Let me guess. You’re a nurse practitioner (NP) with years of experience and a master’s degree. You’ve heard the hype about this new degree, the doctor of nursing practice (DNP), but you already provide excellent patient care, so why do you need more education? Research even backs you up; for decades, master’s-prepared NPs have provided high-quality, safe, and effective care, as demonstrated by a systematic review published in Nursing Economics.
So, after all these years, should you get a DNP? What about new registered nurses (RNs) who want to become NPs? Should they be required to earn a DNP rather than the traditional master’s degree? The purpose of this article is to offer you enough information to answer these questions for yourself.
Here are seven major points to get you started:
1. Is the DNP a Valuable Degree?
When NPs ask me this question, I usually smile and respond, “Depends on how you define value.” Is “value” money, knowledge, impact, esteem, or something else? For starters, let me quickly answer some common questions before diving deeper into the history and purpose of the DNP.
- Does the DNP advance our profession? Yes. The DNP puts NPs on par with other doctorally prepared healthcare providers (e.g. physicians, pharmacists, dentists, optometrists, physical therapists, etc.).
- Do national NP organizations and thought leaders advocate for the DNP? Yes. The American Association of Colleges of Nursing (AACN) and the American Association of Nurse Practitioners (AANP) both agree that the DNP should be a requirement for NPs.
- Does the DNP come with a pay raise? Sometimes. This depends on your employer, geographic location, and negotiation skills. In due time, I suspect doctorally prepared NPs will rise to the top of the resume pile and be hired over MSN-prepared NPs with similar experience.
- Does the DNP increase an NP’s knowledge? Yes! After 40 credit hours (on average) of courses, I find it hard to believe you would come out with less knowledge. For NPs who have already earned their MSN, the type of knowledge you gain from a DNP focuses on translational research, teamwork, and technology.
2. Where Did the DNP Come From?
In 2001, the Institute of Medicine (IOM) published its groundbreaking report, Crossing the Quality Chasm. Here, the IOM famously identified the immense gap between the healthcare we have and the healthcare we could have.
To close this chasm, the IOM recommended changing the way we educate healthcare providers. Much to everyone’s surprise, the IOM did not suggest more clinical or residency hours; instead, they implored physicians and nurse practitioners alike to focus on translational research, teamwork, and technology.
Without delay, the nursing discipline took action and responded to the call by creating the DNP. They designed this new degree to align directly with the IOM’s education reform, and the American Association of College of Nursing (AACN) developed The Essentials of Doctoral Education for Advanced Nursing Practice.
To emphasize its dedication to the IOM’s recommendations, the AACN designated the DNP as the terminal degree for nurse practitioners. Today, there are more than 125 accredited DNP programs across the United States, and they are available in 48 states plus the District of Columbia.
3. Is the DNP Required for Nurse Practitioners?
In principle, the answer is yes; however, state boards do not yet require NPs to receive their DNP in order to be licensed. In its Position Statement on the Practice Doctorate in Nursing, the AACN voted to move the level of preparation for nurse practitioners from an MSN to a DNP beginning in 2015. Some nurse leaders disagree with this requirement, though, so the DNP remains optional.
RAND Health investigated the institutional, political, and professional issues related to requiring the DNP degree. Its findings were published in a detailed report titled The DNP by 2015. Through this research, RAND Health decided that the AACN needed to conduct outcomes studies on the effects of DNP patient care before making the degree a requirement.
4. What’s the Difference Between a DNP and a PhD?
Both a PhD and a DNP are rigorous, challenging doctoral degrees. A PhD is considered a research doctorate, which focuses on generating new knowledge. Nurse practitioners in PhD programs usually conduct original research and pursue a variety of programs including nursing, economics, epidemiology, ethics, health policy, and human-computer interaction. These graduates usually work in academia, research, administration, or industry.
A DNP, on the other hand, is a practice doctorate, which focuses on translating research into practice. A physician, for example, has a professional doctorate in medicine or osteopathy (MD or DO). These graduates usually work in clinical practice or administration.
5. What Do DNPs Learn That NPs Don’t Already Know?
As the IOM noted, modern medicine has progressed to a level of sophistication that no one person could ever comprehend or master. Over the past 100 years, clinicians have become specialized and then subspecialized just to compensate for the sheer magnitude of scientific knowledge.
Today, the amount of medical knowledge that a healthcare provider must know doubles every three years. In 2020, it will double every 73 days. Efforts have been made to more efficiently move research from dark labs and ivory towers into hospitals and clinics, but it still takes 17 years for the latest research to be implemented into clinical practice. Did you catch that? Seventeen years!
This is why the IOM emphasized research, teamwork, and technology. Memorization and additional clinical hours don’t change outcomes; understanding where to find the right information, how to work together, and when to implement technology do.
Doctors of Nursing Practice undergo extra education in these three areas. They study healthcare from a systems perspective. They graduate with a comprehensive understanding of this system, from policy and ethics to finances and informatics. They learn how to improve not just one patient’s life, but the lives of entire populations. These doctors are truly primed to be tomorrow’s change agents and leaders in healthcare.
6. Do DNPs Conduct Research?
All DNP programs require the completion of a final research project that demonstrates clinical scholarship. This DNP project can take many forms, and students work on it throughout their entire program. The project must focus on a change that affects healthcare outcomes for a particular patient population.
Specific guidelines for appropriate projects can be found in the AACN’s report, The Doctor of Nursing Practice: Current Issues and Clarifying Recommendations. Examples of previous students projects can be found on the National DNP Organization website.
7. Where Can I Learn More?
Consider reading the AANP’s DNP discussion paper. Dreher and Glasgow offer a fiercely honest and interesting text on the DNP titled Role Development for Doctoral Advanced Nursing Practice. Dr. Lisa Chism also offers a unique perspective on the DNP in her book, The Doctor of Nursing Practice: A Guidebook for Role Development and Professional Issues.
