148 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE
As a shortage of NPs in these areas exists, what impact will the move to the DNP
have on the existing shortage? Will the added time commitment for graduate educa-
tion, and therefore added expense, combine to act as a deterrent to RNs considering
advanced degrees? If so, what impact will this direction have on schools of nursing if
the number of applicants were to fall significantly? What will be the effect of smaller
numbers of APRNs to society? For all of these reasons, some would argue that the DNP
degree should remain an option rather than a requirement for advanced nursing prac-
tice at least for the foreseeable future. With some educators feeling that preparing the
post-BS student as an APRN while concurrently attaining the competencies expected of
the DNP-prepared NP is perhaps too much, it might give one pause to consider a pos-
sible compromise. Perhaps consideration should be given to the possibility of continu-
ing MS-level APRN preparation for initial certification and licensure, with subsequent
licensure renewals requiring a DNP degree perhaps in a decade or so after entering prac-
tice (Bellini & Cusson, 2012). This would allow APRNs to enter practice with an MS thus
stabilizing the workforce and providing time to learn about health care systems and
the role of advanced practice nurses while practicing and gaining expertise. Would this
potential solution meet the needs of all parties? It might, but at least for now it appears
that the 2015 plan for DNP entry into APRN is not close to being realized before the
close of the year.
■ VARIABILITY AMONG DNP PROGRAMS: TO WHAT EXTENT ARE
DNP PROGRAMS PRODUCING CLINICIANS WHO ARE DISTINCTLY
DIFFERENT FROM MS-PREPARED NPs?There is compelling evidence that the nursing community values DNP education to
“prepare nurses to meet future health care needs” (AACN, 2015, p. 1). However, this
strong support for the value of DNP education has not translated into consistency in
preparation, in spite of guidance provided by AACN in the Essentials document (2006),
as well as numerous position papers and reports in the past 10 years. AACN recognized
the need for further guidance at this juncture and commissioned white papers from two
AACN task forces: the Implementation of the DNP task force and the APRN Clinical
Training task force. The task force for the implementation of the DNP released their
white paper: New White Paper on the DNP: Current Issues and Clarifying Recommendations
in August 2015. This new white paper provides additional recommendations on the
characteristics of DNP scholarship, the DNP project, efficient resource use, and charac-
teristics of programs, such as program length, curriculum, clinical practice, and collab-
oration with clinical partners. AACN’s goal is to enhance consistency across programs,
recognizing that significant variability currently exists.
A recent study by Udlis and Mancuso (2012a, 2012b) demonstrated considerable
variation in admission criteria and program characteristics among the 137 DNP pro-
grams in existence at the time of the study. Particularly salient to this discussion is the
variability in program characteristics across the United States. While some variability is
to be expected, there are indications that some recommendations were not followed. For
example, although credit hours were fairly consistent with AACN recommendations,
the length of time for completion of the post-MS DNP program was recommended to
be approximately 1 year, but the results indicated that the average length was 21 ±
5.9 months. Pertinent to the DNP nurse educator role, few schools offered courses in
nursing education, perhaps in response to the original recommendation by AACN that
preparation in education should not be the focus of the DNP program.