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.