416 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
1960s, but also the norms and social climates of universities, academic medicine, and the
health care establishment. Nursing was viewed as a practice rather than a scholarly dis-
cipline (Bullough & Bullough, 1984). One window into how nursing was perceived in
this period is given by Meleis (1988) in her allusion to the obstacles that nursing faculty
faced as they tried to advance a PhD degree in nursing. Graduate councils and provosts
rejected their proposals because of the state of nursing science and the lack of qualified
faculty with active programs of research. Although the purpose of this chapter is not to
revisit nurses’ struggles to become accepted within academia and health care circles, it
is important to recognize that the DNP is the newest pathway in nurses’ journey toward
academic and professional recognition.
The AACN (2016a) document, Advancing Health Care Transformation: A New Era
for Academic Nursing , reports that most leaders in academia and in practice do not hold
influential positions in academic health centers. Absent from the policy tables, they are
not positioned to inform or direct health care transformation. However, because about
63% of 2.8 million registered nurses (RNs) work in the nation’s hospitals in-patient
and out- patient settings, nursing is on the agenda of academic health centers, even
when nurse leaders are not visible in academic health centers’ circles of power (Health
Resources and Services Administration [HRSA], 2013). Essential V speaks about the pre-
sent and the future.
Ironically, the initiative to develop professional or practice degrees also comes at a
time when traditional PhD programs are being challenged as irrelevant, time consum-
ing, and too narrowly focused on scholarly research (Nyquist, 2002). In describing the
Re- visioning PhD Education Project funded by the Pew Foundation and carried out at
the University of Washington, Edwardson (2004) compares their findings to the state of
doctoral education in nursing in the early years of the 21st century. The Re- visioning
Project described: over- production of PhDs, ritualistic degree requirements, overuse
of doctoral students in undergraduate education, low program completion rates, long
periods of doctoral and postdoctoral training, limited job availability in universities and
colleges, and lack of a diverse student body. In her thesis , Edwardson states that PhD
programs in nursing lack diversity and that some students spend a long time complet-
ing degree requirements (Edwardson, 2004).
Although doctoral programs in nursing were not included in the Re- visioning
Project, nurse educators are considering how this report and the loss of faith in tradi-
tional PhD education affect their discipline. Nurse leaders are very aware that less than
1% of the nursing workforce holds a PhD in nursing or a related field (Anderson, 2000;
Hinshaw, 2001; Robert Wood Johnson Foundation [RWJF], 2013). There is attention to
the diversity and the age of nurses who compose PhD student cohorts. The govern-
ment, private foundations, and schools of nursing have had some success in recruiting,
retaining, and graduating men and women of color. Some schools have accepted the
challenge of the RWJF to shorten the length of their PhD programs. RWJF’s Focus on
Scholars program seeks to decrease the age of new PhD nursing graduates by offering
significant grants to nurses who enroll in 3- year PhD programs (RWJF, 2013). Other
schools have adopted the AACN’s proposal to develop bachelor of science in nursing
(BSN) to PhD programs as another way of shortening the time that nurses spend in
post- baccalaureate studies (Loomis, Willard, & Cohen, 2006). Equally significant as the
age of new PhD graduates and the small percentage of nurses with PhDs is the lack of
a robust PhD pipeline, a factor frequently emphasized in policy statements about nurse
faculty shortages and the rise of DNP education (AACN, 2015c; Berlin & Seachrist, 2002;
Martsolf, Auerbach, Spetz, Pearson, & Muchow, 2015).
It is also interesting that more than 10 years after the AACN’s proclamation on DNP
education, nurses who evaluate DNS programs continue to compare practice- oriented