546 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
it is the student, mentor’s and faculty’s role to identify those educational experiences.
Since the beginning of the modern university, PhD students have been counseled (and
often required) to moderate their ideas, narrow their focus, produce a less complicated
end product (a typical plea from a dissertation chair), while maintaining a high level of
scholarship. The DNP student, at least in this academic dean’s view, should similarly
be counseled. Still, some DNP faculty proclivities insist on a “Change Project” or some
form of “Improvement Science Project,” as the basis of every attempt to solve any clinical
nursing problem in the scientific method. Instead, faculty insistence that doctoral prac-
tice scholarship focus on problem solving that is demanded (and needed) by the market,
the Joint Commission Core Measures (2016) for example, could enhance the position of
DNP scholarship.
Would I add clinical or organizational ethics as a singular and distinct Essential ,
the answer is yes. Would I find a way to combine advocacy, advocacy for safety, and
advances in population health, yes I would ( Essential V, VI, and VII). The marginalization
of more advanced practice skills for the post- master’s student needs to be explored. We
stopped putting RN/ BSN students in all the generic BSN courses decades ago. More skill
in motivational interviewing, or more specifically, increased depth in encouraging social
behavioral change, is an area of expertise where the master’s prepared primary care nurs-
ing provider already excels. In those one third states that already have APRNs practicing
to their current fullest extent, why cannot they be the innovators and explorers of the next
level of doctoral advanced nursing practice? Do those progressive states have to wait for the
other two third to catch up before they can expand their practice domain? Also, the burdens
of the new DNP in the academy who struggles with the tripartite mission (teaching, prac-
tice, and service, whereas practice is not voluntary but required to maintain certification)
is real, as reported by Smeltzer, et al. (2015). Hopefully, in the next revision of the AACN’s
Essentials of Doctoral Education for Advanced Nursing Practice , there will a significant number
of DNP- prepared clinical scholars who can pave the way for the next decade of practice.
■ CRITICAL THINKING QUESTIONS
- Do you believe the eight Essentials of Doctoral Education for Advanced Nursing Prac-
tice indeed guide practice? Defend your answer. - Why does the debate over the proper delineation of DNP scholarship remain so controversial?
- Discuss some of the survey results that surprised you.
- What gives you optimism and pessimism about DNP education?
- Which essential do you consider the most evidence-based and strongly belongs in DNP
education? - Which essential does your own program emphasize particularly well?
- Which essential is underdeveloped in your current curriculum?
- Discuss your own comfort level with advanced health care technology and your experiences
with TIGER initiatives. - Do you have a better conceptualization of what DNP knowledge development is? Explain.
- Devise four new essentials for the next revision of this document.
■ NOTES
- The working definition of “advanced nursing clinicians” includes “ NPs, nurse midwives, nurse
anesthetists, and clinical nurse specialists” prepared at either the master’s or doctoral level. “Doc-
toral advanced nursing clinicians” have explicit, added, doctoral, DNP preparation.