280chapter ELEVEN
Refl ective Response
Nancy C. Sharts- Hopko
A shortage of doctorally prepared nurses able to meet the profession’s multifaceted clin-
ical, educational, leadership, and scientific agendas led to the Institute of Medicine’s
(IOM, 2010) recommendation that the number of doctorally prepared nurses be doubled
by 2020. The authors of Chapter 11 note the confusion that persists around the role of the
Doctor of Nursing Practice (DNP) versus the research doctorate (PhD) in nursing. When
the DNP degree was initially proposed in the United States, its purpose was to prepare
clinical nursing leaders with the knowledge and skills to transform systems of care. As it
has turned out, approximately 40% of DNP graduates each year assume academic posi-
tions (Fang, Li, Arietti, & Bednash, 2014); this is actually the same proportion of PhD
graduates whose primary employment is in an academic institution, but the number of
DNP graduates annually is now far greater than the number of PhD graduates.
Altman, Butler, and Shern (2016) recently reported on results to date of implemen-
tation of the IOM report. They specifically identified concern about the relative stag-
nation in the preparation of nurses with PhDs compared to DNPs. They noted that the
annual number of PhD graduates is insufficient to replace retirees. A major contributing
factor is the shorter length of study required for a DNP degree. Altman et al. indicated
that greater emphasis on PhD program expansion and on incentives for students to
pursue PhD degrees is needed. Of course, this is contingent on having sufficient faculty
with research doctorates to teach and mentor them.
It is anticipated that in the foreseeable future, most doctorally prepared faculty
members in most schools of nursing will hold DNP degrees. Although there is no ques-
tion that these new faculty members are urgently needed in the face of the worsening
nursing faculty shortage, it is imperative that consideration be given to what this trend
means for the discipline of nursing.
In 2006, the Carnegie Foundation for the Advancement of Teaching commis-
sioned a collection of essays on the future of doctoral education, and the greatest
emphasis in the collection was placed on research doctorates. It is particularly ger-
mane at this time to reflect on the specific contribution of PhDs to a discipline. Golde
(2006) emphasized that the aim of PhD education is to prepare the stewards of the
discipline; that is to say that PhD holders are responsible for the discipline’s integ-
rity. Disciplinary stewards should be capable of conserving the most important ideas
from the past, generating new knowledge, and transforming knowledge that has been
generated and conserved by relating it to ideas in other fields. Stewards of a discipline