5: THE ROLE OF THE PRACTITIONER ■ 151a strong message that DNP scholarship is the generation of new knowledge and is a
highly prized commodity lacking and sorely needed in our current health care system.
The task force then goes on to provide recommendations for the DNP project that are
far more directive and prescriptive than previous guidance, in an effort to enhance con-
sistency and dispel uncertainty about the final product of the DNP program. Although
many will appreciate these new recommendations, schools that have followed a differ-
ent path will be challenged to carefully study the recommendations and decide how
their current process meets the recommendations for the generation of new knowledge
that enhances practice outcomes.
■ DO WE NEED ADDITIONAL CERTIFICATION TO INDICATE
“DOCTORAL ADVANCED PRACTICE NURSING”?
Another controversial area concerning NP certification and the DNP degree is certifica-
tion. When in the educational process should NPs be allowed to sit for initial certification
in their specialty area? Historically, NPs have been eligible to sit for certification follow-
ing successful completion of their APRN programs, having achieved an MS degree. As
NP education moves to the doctoral level, the APRN Consensus Work Group and the
NCSBN APRN Joint Dialogue Group Report (2008) will serve as guides for current grad-
uate programs to align their plans for LACE. As of the writing of this chapter, a DNP is
not required to sit for any advanced practice certification examinations; all remain avail-
able with a minimum of an MS degree, despite the initial 2015 timeline endorsed by
AACN. Whether the DNP will be required to sit for NP certification exams in the future
remains unclear at this time in large part due to NONPF’s position that the transition to
the DNP “will be gradual” (NONPF, 2006), or more recently that the transition to DNP
should not take another 10 years (NONPF, 2015), while failing to state exactly how long
the transition should indeed take. The most recent “unified statement” put forth from
NONPF in partnership with the NP faculty specialty organizations (Nurse Practitioner
Roundtable, 2008) clearly stated that the DNP is a degree, it is not a role and further that
it would be inappropriate to attempt to validate an academic credential with a certifica-
tion exam, which inherently tests role competencies and knowledge.
Furthermore, while all NP programs will produce graduates with DNP compe-
tencies, the specialty-specific NP competencies tested in program-specific certification
exams will continue to be developed by the specialty-practice organization (APRN Joint
Dialogue Report). In other words, while additional competencies will be expected of
DNP graduates, the “specialty competencies” will probably remain as they are, with the
exams requiring a DNP rather than an MS, assuming this evolves in the future, which
is not appearing as likely as it has in the past (Auerback et al., 2014). In light of the fact
that research has demonstrated that outcomes of care delivered by NPs currently hold-
ing MS degrees are at least equivalent to those of MDs (Horrocks et al., 2002; Mundinger
et al., 2000), this rationale is appropriate.
The approach taken by the APRN Joint Dialogue Report group, the NCSBN,
AACN, and many other nursing organizations 5 years ago seemed to indicate a clear
path and commonality of purpose. Although evidently intended to serve as the collec-
tive voice of authority in speaking to the uncertainties of a profession moving forward,
not all prominent leaders in nursing agreed with the content areas anticipated for future
DNP certification exams.
For example, some schools of nursing, in conjunction with the Council for the
Advancement of Comprehensive Care (CACC), have endorsed the notion that DNP-
prepared NPs should sit for certification exams as “Diplomats in Comprehensive