528 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
in the context of all nursing education expectations provide continuity to the real foun-
dations of how our discipline is educated. These essentials influence how our profession
matures. However, is practice based on the essentials, and more specifically, is practice
guided by the essentials? This approach opens several possibilities of exploration that
includes a question of how competencies are determined in the academic setting that will
confirm and propel the doctorally prepared nurse into practice. A broader question of
the benefit and detractors of a structure that may (or may not) influence practice is worth
exploring. Is the bureaucracy of academia complementing the bureaucracy of practice?
■ WHY EXPLORE PRACTICE AFTER GRADUATION?
An approach to consider before venturing forward is to ask why we consider this explo-
ration in the first place. After graduation, is the doctorally prepared professional nurse
beholden to the educational model comprised of these eight essentials to help structure
processes that improve health care outcomes? This point can be debated in all disci-
plines and the value of considering this for the nursing profession cannot be discounted.
Questions to be asked of all practice professionals that may address the value of our
respective educational preparation is to challenge the application of our education as a
mechanism of directing our actions. Does our cumulative education dictate what we do
and why we do it? This is not an easy question to address.
Anecdotally, does the reader believe that those who practice as doctorates of phar-
macology reflect back on the structure of their educational preparation when practicing
their profession? Similarly, does a physician rely on the curricular structure in order to
practice medicine, or does he or she rely on thinking processes gained as a result of the
education when providing services? Similarly, we must reflect in our own discipline with
the question of how curriculum delivery impacts practice. Do the eight essentials of doc-
toral education direct practice, or does the structure of the overall curriculum based on
these essentials allow for independent and responsible thinking as a result of the overall
education? The question of how the eight essentials address practice could be convoluted.
Yet when brought down to the basic question of how is practice supported, the value of
the eight essentials as an educational or curricular construct does not dictate the decisions
made by the doctorally prepared nurse demonstrating the highest level of practice.
The following content explores practice and how it is manifested in comparison
to the eight essentials of doctoral education. The conjecture is that these essentials do
not guide practice, nor do they dictate thinking processes. Instead, they are conceptual
structures that build the overall delivery of content for the purposes of building consis-
tency in curriculum.
■ IS PRACTICE BASED ON THE ESSENTIALS?
Doctoral students’ final work products may reflect how the essentials are incorporated
into a cumulative project. However, not all final work products (capstones, scholarly
projects, etc.), include all of the eight essentials of doctoral education. This may be ac-
ceptable to some DNP program leaders. From the perspective of the graduate in practice,
the lack of inclusion of all essentials may not impact practice. Colleges and universities
guide the inclusion of the essentials in an effort to assure that all elements of the edu-
cational process are achieved. This is not a bad expectation by the educators that are
tasked to demonstrate a culmination of an academic process. Many DNP projects reflect
great work that can be expanded in practice after graduation. However, for many, the