The Doctor of Nursing Practice: Reflections on the Past and Visions for the Future

The rapid expansion of DNP programs in the United States has resulted in great variability in curriculum and the final DNP project. However, the principles upon which the DNP was endorsed by the American Colleges of Nursing remain unchanged and include: (1) advanced competencies for increasingly complex clinical, faculty and leadership roles; (2) enhanced knowledge to improve nursing practice and patient outcomes; (3) advanced leadership skills; (4) parity with other health professionals; (5) increased faculty for clinical instruction; (6) improved image (AACN, 2004, p.7). As outlined by the DNP Essentials document, the objective of the DNP is not to conduct rigorous research (AACN, 2006). The DNP prepared nurse is a healthcare leader with expertise in translating research into practice to improve health care quality and patient outcomes (Melynk, 2013; Melynk, 2016).

Many DNP programs continue to require their DNP students to conduct research as their final scholarly project. This has resulted in increasing confusion among both academic institutions and health care systems. This issue is in part perpetuated by the fact that many nursing faculty are new to evidence-based practice (EBP), having never had formal education and skill development in EBP. Faculty cannot teach what they themselves do not know (Melynk, 2013). Improving DNP curricula will require that nursing colleges invest in EBP education for their faculty including EBP skill building workshops so the faculty is best positioned to mentor and advise DNP students (Melynk, 2013).

Administrators in the service setting must also have a clear understanding of the preparation of the DNP nurse so that they can align role responsibilities to the practice/service setting. This includes providing career advancement opportunities such as clinical ladders.

PhD prepared nurses and DNP prepared nurses have great opportunities to transform healthcare through collaborative efforts steeped in their combined expertise: the PhD as the generator of external evidence from rigorous research; and the DNP as the best generator of internal evidence from quality improvement, outcomes management, and evidence-based projects (Melynk, 2013; Melynk, 2016). This model of PhD-DNP collaboration offers tremendous opportunities for nursing science as we move forward in closing the gap of moving research from the academic sphere into the practice setting.