1: THE HISTORICAL AND POLITICAL PATH OF DOCTORAL NURSING EDUCATION ■ 35
A third positive outcome of this doctoral option gives doctoral advanced practice
nurses more parity with other health professionals (O’Sullivan, 2005). Although this was
one of the goals for the creation of this degree, it really should not be a leading reason for
individuals to seek it. The incentive to be called “Dr.” ought to be driven more by what
the doctorate adds to the master’s- prepared practitioner to warrant the higher degree.
Furthermore, the doctorate ought to be credible, have rigor, and must be seen by others
as legitimate. This happens with every new doctorate: Public critical analyses by degree
supporters, detractors, and skeptics, and not just toward the DNP. Furthermore, with
a new degree, some DAPRNs are going to experience some difficulty in the workplace
while working alongside master’s- prepared APRNs who may feel resentment or deny
that there is any difference in practice. Doctoral- prepared physical therapists, working
alongside master’s- prepared physical therapists, have already experienced this, and it is
likely to happen in nursing, too (Salzman, 2010). But parity is important. It allows us to
sit at the table as an equal contributor. Noted health care and nursing journalist Suzanne
Gordon (2006) has written about the “invisibility of nursing” (p. 184). Maybe the DNP
degree can help increase our visibility and permit our practitioners and clinicians (and
others) to be seen as full partners in both practice and policy.
A final positive outcome (and surely there are others) is that this degree was
designed to emphasize the translation and dissemination of research findings (AACN,
2006). Although this author and others believe that generating practice knowledge
through practice inquiry (Dreher, 2010b; Magyary et al., 2006) should be incorporated
into the degree, the opportunity this degree presents the profession is nonetheless
unique. Magyary et al. (2006) write of the DNP student’s role in practice inquiry:
How to frame researchable questions generated from clinical observations
and discourse is an essential practice inquiry competency. Clinical observa-
tions discrepant with habitual ways of knowing and doing may reveal new
insights into clinical phenomena that have received limited or no empirical
inquiry. These types of revelations may generate questions that beg to be
answered through rigorous scientific investigation. (p. 144)
Furthermore, if properly and rigorously educated, the DNP degree graduate
should be a skilled professional who should be able to data- mine (even skillfully scour)
the endless databases that warehouse the enormous amount of research conducted every
year in nursing and the health sciences. These graduates should be experts in knowl-
edge management, poised to extract information and apply it in a novel or utilitarian
way, and then efficiently translate and disseminate this new conceptualization of the
evidence (Dreher, 2009). However, this theoretical rubric for what this graduate can be
trained and educated to do can only be accomplished if the DNP student is exposed to
coursework that indeed enables the student to truly participate credibly in this kind of
practice inquiry. Philosophy of science courses are unusual in DNP programs, although
this content is sometimes dispersed or integrated into other courses. But how else will
these doctoral students understand the concepts of evidence, causation, empirical data,
deduction, induction, probability, bias, scientific truth, and other important concepts all
necessary to practice inquiry and the evaluation of evidence, if this content is absent in
curricula? How can a student perform a meta- analysis or secondary analysis of existing
data, conduct outcomes research, or engage in basic interpretive inquiry if the student
does not have the advanced research methods courses (beyond the master’s degree) to
prepare one for this level of inquiry? The DNP student will likely be at the forefront of
making the impractical practical and Fink (2006) suggests that the professional doctor-
ate graduate should be well prepared for the knowledge economy simply based on the
very practice orientation of the degree.