6: THE ROLE OF THE CLINICAL EXECUTIVE ■ 165(MSN) administrative track, the detail with evaluation, research, evidence- based inter-
ventions, cost- effectiveness analysis, and policy development associated with health care
initiatives, interventions, and outcomes was significantly different. Each of the authors
believes that with the completion of the DNP program, we acquired a new level of thinking
about program development and evaluation; identification and placement of best practices
into practice settings; advanced practice in health care; interpretation of patterns from large
data sets; and, most importantly, leadership in health care. Overall, the DNP practicum
(residency) experiences greatly enhance the learning experience of students and it enables
them to view advanced practice from a macroscopic perspective, which is vastly different
from the more microscopic approach experienced in the MSN administrative track.
■ COMPARISON OF THE ESSENTIALS OF MASTER’S EDUCATION
FOR ADVANCED PRACTICE NURSING AND THE ESSENTIALS OF
DOCTORAL EDUCATION FOR ADVANCED NURSING PRACTICEThis section highlights some of the key areas of difference between the 1996 Essentials
of Master’s Education for Advanced Practice Nursing document (which is currently under
revision) from the AACN and the 2006 Essentials of Doctoral Education for Advanced
Nursing Practice (see Figure 6.2 ). Figure 6.2 demonstrates some of the key differences
noted between the traditional MSN educational preparation and DNP competences as
defined by AACN. There are four critical differences noted :
- The DNP competencies are more system wide and provide a macroscopic
view of health care that combines all the sciences and better prepares gradu-
ates to engage in partnerships that will impact change in health care at a
higher level. The student’s focus reaches beyond the traditional patient setting
within the organization. - DNP competencies are geared toward creating graduates who lead to change
as opposed to assisting with change, which seems to be more the case with
the MSN competencies. This competency is evident through the residency
hours and the capstone projects. Students through their residency hours and
capstones potentially generate new knowledge, and, in most cases, focus on
adapting best practices to the clinical setting. - The DNP graduate demonstrates the nursing role to the community at large
(even nationally) through both performance and communication, while the
MSN graduate competencies focus more on communication of the nursing
role on a narrower scope. - The DNP competencies are more population based and prepare a graduate to
make change globally, while the MSN competencies are more population and
community specific, thus limiting one’s impact on health care to a smaller scale.
Figure 6.2 illustrates a juxtaposed comparison of each set of competencies, point-
ing out key differences, which are shown in boldface. Although there is a small amount
of overlap with a few of the competencies, the differences stated earlier clearly indicate
the variation in the level of preparation among graduates from the two programs.
The CNO’s influence will likely extend to areas outside of nursing. The CNO
must engage in collaborative professional relationships with many internal and
external stakeholders. Many authors conclude that success at the executive level
hinges on being visionary and making decisions on a macroscopic level. Hader
(2010a), senior VP and CNO of Meridian Health System in New Jersey, states that the
CNO’s strategic plan must reach beyond the traditional scope of nursing practice. He