134 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
management of care for individuals and populations, administration of nurs-
ing and health care organizations, and the development and implementation
of health policy. (AACN, 2006, p. 4)
Although the authors point out that the DNP builds on MSN- level education, it
should be understood that the DNP replaces MSN- level education for advanced practice
with comprehensive and in- depth knowledge that is necessary to manage the complexi-
ties not only for individual patient care but also for populations and health care systems.
As outlined in Case Study I, A Women’s Health NP Who Continues to Want
“More ,” the DNP degree provides the education that practitioners need for responding
to the health needs of the nation by being the bridge between research and practice. I
would differ in opinion with this author who stated that this degree is for the NP who
wants more , but I declare it is for the NP who needs more to continue to be effective in fac-
ing the challenges of taking care of patients in the ever- changing and expanding health
care system. This is not to say that MS- prepared APNs are ineffective in their roles, but
it is to say that continuing their education to the DNP will allow them to be even more
effective, not only in their roles but also in improving the care they deliver. In doing so,
it will be instrumental in changing practice to better serve their patients.
In Case Study II, Transitioning in Academia, Practice, and Scholarship: One DrNP’s
Story , the author highlights the importance of the DNP- prepared educator. Colleges
of Nursing educate practitioners, and what better- prepared faculty is there than the
“Practice Expert?” There is a national shortage of qualified nursing faculty that is fur-
ther contributing to the nursing shortage nationally. The increasing number of DNP
programs opening across the nation is one answer to the faculty shortage as it increases
the number of faculty who can train nurses at both the entry and advanced levels. I
agree with this author that it is very important to choose a DNP program that will fulfill
the candidate’s future career goals.
Finally, it is important to point out the importance of the DNP- prepared APN as
a member of a research team, even as the leader of clinical research endeavors. This
important point is still not appreciated in the AACN’s revised White Paper on the
DNP published August 2015, which attempts to clarify the scholarly role of the DNP
student and graduate. When it comes to evidence- based practice, it is important to
understand that there is not a linear pathway to improving patient care. Rather, it is a cir-
cular path that always feeds back into primary research. Without measuring outcomes
of evidence- based changes in practice, there is no way to ascertain that such change has
actually improved patient care and outcomes. It is imperative that DNP- prepared APNs
are able to not only synthesize science, but also to apply it to practice and measure the
impact of such change. The question here is, At what point is the generation of evidence-
based practice knowledge considered ’research’ and how do they differ? DNP- prepared
practitioners are able to and should be prepared to measure the impact of their practice,
whether by measuring the process of a program or practice change or by measuring indi-
vidual patient outcomes. If this is considered “research,” one can comfortably say that
it is not primary knowledge generating research, but evidence- based practice that will
actually benefit the health care system. Dreher (2016) has labeled this “practice knowl-
edge” derived from practice evidence and Melynk and Fineout-Overholt (2014) label this
“internal evidence” (p. 11) that is practice- generated. Webber (2008) raised an important
question regarding the decision of DNP programs not to prepare graduates to be princi-
pal investigators of clinical research. She argues that such action “will limit the creation
of a broader, more inclusive research environment and thus perpetuates marginalization
of research for many faculty, students, and practicing nurses” (p. 466). Webber points out