The Practice Doctorate in Nursing: An Idea Whose Time Has Come

Elizabeth R. Lenz, PhD, RN, FAAN

Disclosures

Online J Issues Nurs. 2005;10(3) 

In This Article

Patterns in Practice-Focused Doctoral Education

The survey of existing programs by the AACN task force included all institutions that at that time offered practice-focused doctorates or had formally begun planning a practice-focused doctoral program. The phone interviews were conducted between May and September, 2002. The interviews revealed distinct differences between research- and practice-focused doctoral programs in nursing which still differentiate the two types of doctoral degrees. It is important to recognize that all of the institutions surveyed offered a research-focused doctoral programs in addition to the practice-focused program, so were very well able to articulate the differences between the two types of programs. When contrasted with research-focused programs, practice-focused programs tend to include more emphasis on practice, less emphasis on theory and meta-theory, and less extensive research methodology content. However, research methods content was noted to be essential for both types of doctoral graduates.

The research-related expectations of graduates differ, in that the research-focused programs generally state that their graduates are producers of research, i.e., expected to design and carry out major programs of research. On the other hand, practice-focused programs expect their graduates to be expert evaluators and consumers of research, prepared to evaluate evidence for application in practice. They are also expected to design and conduct practice-related research projects, such as those designed to evaluate clinical interventions.

Practice-focused doctoral programs generally include a residency or intense integrative clinical experience. In lieu of a knowledge-generating dissertation, the student in a practice-focused program is generally required to carry out a clinical, application-oriented "capstone project" that is related to the clinical residency. Depending on program requirements and the student's area of emphasis, such a project might include the development of a program of intervention, or an analysis of a health care policy, or a discussion of patient care provided.

The survey revealed two distinct foci in practice-focused programs (or tracks): clinical and executive/administrative. Programs with clinical emphases including both those addressing hands-on patient care (including the advanced practice nursing roles of nurse practitioner, nurse midwife, nurse anesthetist, and clinical nurse specialist), and also those addressing the care of aggregates, including clinical populations. Some programs were limited to one domain, whereas several included both clinical and administrative foci as different tracks.

An analysis of the curricula and content addressed in the existing, practice-focused doctoral programs revealed both commonalities and differences among the programs. Several content areas were addressed – albeit to varying degrees – in all of the programs. For example, all programs included content regarding advanced clinical practice and clinical populations; at least some research methodology, particularly as it concerns application of research findings to practice; critical thinking; health care organization and management; use of computer technology; and the scientific underpinnings for practice from nursing and related disciplines. Depending on the specific focus(foci) of the program and the level of preparation of entering students – i.e., whether admission was limited to whose already prepared as advanced practice nurses – some of these content areas could receive considerably more attention than others. Nevertheless, such content areas were considered to be relevant for both hands-on and administrative/executive practice domains, so were potential core content for all practice-focused doctoral programs.

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