Innovation in Doctoral Nursing Education: One University's Response to the IOM Recommendation

Saturday, 28 October 2017

Carie Denise Hancock, PhD
School of Nursing, William Carey University, Biloxi, MS, USA

In 2010, the Institute of Medicine (IOM) in conjunction with the Robert Wood Johnson Foundation released a report with key messages and specific recommendations for the profession of nursing. One of the key messages was nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Specific recommendations included increasing numbers of baccalaureate-prepared nurses and doubling the number of doctorally-prepared nurses by 2020.

At that time, only 28% of nurses in Mississippi and 50% of nurses in the U.S. were prepared at the baccalaureate level or higher. Only 0.7% of nurses in Mississippi and 1.7% of nurses in the United States were prepared at the doctoral level ((Mississippi Institutions of Higher Learning, 2011). One university accepted the challenge to increase the number of doctorally-prepared nurses by creating a new Doctor of Philosophy (Ph.D.) in Nursing Education and Administration program. The success of the program is predicted to have a ripple effect as more academically-qualified nurse educators are available for faculty roles in baccalaureate and graduate education programs.

With a population of 27,801 Registered Nurses, only 0.7% of nurses in Mississippi were doctorally educated (BLS, 2015). The Mississippi Institute for Higher Learning reported that there were 119 nursing faculty with a doctoral degree in 2013 (McCrory, 2014). The production of new PhD graduates was low. The state reported two to three nursing PhD graduates per year between 2003 and 2010 (Jones, 2010)

The university had a rich history in nursing education, with programs for traditional Bachelor of Science in Nursing (BSN), RN to BSN, and Master of Science in Nursing (MSN) degrees. Because the existing MSN program emphasized nursing education, the faculty agreed that a PhD in nursing education and administration would be a natural fit for faculty skills and interest.

The first step in the process of developing a new PhD program was to examine the current system and conduct a preliminary study to identify barriers. Administration and faculty leaders identified and interviewed nurses who were “all but dissertation” in the PhD process. Doctorally-prepared nursing faculty eligible to teach in PhD programs were also interviewed. Students and faculty reported that the biggest barrier to educational success was the traditional dissertation process.

Administrative leaders encouraged faculty to brainstorm for innovative ideas that would overcome the identified barriers noted in traditional PhD programs. In response, faculty designed a curriculum including a hybrid course delivery format with a guided dissertation process as the key feature. The guided dissertation process is facilitated by consistent, readily-available committee members who provide scholarly feedback in a prompt manner. Each committee member is compensated through assigned dissertation courses which apply to annual assigned faculty workload.

The PhD program was implemented in Fall 2012. The program consists of 60 credit hours offered in a hybrid format which allows the student to take 6-8 hours per term. Students could complete the plan of study in two years of full-time enrollment, or three years of part-time work.

The PhD in Nursing Education and Administration program graduated 21, 27, and 31 students in 2014, 2015, and 2016 respectively. This graduation rate dramatically exceeded the previous rate of new PhD graduates within the state of Mississippi which reported two to three nursing PhD graduates per year between 2003 and 2010 (Jones, 2010) and six in the 2012-2013 academic year (McCrory, 2014). Although not all of the 79 nurses who graduated from 2014-2016 remained in Mississippi, the majority did. Overall statistics are not yet available for the state, but many graduates report employment in the nursing education programs of Mississippi and neighboring states.

Upon graduation of each cohort group, the curriculum was evaluated by graduates and faculty. Curriculum revisions have included consolidating courses with similar content, adjusting credit hours and content within courses, and streamlining the class and committee meeting schedules. The guided dissertation process continues to be refined with the addition of a university-based statistician provided for each dissertation committee and fine-tuning assignment timing.

The program continues to be successful and has expanded beyond the region to include students from thirteen states and one foreign country. Further recommendations for change will be identified with faculty and student evaluations. While there are undoubtedly more changes to follow, this university has taken a lead in overcoming the barriers to doctoral nursing education and increasing the supply of doctorally-prepared nurse educators.