced practice nursing roles not obtained by a master's degree in nursing (Hathaway, Jacob, Stegbauer, Thompson, & Graff, 2006). 

Requirement of Nurses with DNP

    Nurses who have completed the DNP degree report that provides them with improvement in their clinical expertise and the ability to shape healthcare policy (Loomis et al., 2007). Opponents of the DNP believe that it only serves to confuse the public about various nursing roles and functions. Additionally, its development precludes preparation for the role of nurse educator, creates possible shortages of advanced practice nurses who cannot afford to take the additional coursework needed to complete the DNP, and excludes schools of nursing that may not have the resources to develop a DNP program (Chase & Pruitt, 2006).

DNP Programs in Nursing 

    Despite these debates, today there are 46 DNP programs, with 140 more nursing schools considering starting this program (AACN, 2007c). As the DNP gains momentum and nurses prepared with the DNP begin to enter the workforce, it will be important for all in the nursing profession to understand how the DNP prepared advanced practice nurse can potentially contribute to the nursing profession. For example, outcome studies that demonstrate how nurses with a DNP influence the health of individuals, groups, and populations will be necessary to document their contributions to health care. 

DNP and Nurse Educator

    Although not necessarily receiving academic preparation as educators, in response to the nurse faculty shortage many DNP-prepared nurses will likely find roles as nurse educators in schools of nursing will they be adequately prepared to assume these roles? (See Contemporary Practice Highlight 2-2.) Another important consideration will be what resources are needed to assist in the development of DNP programs in significant enough numbers in schools of nursing with diverse educational missions to produce the number of advanced practice nurses needed in the United States.

    It will also be essential to help the public and other healthcare providers understand the DNP role. Nurses who are considering the pursuit of doctoral education will need to carefully consider which doctoral degree is the best fit for their professional career goals the PhD, DNS, or DNSc degree with a research focus or a practice doctorate such as the DNP.

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