1: THE HISTORICAL AND POLITICAL PATH OF DOCTORAL NURSING EDUCATION ■ 27
the master’s degree, but they did not identify or recommend any specific date by which
would be mandated (or recommended; 2016). The decision to not suggest a date by which
to accomplish this was prudent because the elusive 2015 date previously suggested by
the AACN for broad adoption of the DNP by APRNs came and went, practically with-
out comment. Moreover, because conversion to the entry- level DNP (BSN to DNP) had
been so sluggish (with programs overwhelmingly maintaining their master’s APRN
degree programs while adding post- master’s DNP degree options), as previously men-
tioned in this chapter, the AACN commissioned the prestigious RAND Corporation to
study the barriers to the entry- level DNP (Auerbach et al., 2015). Many of the major NP
specialty organizations have endorsed the NP DNP Education, Certification and Titling: A
Unified Statement (Nurse Practitioner Roundtable, 2008), which states:
Current master’s and higher degree nurse practitioner programs prepare
fully accountable clinicians to provide care to well individuals, patients with
undifferentiated symptoms, and those with acute, complex chronic and/ or
critical illnesses. The DNP degree more accurately reflects current clinical
competencies and includes preparation for the changing health care system.
It is congruent with the intense rigorous education for nurse practitioners.
This evolution is comparable to the clinical doctoral preparation for other
health care professions. (p. 1)This unified statement is actually quite progressive. It does not appear to disen-
franchise current MSN- prepared NPs (I note the emphasis on “current” however), while
acknowledging that they endorse the evolution of clinical doctoral preparation for NPs.
More recently, the American Association of Nurse Practitioners (2013), a member of the
Roundtable and the largest organization representing NPs, essentially reaffirmed this
statement.
After the constitution of the AACN Task Force on the clinical doctorate in 2002,
the NONPF and the AACN cohosted the National Forum on the Practice Doctorate in
December 2003. What is interesting about the executive summary of this document is the
following: (a) The constituent attendees identified that “practice” might encompass the
clinical role, administrator, educator, or informaticist; (b) “Also clinically expert, doctor-
ally prepared faculty will have to be recognized and have parity with other doctorally
prepared faculty” (p. 3); and (c) “If the scope of practice remains unchanged, certifica-
tion could accommodate an evolution from master’s to doctoral preparation” (National
Forum on the Practice Doctorate, p. 4). Although this forum had much more representa-
tion than the AACN Task Force, it still had only 51 attendees plus the invited speakers,
and it appears that concerns expressed about moving forward with an acute nursing
shortage and aging population, as reported by Hawkins- Walsh (2004), went unheeded.
Along with Hawkins- Walsh, this author and colleagues Donnelly and Naremore in 2005
also questioned why the AACN undertook a new doctorate for advanced practice and a
new generalist master’s degree role (i.e., clinical nurse leader) when there were already
two more critical nursing issues facing the nation: (a) a protracted nursing shortage and
(b) a nation that was woefully preparing for an aging population with a meager pro-
duction of geriatricians and gerontological NPs (Dreher, 2008b; Dreher et al., 2005). Both
physician and nursing leadership can be faulted for this poor health policy planning.
What is also interesting about this meeting was that the seeds were already planted that
this degree would not be for practitioners only. On the conference’s second point, the
disenfranchisement of DNP faculty nevertheless took place, as many research- intensive
and research- oriented universities have denied them tenure- track positions, but smaller,
largely liberal arts colleges have been more accommodating. In a small, but recent study