Curriculum Models for the Practice Doctorate in Nursing

Lucy N. Marion, PhD, APRN, BC, FAAN; Ann L. O'Sullivan, PhD, CRNP, CPNP, FAAN; M. Katherine Crabtree, DNSc, APRN, BC, FAAN; Marva Price, DrPH, RN, FAAN; Susan A. Fontana, PhD, APRN, BC

Disclosures

Topics in Advanced Practice Nursing eJournal. 2005;5(1) 

In This Article

Drivers of the Practice Doctorate Movement

The practice doctorate in nursing initiative has advanced surprisingly rapidly over the last several years, prompting nursing educators, prospective students, and clinicians to question and indeed to work to influence the future of education for advanced practice registered nurses (APRNs). The swift emergence of new programs (some are in developmental stage) and the ongoing national dialogue suggest broad recognition that the practice doctorate is more than a mere interruption but rather a response to the need within the healthcare system for expert clinical teachers and clinicians. The challenge and opportunity within the profession is to develop a shared strategic vision for the structure and focus of practice doctorate programs. A task force within the National Organization of Nurse Practitioner Faculties (NONPF) has identified sample curriculum models for consideration by educators in creating practice doctorate programs.

The NONPF Practice Doctorate Task Force previously introduced key issues surrounding the practice doctorate in a Teleweb seminar[1] and then published in this eJournal a widely read article assessing the impetus for this movement -- "The Practice Doctorate in Nursing: Future or Fringe?"[2] In brief, key drivers for the movement include the following:

  • Parity with other disciplines -- Other disciplines such as audiology, dentistry, medicine, pharmacy, and psychology have established the practice doctorate as the standard entry into practice. Nurse practitioners (NPs) and other APRNs will be left behind with master's preparation.

  • Credentials to correspond with educational preparation -- NPs and other APRNs currently complete master's programs that require far more credit hours for completion than most master's degree programs in other disciplines. Professional students today expect to gain higher degree recognition, and nursing will lose prospective students to other disciplines where they can achieve a higher terminal degree for clinical practice for an equivalent amount of time and other costs.

  • Faculty shortage crisis -- The current shortage of nursing faculty is impeding the progress to expand nursing educational programs to address practice shortages in most healthcare arenas to include acute and critical care, public health nursing, and home care nursing. Predictions are that this faculty shortage will continue to rise significantly. Clinical teaching necessitates advanced clinical expertise.

  • Changes in healthcare systems -- Despite the high number of credit hours in current APRN programs, nurse educators feel an urgency to pack content into the curriculum and yet must make difficult choices about what to include and exclude. Nevertheless, the increasing complexity of healthcare systems requires additional leadership and management content for APRNs. As well, with the rapid expansion of healthcare knowledge, APRNs need more skills in utilization rather than acquisition. We no longer can train students to memorize all content but rather to access information quickly and to synthesize for critical thinking to improve patient outcomes.

In a recently released position statement, the American Association of Colleges of Nursing[3] reported on their task force study of the practice doctorate and provided further discussion of the need for implementation of these programs. This paper was accepted by member deans in 2004, but concerns about diminishing the importance of the doctorate of philosophy in nursing and disenfranchising master's prepared nurses were voiced by the membership.

NONPF established a Web-based resource center[4] to provide members and other interested persons with access to information about the practice doctorate. This site includes statements and recommendations from the NONPF Board of Directors, key articles, and key presentations.

Information posted on the site includes a slide overview of the curriculum models as presented by the NONPF Practice Doctorate Task Force to the NONPF membership in 2004. This article provides the first published elaboration of the different identified models for the practice doctorate. NONPF hopes that the models will provide educational institutions with a wide variety of options to consider in offering the practice doctorate to their students. Each of these models can lead to the same outcomes -- practice doctoral competencies.

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