18: DNP-PREPARED NURSE’S ROLE ■ 417doctorates to research doctorates (AACN, 2014; Fulton & Lyons, 2005; Loomis et al.,
2006). Sometimes, the comparisons are critical (Meleis & Dracup, 2005); usually they are
descriptive efforts to differentiate the purpose, the educational and/ or clinical content,
and the intended outcomes of each program (AACN, 2014, 2015b). The 2015 report from
AACN’s task force on the implementation of the DNP program is AACN’s latest effort
to restate the intent of the DNP degree; emphasize the incorporation of The Essentials
of Doctoral Education for Advanced Nursing Practice into curriculum and outcome assess-
ments; and re- state its position that the DNP degree is the educational pathway to
advanced practice (AACN, 2015b).
Martsolf et al. (2015) note that although many schools have developed and value DNP
education as the route to advanced practice, only about 30% of the schools offer the BSN to
DNP program as the entry level into advanced practice. Their data also suggest that the mas-
ter of science in nursing (MSN) remains a viable and perhaps preferred option for advanced
practice education. As yet, there are no published studies that link patient outcomes to the
educational pathway of the DNP- prepared APN. Outcome studies do support the quality
of care provided by MSN- prepared APNs (Cronenwett et al., 2010; Stanik- Hutt et al., 2013).
Although the doctorate of nursing practice is relatively new, it is being embraced
by the nursing community; its rapid growth also heightens concern about the PhD pipe-
line. Early objectors to the DNP program saw this new degree as adding another dimen-
sion to the confusing and unresolved debate about the educational preparation for entry
into practice (Meleis & Dracup, 2005). Others acknowledge that nurses aspiring for clin-
ical or administrative careers would select DNP programs because they are shorter and
are more appropriate for their future roles (Loomis et al., 2006).
There is also strong support for DNP education from national organizations, nota-
bly the AACN, the American Association of Nurse Practitioners (AANP) , the American
Academy of Nurse Practitioners (AANP), the National Association of Pediatric Nurse
Practitioners (NAPNAP), and the National Organization of Nurse Practitioner Faculties
(NONPF, 2015). Their websites actively market the significance and the importance of
the practice doctorate. The literature also presents opinion articles, survey data, and
reports of interviews and studies of nursing schools’ approaches to: the BSN to DNP
or the post- master’s DNP (Martsolf et al., 2015). Almost 30 years ago, Downs (1989)
observed that educators have debated the differences surrounding doctoral education
since it began in the United States. It seems that nursing has now found a way to con-
tinue the entry into practice debates at the doctoral level.
■ THE DNP DEGREE
What can be said about the state of the DNP? There has been an amazing response from
schools of nursing to the AACN’s 2004 statement on practice doctorates. In a recent
review of the AACN’s (2016) website, the month after the 2015 transition deadline
for recognizing the DNP degree as the entry level into advanced nursing practice had
passed, 271 schools of nursing offered DNP programs and another 100 programs were
said to be in planning stages. In Figure 18.1 , the AACN shows a comparison between
the growth of DNP and PhD programs between 2006 and 2014 (AACN, 2015a).
The AACN (2015b) notes, however, that the variability among existing DNP pro-
grams transcends the different entry pathways: the BSN to DNP or post- master’s DNP.
Institutional, academic, regulatory, professional, and economic factors influence how
each dean and faculty plan, implement, evaluate, and fund the DNP program of studies
and establish admission standards (AACN, 2014).