Emergent Forms Of Doctoral Education In Nursing Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

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The Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature following are perspectives for educators and students.

Evolution and Nature: Emergent Forms Of Doctoral Education In Nursing

Professional doctorates are not new and have emerged in a wide range of disciplines; for example, Doctor of Education ( DEd ); Doctor of Psychology ( DPsych ); Doctor of Dental Science (DDS); Doctor of Physical Therapy (DPT). By tracing their historical roots, their purpose can be explored. The range of doctorates in a multi-professional context has been outlined with a short description of their history by Pierce and Peyton (1999).

Emergent Forms Of Doctoral Education In Nursing Evolution and Nature. Several professional doctorates, including DDS and Doctor of Pharmacy (PharmD) have reflected the historical roots of the Doctor of Medicine (MD) degree. The MD has a long history; At its inception in the USA the MD was a baccalaureate degree with acquisition of clinical skills based on an apprenticeship model. Pierce and Peyton (1999) argue that these three degrees were driven by a requirement to enhance practitioners’ competence in clinical practice.

The success of these three fields in their adoption of similar curricular models emphasizing a preliminary degree, advanced education, higher standards for entry, research-based practice and extended clinical internships recommends this approach to practitioner education as one that has proven effective. (Pierce and Peyton, 1999, p. 66).

Within nursing, an early definition of a professional doctorate in nursing provided by Newman (1975) reflects historical parallels with MD degrees:

A professional doctorate is not to be confused with an academic doctorate. The latter, the PhD, is an advanced research degree, preceded by basic undergraduate education in the field and is intended to prepare scholars who will advance and teach knowledge in the field. In contrast, a professional doctorate is a practical degree similar to the doctor of medicine degree and constitutes basic preparation for practice. (Newman, 1975, p. 705).

Note that Newman was discussing an ND degree (Nursing Doctorate), conceived as the entry level practice degree, similar to the MD, DDS and PharmD. This degree is currently offered by three institutions within the USA. As already described, provision of doctorates in nursing has developed within different international postgraduate arenas with different histories and structures.

Historically, the main drivers for US doctorates were to prepare ‘faculty’. Murphy’s analysis (1981) concludes that from 1926 to 1959 a generation of nurses who undertook educational doctorates were prepared for functional roles mainly in teaching settings, whom she labels ‘the functional specialists’ .

Later, doctorates placed emphasis upon nursing theory and clinical issues which reflected both developments in healthcare in that decade and the disciplinary focus of nursing (1960–1969)—the ‘nurse scientists’.

Finally, a cadre of nursing scholars emerged whose doctorates of nursing were focused on knowledge development in nursing (from the 1970s). A major influence has been the increasing specialization in clinical practice as evidenced by a growing provision of clinically specialized Master’s courses (Cotton, 1997), and increased clinical specialization within doctoral programs (Bigbee, 1996).

Therefore, doctorates have changed in both structure and focus over time, reflecting an increased demand for specialist roles in education, clinical practice and management, at both preregistration and postgraduate levels.

Other US literature has also emerged which describes new types of doctorates labeled ‘non-traditional’ (Pickard, 1986; Scott and Conrad, 1992; Sakalys et al, 1995). These authors describe programs that are intensive and concentrated in shorter time spans (for example ‘over the Summer’ such as that provided by the University of Colorado Health Sciences Center).

Emergent Forms Of Doctoral Education In Nursing Evolution and Nature.These are programs that meet both a professional and an adult learning agenda and are a direct response to the high demand for doctorally prepared clinicians, who find the typical program inflexible, or not provided locally. These ‘non-traditional’ programs have an overall goal of facilitating adult learners to develop professionally at the same time as overcoming problems related to full-time study and geographical inaccessibility, perhaps ideally suited to both clinicians and managers.

In 1995, six US universities offered intensive summer-only options and demand was reported as very high ( Sakalys et al, 1995). Evaluation of the programs suggest that they are commensurate in quality and levels of student satisfaction but that they have a potential to cause stress and fatigue (Scott and Conrad, 1992; Sakalys et al, 1995).

Elsewhere, doctorates for specific professionals have been slower to emerge ( Bourner et al, 2001), and the earliest programs were made available in 1992 (the Doctorate of Education at Bristol University). Prolific development followed, and by 1998 there were 109 programs available in 19 subjects. Bourner et al report that medicine, business administration, education, psychology and engineering account for almost 80% of the programs, but that there is a growing range of subjects.

In addition, part-time study programs have increased in number, reflecting the increasing demand for postgraduate study with professional and personal development objectives (UKCGE, 2002). The disciplines relevant to health and social care and the number of programs that were in existence in 1998 are summarized as follows: Doctor of Education, 29; Doctor of Medicine, 20; Doctor of Clinical Psychology, 19; Doctor of Business Administration, 9; Doctor of Psychology, 4; Doctor of Educational Psychology, 4; Doctor of Public Health, 1; Doctor of Occupational Psychology, 1; Doctor of Clinical Science, 1 ( Bourner et al, 2001).

It is of note that a number of doctorates in business administration have also evolved, perhaps reflecting increasing demand for professional practice and personal development in the business and industry sector. These too may be attractive to managers in the healthcare sector (Holloway and Walker, 2000).

There are also a large number of educational doctorates often attractive to nurse educationalists. In summary, a range of doctorates have emerged that are distinct from the traditional PhD, which aims to understand the needs of specific professional groups relevant to nursing.

They reflect a range of learning outcomes specific to professional needs in practice. The UK Council for Graduate Education (2002) defines the nature of these doctorates as: a program of advanced study and research which, while satisfying the University criteria for the award of a doctorate, is designed to meet the specific needs of a professional group external to the University, and which develops the capability of individuals to work within a professional context . (UKCGE, 2002, p. 62)

Galvin and Carr (2003) have reported students’ perceptions of the increasing opportunities for nurses to engage in professional doctorates in nursing, with several UK programs in existence in 2000. Due to the curriculum placed requirements on British universities ( Bourner et al, 2001) most share a common structure with a range of ‘taught core units of study’ and a thesis. Galvin and Carr (2003) have observed that most nursing doctorates comprise core units, delivered as taught modules or through the seminar approach.

Emergent Forms Of Doctoral Education In Nursing Evolution and Nature. A major feature is the requirement of a thesis with reduced length (40,000–60,000 words) compared to the traditional thesis of 80,000–100,000 words. In their study ‘New knowledge for improvement’ they describe the underlying program mission from data generated by course leaders about the objectives guiding the nursing doctorates.

In a small study of professional doctorate students Galvin and Carr (2002) also highlighted that practice-focused careers rather than career academics are prominent aspirations; the motivation for doctoral study among their sample was to contribute to practice and have an impact on patient care.

However, the findings also showed the need for expertise in a wide range of research methods; they report that a broad skill set within a context of multi-professional care delivery is not fully acknowledged by existing doctoral students. The features of healthcare practice provide a clear rationale for multiple doctorate programs that are both traditional and non-traditional and that facilitate clinicians, educators and managers.

Most UK doctorates are primarily focused on meeting particular professional needs, often reflected in their titles (eg Doctor of Administration, Doctor of Finance, Doctor of Counseling Psychology, Doctor of Nursing Science).

Emergent Forms Of Doctoral Education In Nursing Evolution and Nature. However, a small number of universities in the UK offer generic professional doctorate programs with the content negotiable with the student to meet personal and professional needs (for example, Doctor of Professional Studies or Doctor of Professional Practice). In addition, inter-professional educational strategies are beginning to emerge (UKCGE, 2002).

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

Emergent Forms Of Doctoral Education In Nursing: Evolution and Nature

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