564 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
Doctoral Essentials needs to embrace faculty/ education competencies as a key essential
much like the Jonas Foundation is embracing nursing education at the doctoral level.
■ SUMMARY
Clayton Christensen, heralded as the guru of innovation, describes disruptive innova-
tion as a “process by which a product or service takes root initially in simple applica-
tions at the bottom of a market and then relentlessly moves ‘up market,’ eventually
displacing established competitors” (2009, p. 1). In 2006, nursing scholars, using this
term first coined for the business world, described the new DNP degree as a disruptive
innovation (Hathaway, Jacob, Stegbauer, Thompson, & Graff, 2006). Ten years later, this
vision for the DNP has not been realized. Although the numbers have increased, the
impact is not as quantifiable. Dracup, Cronenwett, Meleis, and Benner (2005) feared
the DNP would be a threat to the nursing discipline by diluting doctoral education,
reducing the brain trust that pursues the PhD, and negatively impacting high quality
nursing science. In 2016, AACN announced that DNP enrollment has increased 19.1%
while PhD enrollment has decreased 3.2% (Deborah Trautman, personal communica-
tion, March 21, 2016). When one considers the impact of PhD- prepared faculty retire-
ments in the next decade, it appears that, in the future, the academy will have a greater
number of DNP- prepared faculty versus PhD- prepared faculty if this trend continues.
It appears as though the DNP is taking nurses away from an academic research career.
It is not known if these DNP- prepared faculty will seek a PhD, research doctoral degree
post- DNP.
The question remains if the nursing profession should create DNP- to— PhD pro-
grams for this cadre of faculty and/ or imbed more research content and skills in the DNP
degree which are relevant to the practitioner scholar. There is also the concern about the
uneven quality and rigor in DNP programs. We have heard the final scholarly out-
come (i.e. capstones, theses, scholarly projects, clinical or practice dissertations) vary
from a pretest/ posttest with a poster presentation to complex retrospective studies
with large data sets and a final defense. As a profession, we need to come to terms with
the goal of the degree, the appropriate amount of epidemiology, statistics, and meth-
ods courses, as well as rigor. DNP scholarly projects should focus largely on quality
improvement, access issues, and health promotion. Doctoral nursing faculty supervis-
ing DNP students should encourage scholarly projects directly focusing on the triple
aim of Institute of Healthcare Improvement (IHI) to deliver quality care, improve out-
comes, and reduce cost are particularly relevant to health care systems. DNP students
need to be educated in “basic science, translation, implementation, teaming, writing,
collaborating, and leadership capabilities that are based in evidence and suited to the
evolving market” (Terhaar , Taylor, & Sylvia, 2016, p. 8). We concur that the DNP degree
will be shaped by the outcome data that will emerge as scholars study these graduates
and their impact on the health care system; and by the rapidly changing health care
consumer marketplace. With 30 million or more individuals entering the U.S. health
care system, DNP graduates are particularly positioned to capitalize on this oppor-
tunity to provide more high- quality, effective care. The DNP’s success and impact in
academia is less clear.
Although supportive of the BSN-to-DNP academic progression model, there is a
concern that the transition to the entry- level doctorate for advanced practice and possi-
ble dissolution of the master’s degree over time may create a decline in overall numbers
of new NPs entering practice (Bloch, 2007; Dreher & Gardner, 2009; Ford, 2008). In an