Substance of Doctoral Education In Nursing: The Content of Doctoral Education

Content of Doctoral Education

Unsteady foundations and Uncertain futures

A doctoral program is a preparation in research. All are agreed on this. However, in a changing world there are perhaps grounds for reflecting on what this means. There is a sense in which this means training to be a researcher. In the past, the student learned how to do a specific kind of research in a specific area of work, and usually within the confines of a graduate school or laboratory.

On completion, the student would work in an academic institution or in a commercial laboratory setting, doing work the same as or similar to what he or she had been trained for. Sometimes, in the academic setting, the researcher would also teach, but little in the way of preparation for this was involved, at least during doctoral preparation. Issues of values or moral dilemma were not a concern, beyond those that would come under the rubric of research ethics (issues of informed consent, standards in respect of work with human or animal subjects, etc.).

For the future, this will not do. As society-wide awareness of the impact of the product of research, both positive and negative, upon our modern world increases, there are also emerging arguments about other concerns that should be addressed in such programs. For example, those who undertake such programs will need to take account of the impact of their work on the real world, and the impact of this world on how research should be conducted in the future.

Indeed, as was suggested earlier, the new world of global modernization presents new threats and challenges that may even demand that different types of research work are carried out in very different ways. Doctoral preparation must change. The question is, how?

On the basis of our earlier discussion of emerging trends, it seems likely that now, much more than previously, there may be a willingness to countenance, and indeed adopt, new approaches to doctoral education. There is evidence that this is the case.

However, the point reached in this process is unclear and there is currently considerable variability across the international stage. The degree of confusion is increased by the fact that not only do doctoral programs vary from country to country, but also that this is in part a result of the overall variations in educational systems of which doctoral education is one end-point. Examples of such variations (the descriptions are not specific to nursing) include:

  • In the USA, PhD programs have typically extended over four years’ fulltime study and included an assessed coursework element. While apprenticeship or mentorship has been a significant element, this has not always been standardized. Assessment would typically be by defending a thesis to a panel.
  • In the UK, PhD programs have traditionally extended over three years’ full-time study, excluded an assessed coursework element (although sometimes requiring entry following a master’s degree), and functioned largely on master-and-apprentice models. Students are typically admitted as undifferentiated research students and assessed as meeting the standard (or otherwise) for doctoral study at the end of the first full-time year of study or its equivalent. In instances where the standard is not reached, the student proceeds to a master’s level research degree (usually entitled MPhil) or withdraws. Assessment would typically be by presentation of a thesis and viva (oral) examination by an internal and external examiner.
  • In France the PhD (known as the Doctorate ), can only be embarked upon following a master’s level program where coursework is intensive and formally assessed, and requires four years of study. Assessment is by an internal panel of examiners followed by a public defense of the thesis.

Notwithstanding such differences, the international similarities in doctoral preparation outweigh national differences. Such programs represent the most advanced level of tertiary or higher education, and in all situations their primary focus is the preparation of researchers or those for whom research or its application will be a significant aspect of their future careers. By the same token, in all situations the problems faced are similar. That is, the question of appropriateness of the PhD for meeting the challenges of the modern world.

Changing the Gold Standard

Concerns about the extent to which the PhD has adequately prepared researchers have led to increasing efforts to improve such programs, and this has often included ‘taught’ elements. However, there is great variation from institution to institution in terms of the amount of student support.

In some instances this is limited to what is provided within the supervisor—student relationship, while in others there is a more formal program that often includes formally assessed elements. As indicated above, the inclusion of a coursework or taught element in the PhD program is a standard approach in the USA, and in other countries the requirements for progression are also highly structured. While this has not been the case in the UK, here also there is a recognition of the need for greater attention to the organization of learning within the doctoral programme.

Significantly, within PhD programs, where coursework is an element of the program, the emphasis is on a more systematic underpinning to research issues—capacity for analytical and critical thinking, an understanding of the research process, the addressing of methodological issues, means of systematically reviewing literature, training in research design and methods, data analysis, report writing, etc.

Augmenting these intellectual and research skills, in the past 15–20 years, PhD programs in the USA have included content in various areas of nursing science that correspond to national health priorities and/or faculty research expertise. While there is no national standard within the UK, guidelines issued by the Quality Assurance Agency (QAA) for Higher Education (the national body charged with monitoring and assuring higher education quality) provide a broad framework that institutions may use.

Innovative Departures

As interest in doctoral education has advanced, various issues (perceived deficits in PhD, desired ‘product’, innovative approaches, etc.) have led to a rather confusing scenario. Much of this centers around the efficacy of the research program, and this of course relates in large part to its goals in each case. One useful contribution is the ’empirical taxonom ‘ of doctorates proposed by the UK Council for Graduate Education (UKCGE), as presented in the following list (Bones, 2002):

  • PhD by research
  • PhD by publications
  • New route PhD/advanced PhD/PhD plus
  • Undertaken doctorate
  • Professional doctorate
  • Doctor of Medicine

The notion of a ‘taught doctorate’, i.e. one that largely consists of taught and assessed course elements, has tended to be unpopular in the UK, where the view that all doctorates are essentially research oriented holds sway. While a need for more educational input and training in research methods has been recognized, alternatives such as enhancing the PhD program (new route PhD, PhD plus, etc.) that maintain the doing of research as the main activity are preferred. The Doctor of Medicine degree is usually specific to the medical profession and has similarities to the notion of a professional doctorate in other professions.

As a consequence, the broad division emerging is between those described as PhD/DPhil (which in the UK can be achieved by research or publications) and the professional doctorate route. It is worth noting in passing that in the UK, within nursing, the professional doctorate is commonly described as a Doctor of Nursing Science ( DNSc ) degree. In the USA, degrees of this title are most often highly research focused and aligned with the PhD route, with a doctorate that has a more professional orientation being completed Nursing Doctorate (ND).

The idea of a professional doctorate is essentially that it will meet the needs of professionals whose main aspiration is the application of research within practice settings (McKenna and Cutcliffe, 2001). Such individuals aspire to leadership, managerial, advanced practice or educational roles rather than roles as career researchers within universities or research organizations (unlike in the USA, a doctorate in nursing education as a separate route has not emerged in the UK).

While this has been the main form of innovative departure in doctoral education outside of developments within the PhD route itself, there is unfortunately a lack of consensus about the nature the variation should take. There is also a concern within the UK, Taiwan and Australia that professional doctorates may not have the same degree of international currency and credibility as the longer established PhD route.

This is also an issue in the USA, as reported by Carpenter and Hudacek (1996). The different types of doctorate are described in detail elsewhere in this volume. The main features of such programs are outlined below (drawn from various sources: Lunt, 2002; Higher Education Funding Council for England (HEFCE), 2003; Slevin, 2003b).

  • They are Research Degree Programs (RDPs).
  • They are formally recognized by governmental and accrediting bodies.
  • There is normally a noun formal taught component.
  • They tend to be designed to meet the professional needs of students who are at levels of advanced standing within their professions.
  • While such doctorates are research degrees, there is generally a broader conception of scholarship involved.
  • There is an issue of whether professional doctorates in all cases produce new knowledge or extend current knowledge, or whether the application of research to practice is the most important criterion.
  • Such programs invariably involve the student/participant in activities of research or scholarly inquiry.
  • There tends to be more flexibility and innovativeness in how these demands are expressed within programs.
  • The focus on flexibility and innovativeness is sometimes carried through to assessment, which may involve assessment of taught learning elements as well as these, and may involve senior professionals in the learning support and assessment.

The context within which these programs have developed is also one that is increasingly concerned with matters of quality. This has particularly been the case since the commencement of the millennium. In the UK, the Scottish Higher Education Funding Council (SHEFC) commenced this with the influential consultation entitled Research and the knowledge age (SHEFC, 2000).

This is reflected in the current consultation on doctoral programs being carried forward by the four UK higher education funding bodies (Metcalfe et al, 2002; HEFCE, 2003). Indeed, the inception of taught and professional doctorates was a fundamental driver in the impetus towards establishing quality and standards for programs. Equally significant, and on a larger scale, is the project on reenvisioning the PhD in the USA. This project is a courageous attempt to engage all stakeholders in shaping the PhD for meeting the needs of the new millennium (Nyquist, 2002).

An issue of ongoing debate, both in respect of PhD and professional doctorate program, is the amount of coursework or teaching and learning (excluding supervision or mentorship) that is involved. As changes in the wider world impact upon academia, and as this has resulted in more organized approaches to PhD education, the differences between the two routes have sometimes become blurred.

In some instances, while there has been a movement towards more coursework in some PhD programs, there has been a drift within professional doctorates towards more emphasis on research. This trend creates a situation in which, in some UK higher education institutions, while there are often differences in the declared goals of the two routes, there is great difficulty in discerning any real variation in content.

However, where such differences can be discerned, they emanate from the different intentions. While the emphasis in the PhD route is knowledge construction, the professional doctorate research element frequently incorporates a practice development orientation. While in the former the emphasis is on advanced study in research methods, in the latter advanced professional studies are also usually included.

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