1: THE HISTORICAL AND POLITICAL PATH OF DOCTORAL NURSING EDUCATION ■ 29
the notion of “what is nursing knowledge development?” In recent years, this issue was
revisited as it has been acknowledged that DNP graduates are actually involved in the
development of new knowledge, explicitly “clinical knowledge” or “practice knowl-
edge” derived from practice evidence or internal evidence (AACN, 2015a; Dreher, 2013;
Melnyk & Fineout- Overholt, 2011) practice. But even with the AACN white paper on
the DNP, this is not a settled issue and good nursing scholars can disagree on this point.
Some feel the degree should be made more accommodating to practice scholars who
have every right to conduct research, others feel just as strongly that this is precisely
what the PhD is for. Thus, with the early train headed toward a nonresearch DNP, the
dialogue at open meetings leading up to the 2004 vote and the post- vote “team build-
ing” nevertheless, for some, seemed unstoppable.
■ THE AACN’S 2015 POSITION AND THE RUSH BEGINS
As we reflect on the history that both Columbia University and the University of Kentucky
have provided to the contemporary practice doctorate, it is also important to examine the
first critical mass of schools that began DNP programs in 2005. At the time, despite the
October 25, 2004, vote^14 by the AACN to require the DNP degree for all advanced prac-
tice nurses— NPs, CRNAs, CNMs, and CNSs— by 2015, the landscape and the curricula
of the DNP degree had not yet evolved. Table 1.3 lists the DNP programs (both DNP and
DrNP) that existed in August 1, 2005, the first critical mass of DNP programs.
Right after Columbia University introduced their DrNP model in early 2005, Drexel
University developed its own DNP degree model in March 2005 and labeled it a “clinical
research doctor of nursing practice degree.” It combined both advanced practice and the
conduct of practical clinical research, concluding with a clinical dissertation. The degree
was modeled after the PsyD and DrPH degrees (both professional doctorates that include
a research emphasis), and the authors detailed their new degree model in The Journal
of Online Issues in Nursing in 2005 (Dreher et al., 2005). As the former chair of that doc-
toral nursing program development committee, I can say that the faculty- working group
began contemplating this particular degree model in 2000 in an innovative quest to find a
practice- oriented degree as an alternative to the PhD. However, the Drexel nursing faculty
felt very strongly that the research mission of the degree should only de- emphasize the
PhD degree’s focus on conducting research and creating new knowledge, not eliminate
it. Certainly, since 2005 the Drexel program was an obvious outlier, but other programs
using the DNP initials quietly let its students engage in clinical research as this was prob-
ably what the faculty felt more comfortable mentoring its students to perform. The DrNP
was actually modeled on the PsyD clinical dissertation; so in many ways, the professional
psychology doctorate was the “hybrid professional doctorate,” which the AACN in 2004
was not actively considering, despite the open- review process it was publicly claiming it
was conducting (Murray, 2000). All hybrid doctorates in the health professions complete
a research project, usually in the form of a dissertation (Dreher, Fasolka, & Clark, 2008;
Hawkins & Nezat, 2009; Smith Glasgow & Dreher, 2010). Figure 1.1 indicates that the
DrNP degree was theoretically designed to fall in between the PhD and the DNP degrees,
and Figure 1.2 indicates how this is similarly approached (from a practice doctorate with
the smallest emphasis on research to the most, the PhD) in occupational therapy. Finally,
as the DrNP degree model at the time included four roles (practitioner, clinical executive,
educator, and clinical scientist), it is interesting to note that 50% of first 16 current gradu-
ates who entered the doctoral program in a role other than that as an educator (most were
full- time practicing certified NPs) went into academia postgraduation, and 56% of these