25: TODAY, TOMORROW, AND IN THE FUTURE ■ 555more of what The Essentials of Doctoral Education for Advanced Nursing Practice (AACN,
2006) refers to in Essential VIII as Advanced Nursing Practice (p. 16). In other words, for
the post- master’s DNP student— you already are an advanced practice nurse and now
matriculating to become a doctoral advanced practice nurse — what in your respective cur-
riculum fits specifically into this box? Are you getting additional content in practice?
Are you building on what you already know? Is your program leveraging technology
to give you additional experience with complex standardized patients (very critical in
bachelor of science in nursing [BSN]- to- DNP programs), or informatics skills to track
and document patient assessments and outcomes in near real time? We hear that family
NP graduates from master’s programs indicate that they wish they had more advanced
skills at differential diagnosis, and more in- depth, cadaver- based anatomy in which
to better support their case presentations during grand rounds with other interprofes-
sional colleagues (often interns, residents, and other medical professionals). Perhaps
most importantly, we firmly believe that DAPRNs ought to be the most skilled at imple-
menting social/ behavioral interventions for their primary care patients.^1 Do you have
a course that focuses on or includes this content? We challenge you to challenge your
faculty to be clear about what additional skill sets your DNP program offers you and is
going to help you achieve. For BSN- to- DNP program students the challenge is similar,
but different. Here the question is what didactic curriculum can be clearly differentiated
as truly doctoral advanced nursing practice content and what would typically belong
to a traditional MSN practitioner’s program? Whether you are a post- master’s (entering
with an earned master’s degree) or an entry- level DNP student (entering with a BSN),
we know these may be difficult questions for new programs to answer.^2 However, only
by creating a different kind of graduate will the degree and the permanence of the DNP
graduate in the marketplace take hold and graduates likely be compensated addition-
ally and equitably for the higher education they possess.
In the classic futurist book Future Shock , Toffler (1971) coined the term informa-
tion overload. Certainly, this was one of the many reasons given for the formation of
the DNP degree. With technological advances in society increasing exponentially, it
was often assumed that in order to master more information, the APRN in a typical
master’s program needed more courses and more credit hours to maintain compe-
tency. Even though many master’s programs in other disciplines typically are com-
pleted in 30 to 36 semester credits, many MSN programs, especially those preparing
advanced practitioners, vastly exceeded 30 credits. Thus, one rationale for creating
the DNP degree was to avoid any further master’s “credit creep” and to recognize
that the current length of the MSN degrees was already heading toward common
total credits awarded for a doctorate (American Association of Colleges of Nursing,
2006). Therefore, a powerful argument for degree credit parity was made for the cre-
ation of this doctoral degree instead of again just adding more additional master’s
credits and courses (Dracup & Bryan- Brown, 2005). We agree that information over-
load, possibly a problem for society even pre- Toffler, remains a contemporary issue
for the DNP student and graduate. Upon reflection, in some ways the pace of new
knowledge has probably not changed since 1970. However, today’s DNP student and
graduate increasingly faces, perhaps more than ever, the legal burden (not to men-
tion the ethical obligation) to “keep up to date” to maintain expected practice com-
petencies. We would even go as far as to surmise that the DNP graduate, especially
the practitioner who may often be working side- by- side in clinic environments with
other doctorally prepared clinicians, may have an additional burden to project and
demonstrate that their practice skill set is superior to APRN colleagues who have a
master’s degree.