INTRODUCTION ■ 5We embrace debate, discourse, and difference in this text. The concept “difference”
in many ways is naturally associated with “innovation” and indeed the statement made
by Collinge, Burfitt, and MacNeill (2006) that “ ’Innovation’ is the process of bringing
’novelty’ into being, but to analyse this a little further it is useful to recognise that nov-
elty is a kind of ’difference’ ” (p. 4). For this reason, as this degree moves beyond its first
real decade, differences in DNP programs ought not be the focus. Premature conformity
in any industry (including education) can stamp out innovation and that is why “dis-
ruptive innovators” like Uber (founded in 2009) and Twitter (founded in 2006) generally
burst onto the scene with success (Christensen, 1997). In higher education, both online
and digital learning remain disrupted innovations that many (including academics) still
bemoan and malign for different reasons (Horn, 2014). But simply choosing to ignore
the impact of digital learning and its penetration into most aspects of higher education
is really not a realistic option. What may be the better focus for the DNP and the current
dialogue on doctoral preparation for APRNs may be to examine what curricular areas
require strengthening or refocusing? This might allow the discipline to spend less time
on issues with the practice doctorate, such as “whether we should have this degree” or
whether “doctoral nursing practice is better than master’s practice” (we contend it is
more advanced, but the literature does not yet support it is better) and focus more on
“what is the role of the DNP graduate with regard to knowledge development” and
“how will DNP graduates be socialized to be more engaged stewards of the discipline
than master’s graduates?” We aver that DNP graduates must advance the discipline,
even if some traditional PhD- degree- focused faculty remain skeptical. After all, Lee S.
Shulman (2010), president emeritus of the Carnegie Foundation for the Advancement
of Teaching and professor of education emeritus at Stanford University, recently stated,
“Doctoral education shouldn’t be a marathon” (p. 1).
The great advances of this degree in the profession include: (a) giving nurses a
doctoral degree option other than the PhD; (b) more degree parity for highly educated
nurse clinicians, nurse executives, and others; (c) enhanced credibility and prestige of
DNP graduates in the corridors of the health practice environment and at the tables of
health policy; and (d) more refined skills in knowledge management and in the trans-
lation and dissemination of evidence for health care utilization. However, unresolved
issues remain: (a) how much scholarship (even the word “research” in nursing becomes
a loaded word) belongs in the practice doctorate?; (b) should DNP graduates become
leaders in practice knowledge development derived by generating practice- based
evidence (versus evidence- based practice)?; (c) is 1,000 total clinical hours for the post-
master’s DNP degree reasonable and sound?; (d) should there be any crossover course-
work between DNP and PhD students?; and (e) should the PhD and DNP degrees
ultimately be the only nursing doctorates offered? Finally, after examining trends in
the educational preparation of nursing faculty discussed in Chapter 11, we often now
wonder if the resurgent EdD in nursing education ought to become the degree of choice
especially for academics who do not teach in research- intensive universities, and who
predominate in the teaching ranks across the country. As these issues are debated and
hopefully resolved, it is still likely that the DNP degree may ultimately look different at
research- intensive universities than at colleges where teaching is more of an emphasis.
We, and the multiple contributors to this text, write with great optimism, but also with
circumspect and critical analyses of the DNP degree. We view this approach to this text,
retained from the first edition, as a strength.
This text is divided into three sections. The first section is titled “Historical and
Theoretical Foundations for Role Delineation in Doctoral Advanced Nursing Practice.”
In this section, the historical and political evolution of the DNP degree is traced and an
analytical view of the “state of the degree” is presented. This section continues with aDreher_71733_PTR_01_int_p1-8.indd 5Dreher_71733_PTR_01_int_p1-8.indd 5 12/7/2016 6:04:22 PM12/7/2016 6:04:22 PM