1: THE HISTORICAL AND POLITICAL PATH OF DOCTORAL NURSING EDUCATION ■ 11
members could work more cohesively toward the broader benefit of increased access to
health services and ultimately to the improvement of health in our nation.
Hopefully, as we reflect on from where we have come, we can emphasize graduate
nursing education policy that is both evidence based and does not do what Melosh says
happened in our earlier history when “Nurses on the job were sometimes threatened
by the strategies leaders adopted, for the rising standards of professionalization often
meant downgrading or even eliminating current practitioners” (1982, p. 5). Dracup and
Bryan- Brown (2005) also express these concerns, stating “We also worry that the current
advanced practice nurses who hold MS degrees will feel disenfranchised” (p. 280). And
in very frank language, Dracup and Bryan- Brown echo much of Melosh’s (1982) early
analysis:
When nursing education moved from the hospital to the university or college
setting, diploma nurses found themselves with an education that provided
little or no college credit. We had an entire generation of embittered nurses
who saw nursing academics as out of touch with clinical practice. (p. 280)We implore the nursing profession not to forget its history and, this time, to learn from
some of these very painful growing pains in our discipline, and respond differently
in the future. As Dracup and Bryan- Brown beseech, we must avoid disenfranchising
a large number of nurse practitioners (NPs), nurse- midwives, nurse anesthetists, and
clinical nurse specialists (CNSs) who believed they were properly prepared for their
roles when they entered advanced practice with a master’s degree.
■ BACKGROUND
This book may be the first to have ever declared that the first doctorate in nursing,
the EdD in nursing education at Teachers College, Columbia University, in 1933, was
actually a professional (or practice) doctorate.^3 Globally, the EdD degree is viewed as
the professional doctorate in education, whereas the PhD in education is viewed as the
research degree (Maxwell, 2003; Townsend, 2002). Herein lies one of the issues that still
plague the nursing academy with the DNP degree. The EdD graduate also completes a
dissertation (like the PhD graduate), but the EdD dissertation is more practice oriented
and work based. Some even view the EdD as a research degree, too, but it is worth
noting that the Harvard School of Education does not offer the PhD in Education (only
in collaboration with the School of Arts and Sciences); it offers only the EdD (Baez,
2002; Courtenay, 1988; President and Fellows of Harvard University, 2016). And like
Harvard’s doctor of business administration (DBA) degree, both are viewed as profes-
sional doctorates, but include practice- oriented, rigorous research (Fink, 2006). The DNP
degree, however, is very similar to other professional doctorates that do not normally
include an original research project— the doctor of medicine (MD), the doctor of phar-
macy (PharmD), and the doctor of physical therapy (DPT), for example. Nonetheless, in
2016, this question remains one of the most contentious discussion points among doc-
toral nursing educators (both DNP and PhD): What is the role of research in the DNP
degree, and should DNP students and graduates generate new nursing knowledge or
be restricted to expertly translating and disseminating what is currently known? As the
AACN (2015a) has recently published a white paper that clarifies this knowledge pro-
duction role some, we will revisit this issue later in this chapter as we discuss the central
unresolved issues with the degree. Nevertheless, maybe what we are attempting now
with the largely DNP degree is simply a return to nursing’s orientation as a practice