556 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
One of the precepts of another seminal book on futurism, Megatrends , from the
1980s, was that “We are moving in the dual direction of high tech/ high touch, matching
each new technology with a compensatory human response” (Naisbitt, 1982, p. 1). We
think the future DNP practitioner is going to be more technology oriented than even
today. Indeed, it is the doctorally prepared clinician who is the most adept at knowledge
management and who will likely become the most expert clinician (Dreher, 2009b). The
question for today’s DNP student is what kind of focus on technology does your curricu-
lum include? Are you learning how to manage the massive amount of information input
you need, to evaluate and discriminate among in order to stay abreast of your particular
field? This means going much further than subscribing to and reading the right journals
in your discipline. It is about using technology devices that can comb new articles and
findings in one’s field electronically, and having them sent directly to one’s iPhone or
smartphone, or perhaps to the next- generation device that has not even been identified
yet. Indeed, one such program (PubMed) does this and was described in Chapter 14. We
do not know today what kind of technology competencies will be required for DAPNs
to maintain the kind of expert practice required of them in the future. But we already
see clinicians in progressive practices walking out of patient rooms with Dictaphones
in hand, dictating their notes in real time using DragonFly, probably the leading voice
recognition software on the market today in health care practices. What about you?
What is your technology quotient? Are you a “techie”? If not, are you at least competent
with the latest health care support technology? More importantly, how do you envision
your future practice, and how do you plan to “keep up” and be competitive with your
other health care professional colleagues? Already it is increasingly recognized that bac-
calaureate and master’s nursing education programs have increased their emphasis on
technology in health care, and particularly the use of digital recordings of standard-
ized patients and high- fidelity simulation (Defenbaugh & Chikotas, 2016; Mompoint-
Williams, Brooks, Lee, Watts, & Moss, 2014). Similarly, at the doctoral level, we believe
this is a prime area where DNP graduates can show a level of technology mastery above
and beyond what the other health care practitioners from other disciplines commonly
use. Again, look at your own DNP curriculum. Is the technology support you will need
for doctoral advanced nursing practice there?
H. M. Dreher, the first author of this chapter, was privileged to attend the Harvard
Macy Institute’s Program for Leading Innovations in Health care and Education at the
Harvard Business School and Harvard Medical School in 2007. The week- long pro-
gram was led by the guru of innovation, Clayton Christensen, DBA (Doctor of Business
Administration, Harvard). With an audience largely comprised of physician educators
from medical schools from around the world (but with some nursing faculty and other
related disciplines also in attendance), Dr. Christensen startled the attendees one morn-
ing by announcing that physicians should stop their turf battles over who should pro-
vide primary care. Of course my ears pricked up with this discussion (as I am sure did
the ears of the several other nurses in attendance), and he went on to say that there were
already nonphysician primary care providers such as NPs and physician assistants who
have demonstrated they can provide a high level of primary care effectively. Moreover,
he thought many physicians were simply underused for the vast education and exper-
tise they possess. He encouraged physicians to focus less on the less complex diagno-
sis and treatment of common disorders, which other disciplines could manage more
cost effectively, and instead focus on the next horizons of medical specialty practice
and science. Dr. Christensen’s (2009) book (with Grossman & Hwang), The Innovator’s
Prescription: A Disruptive Solution for Health Care , even states “NPs (and other physician
extenders) practicing in retail clinics, should disrupt the precision medicine portion of
the physician’s practice” (p. 112). I found the discussion absolutely exhilarating, and as