24: ESSENTIALS OF DOCTORAL EDUCATION ■ 533Just more than 52% of respondents reported a slight or no change in function as an
administrator within their practice; 58.2% report no or minimal change in developing,
implementing and/ or evaluating information systems; 55.7% report no or minimal
change in initiating a program to address disparities within a practice setting; and
50.3% report no or minimal change after graduation in initiating an organizational
level change initiative. These and other characteristics of practice reflect the expec-
tations of the eight essentials. This collection of information does not mean that the
respondent is not doing good work, but does suggest that the efforts of their respec-
tive roles after graduation do not reflect the eight essentials that were the foundation
of the DNP educational process.
Let us circle back to the question of whether or not DNP- prepared professional are
demonstrating improved outcomes as a result of the eight essentials? To date, outcome
data from DNP, Inc.- sponsored surveys reflect perceptions and self- reported examples
of commitment to improving outcomes. Presentations typically take place in the context
of an academic presentation, seminar, symposium, or conference that is reliant on the
educational process for structure. Colleagues in academia strongly support this type
of dissemination (and rightfully so). Scientific presentations of practice have indeed
been made in practice- focused conferences for advanced practice nurses. These pre-
sentations use the eight essentials as a justification of the components and processes
of the practice change the project reflecting the efforts of the student who completes
the projects. Are practice conferences, symposia, and publications as responsive to the
structure of practice or are these types of presentations reflective of the presenter’s aca-
demic indoctrination?
■ SUMMARY
The question that has not been adequately addressed from the point of view of this
author is if the DNP educational process that includes the eight essentials is influenc-
ing practice, or are practice issues being addressed outside of this academic struc-
ture? Surveys and presentations alone do not capture this information. Identifying
and then evaluating the psychometrics of competencies to determine how they im-
pact practice is the next step needed to support the growth of practice. The eight
essentials play a role in this evaluation of competencies, but from the perspective of
this practitioner, they are not competencies that guide practice. As discussed earlier,
these essentials support the education of DNP students, but are not the basis for
practice.
Quantifying the impact of DNP- influenced initiatives reflects outcomes and prac-
tice. This is accomplished within the context of the practice setting reflecting how the
actions of the professional nurse successfully reflect practice change. This approach of
measuring outcomes in the context of the setting steps outside of the eight essentials.
The goal of improving outcomes is the responsibility of all in the health care delivery
system and is supported by our individual and collective educational efforts that are
later translated into practice. Building on the foundation of the essentials, the graduate
influences systems and hopefully, successfully reflects the best kind of practice. This is
the highest honor we can acknowledge for our education, recognizing that the academic
process prepares us for practice, but this academic process does not mandate or guide
practice. We are all rowing this boat together. Recognizing the strength of our respective
oars is valuable in helping to move this ship forward.