220 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE
Despite the variations in the definition of what scholarship means, the following
are common themes that describe a scholar. Clinical scholars are characterized by a high
level of curiosity, critical thinking, continuous learning, reflection, and the ability to seek
and use a spectrum of resources and evidence to improve the effectiveness of clinical
interventions. They consistently bring a spirit of inquiry and creativity to their practice
to solve clinical problems and improve outcomes (STTI, 1999).
■ HOW IS CLINICAL SCHOLARSHIP DEMONSTRATED
IN DNP GRADUATES?
In an era of unprecedented accountability for the delivery of quality, cost- managed
health care, the nurses are being challenged to demonstrate effective and efficient care.
Well- informed consumers are demanding greater access to quality health care. Rising
patient acuity, escalating complexity in health care needs, and the increasing infu-
sion of technology in health care systems are creating daunting challenges for nurses.
Additionally, nurses are practicing in environments with limited financial resources.
As these challenges increase, nurses can no longer rely on traditional nursing practices
or base their clinical decisions on intuition and years of clinical experience to plan and
implement care required in today’s patients. Responding to this challenge requires col-
lective knowledge, clinical expertise, and commitment to base patient- care decisions
on evidence and involvement of patients. Clinical scholarship is particularly important
for APNs with practice- focused doctorates to provide leadership in establishing clinical
excellence and informed health care policy.
The master of science in nursing (MSN) degree historically has been the degree for
specialized advanced nursing practice. With the development of DNP programs, a prac-
tice- focused doctorate, the DNP degree will become the preferred preparation for spe-
cialty nursing practice. According to the National Organization of Nurse Practitioner
Faculties (2006), the competencies for the DNP are similar to the MSN (with mastery
of an advanced specialty within nursing practice), but the DNP competencies are for-
mulated with more emphasis on leadership, quality improvement, health care deliv-
ery systems, and health care policy. The implementation of a model for evidence- based
practice has been documented to promote clinical scholarship among clinical nurse spe-
cialists in various institutions such as Baystate Medical Center in Massachusetts, the
University of Texas Medical Branch, Kaiser Permanente and California Pacific Medical
Center, and the University of Iowa Hospitals and Clinics and College of Nursing (STTI,
1999). Clinical scholarship among nurse specialists provides opportunities to generate
reflective thinking for improved clinical practice and heightened awareness for a new
standard for evidence- based thinking (STTI, 1999). Clinical scholarship for the practice-
focused doctorate should build on what has been started by clinical scholars with the
MSN degree to provide leadership for evidence- based practice. This requires the appli-
cation of knowledge to solve clinical problems and generate evidence through their
practice to guide improvements in practice, outcomes of care, and participation in col-
laborative research (DePalma & McGuire, 2005; Magyary et al., 2006). Evidence- based
practice should result in better outcomes leading to a better quality of life for all citizens.
DNP graduates engage in advanced nursing practice and provide leadership for
evidence- based practice. This requires competence in knowledge application activi-
ties: the translation of research into practice, the evaluation of practice, improvement
of the reliability of health care practice and outcomes, and participation in collaborative
research (DePalma & McGuire, 2005).