9: CLINICAL SCHOLAR ROLE ■ 219In addition to observation, analysis, and synthesis, clinical scholarship includes
application and dissemination— all of which result in a new understanding of nursing
phenomena. With the current explosion of knowledge, there is an expectation that rel-
evant knowledge must be translated to benefit societies. Various nurse scholars argued
that clinical scholarship requires the ability to engage in critical theoretical discourse
and discern gaps in knowledge related to clinical practice (Dracup, Cronenwett, Meleis,
& Benner, 2005). Knowledge of different theoretical frameworks with various assump-
tions and theoretical propositions is critical for clinical scholars when choosing differ-
ent types of evidence and in translating evidence into clinical practice. The Doctor of
Nursing Practice (DNP)- prepared nurse can discover new ways of refining or trans-
forming practice by using or adapting constructs and concepts in existing theoretical
frameworks to solve everyday problems.
The scholarship of application encompasses translation of the knowledge to solve
problems for individuals, families, or society. This type of scholarship requires inte-
gration of the knowledge of best practices in achieving the best outcomes. Building on
Boyer’s (1990) perspective on scholarship, Palmer (1986) described the scholarship of
application as a complex activity and synthesis of observations of clients and patients “a
complex activity that has as its purpose, the discovery, organization, analysis, synthesis,
and transmission of knowledge resulting from client- centered nursing practice” (p. 318).
According to the American Association of Colleges of Nursing (AACN, 2015),
clinical scholarship is focused on generating new knowledge through innovation of
practice change, the translation of evidence, and the implementation of quality improve-
ment processes in specific practice settings, systems, or with specific populations to
improve health or health outcomes. New knowledge generated by the DNP graduate
can be transferred to other population or systems but is not considered generalizable
(AACN, 2015).
Clinical scholarship requires that the desired outcomes are identified and system-
atic observation and scientifically based methods are used to identify and solve clinical
problems. Additionally, scientific principles, current research, consensus- based guide-
lines, quality improvement data, and other forms of evidence are used to support clini-
cal practice and clinical decisions. Evidence- based practice stresses the use of research
findings as well as other sources of reliable data from quality improvements, consensus
of recognized experts, and affirmed clinical experience (Stetler et al., 1998). The move-
ment in nursing toward “evidence- based practice” has been articulated by the leaders
like Melnyk and Fineout- Overholt (2005), and has been widely adopted by the DNP
program. For example, the faculty at the University of Washington have developed a
practice- focused doctorate that includes practice inquiry in the curriculum, addressing
the appraisal and translation of evidence into practice, and evaluation with the potential
for collaborative clinical research endeavors (Magyary, Whitney, & Brown, 2006). Both
evidence- based practice and practice inquiry are likely to impact DNP clinical scholar-
ship now and in the future.
The clinical scholar with a practice- focused doctorate will provide leadership
for evidence- based practice with skills in translational research. Clinical scholarship
is achieved by reading, by thinking, by discussing with colleagues (interdisciplinary
efforts), and by mentoring to generate possible explanations on a clinical problem.
Clinical scholars seek validation with fellow clinicians on their documented observa-
tions regarding patients’ goal- related progress. Interdisciplinary efforts are necessary
skills for the translation of research findings. The value of shared reflections on practice
and experience is critical. These reflections can be developed formally through writ-
ten clinical narratives (Benner, 1984). Reflection, self- scrutiny, and subsequent dialogue
form the basis for personal growth and mutual learning among peers.