488 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
change within the health care organization to improve quality of care and
health outcomes.■ AN ECOLOGIC EDUCATIONAL FRAMEWORK APPROACH
TO THE PRACTICE DOCTORATE
Initially, the goal held by many educators is that future roles for DNP graduates would
be in practice (Bloch, 2005; Boland, Treston, & O’Sullivan, 2010; Newland, 2010). This
is not necessarily where most NPs end up once completing their DNP degree due to
the dire market need of NP faculty with doctorate degrees. Nonetheless, curricula are
designed to allow the doctoral educational journey to be one of professional growth and
empowerment that builds on clinical experience and expertise shaped by prior MSN
preparation. The educational journey for APRNs can be viewed as an advanced version
of the “novice to expert” progression from entry into APRN practice with a MSN degree
to a more expert role with a DNP degree. With this novice to expert construct applied to
APRN roles, the goal for the DNP role is that DNP graduates are well positioned (with
their new doctoral level knowledge) to seize new opportunities. They can leverage their
academic credential (DNP) to open doors, be creative, and help transform their work-
place or the health care system where they seek employment. This theme can be seen in
the published literature on DNP outcomes, such as the descriptive longitudinal study
of 22 DNP graduates from the University of Washington (Brown & Kaplan, 2010). The
graduates emphasized that their doctoral work enhanced their practice roles in mul-
tiple ways, including that it increased their parity with physician colleagues with bet-
ter clinical skills and opportunities to translate research to practice and policy (Brown
& Kaplan, 2010). Students who are deciding between a practice doctorate (DNP) or a
research doctorate (PhD) should decipher where they really would like to see them-
selves. Do they envision a role that is (a) entrenched in the real world of health care
practice and clinical teaching or (b) behind the “ivy towers” entrenched in building and
sustaining a program of research?
A PhD is a research degree and can prepare one to lead research teams to advance
nursing knowledge through competing for the fiercely competitive research grants.
The old adage of “publish or perish” still prevails in the work environment for PhD-
prepared nursing faculty. Yet, these two worlds are intersecting in academia. Those
with DNPs are demonstrating an important academic role educating future APRNs.
Likewise, DNPs are contributing significant scholarship to the nursing profession.
Therefore, the dichotomy between PhD and DNP is not so clear and the nursing disci-
pline should look at other disciplines (e.g., medicine, dentistry, law) where practitioners
and researchers often move between both worlds. Merged communities of researchers
and practitioners are essential for effective feedback loops of knowledge dissemina-
tion and translation necessary for evidence- based practice and practice- based evidence
(Bloch, 2015; Lyons, 2009).
Conceptualizing the possibilities of DNP roles and their subsequent impact
on health and health care can be understood by an ecological education framework
emphasizing how the DNP academic degree is built on the BSN and MSN academic
degrees. Within an ecologic framework, a systems perspective is viewed, consisting
of the health care system and various but distinct nursing systems, integrating within
this larger system with complex microlevels and macrolevels. This synergy of systems
demands multidisciplinary participants having educational competencies that allow