24: ESSENTIALS OF DOCTORAL EDUCATION ■ 539
that “Research- focused doctoral programs in nursing are designed to prepare graduates
with the research skills necessary for discovering new knowledge in the discipline. In
contrast, DNP graduates engage in advanced nursing practice and provide leadership
for evidence- based practice” (p. 11) to the new white paper which instead now states
“Graduates of both research- and practice- focused doctoral programs are prepared to
generate new knowledge” (p. 2). It actually is a proper evolution because nursing has
always, beginning with the days of Nightingale who collected and analyzed data re-
ligiously, relied on its ability to create new knowledge derived from observation (and
data) in practice. It is this data (transformed and interpreted into evidence) that over
time advanced the health of patients, thus advancing the profession, and ultimately
help nursing become a full- fledged discipline (Dreher, 2016b).
The DNP graduate is no longer restricted to a “capstone,” and while the AACN
now recommends the term “DNP Project,” each nursing faculty does have the right to
determine the content and title of what their DNP graduates will have to complete as a
scholarly end product to the awarding of a doctoral degree at their institution. Whether it
is a DNP thesis, doctoral practice dissertation, or a DNP project, it really only matters in
the halls of the academy. But the global world of science (specifically the academy where
many DNPs are employed) does not understand what a DNP project is, I assure you
(remember, this degree is only about 10 years old). They do understand, however, what
a doctoral thesis (or doctoral practice thesis) is. A simple review of what individual DNP
programs call this end product is endless and some standardization will evolve with
time. There is also significant diversity in PhD in nursing/ nursing science programs and
their quality, and in time DNP programs will likely normalize in comparison too. The
DNP at research- intensive and research- oriented universities will likely highly empha-
size practice knowledge development. To other DNP programs, this emphasis will vary.
Physician practice, in comparison, really is not much different. In urban and suburban
teaching universities where many physicians and members of the interdisciplinary health
care teach, DNP practitioners are involved in the research enterprise and many hospitals
(and networks) are absolutely dependent on federal research dollars. Physicians (and
nurses) in more rural areas, are mostly fully engaged in just practice and may rarely
have the need or demand to publish. These are the realities of modern health care and
the expectations of knowledge production across disciplines. This author’s chief concern
is that if the DNP graduate does not publish his or her work and generate new evidence
from his or her new practice environments, then the nursing discipline will suffer. As the
largest health care profession, we have an enormous need for more evidence from which
to base our practice. Our discipline and our contribution to improve the global health of
all can only grow with the synergy of a community of doctorally prepared primary nurs-
ing clinicians, scholars, and clinician– scholars, who are uniquely qualified and extraordi-
narily prepared to bridge the gap between practice and the academy.
Essential IV: Information Systems/ Technology and Patient Care Technology
for the Improvement and Transformation of Health Care
In this essential, the following is expected of the DNP graduate:
- Design, select, use, and evaluate programs that evaluate and monitor out-
comes of care, care systems, and quality improvement, including consumer
use of health care information systems. - Analyze and communicate critical elements necessary to the selection,
use, and evaluation of health care information systems and patient care
technology.