Yesterday was graduation day for a wonderful group of future nursing and midwifery leaders in our school. We launched 92 new “Yale Nurses” from our Master of Science in Nursing, Doctor of Nursing Practice (DNP) and PhD programs. As our students walked proudly across the stage, supported by the cheers of faculty, family and friends, I began to think about their exciting new opportunities and future responsibilities as current and future nursing leaders.
Our profession seems to be constantly evolving and redefining educational essentials to keep up with the ever-changing landscape of healthcare. Expectations of our clinical nursing leaders have moved far beyond proficiency in a specialized area of clinical care. Clinical nursing leaders face increasing demands to provide expertise in project management, informatics, bioethics, navigating the business of healthcare, developing and applying healthcare policy, and implementing evidence-based nursing care to meet the healthcare needs of diverse patient populations.1,2 A new cadre of nurse leaders is currently embracing this professional challenge in the United States (US) by completing their Doctor of Nursing Practice (DNP) qualification. Yale School of Nursing (YSN) just graduated our second cohort of DNPs – 14 new nurse leaders in total.
DNP programs have spread across the US in recent years, with over 240 DNP programs currently available nationally.3 Traditionally, PhD programs have been the pathway to a terminal degree for nurses and midwives. PhDs provide rigorous research training, enabling nurses and midwives to make significant contributions to the body of knowledge within our disciplines. Graduates of PhD programs can provide the answers to important research questions, generating evidence to inform practice. The DNP is also a terminal degree, yet it offers something quite different to that of a traditional research doctorate. While research leaders with PhDs expand our evidence base, DNP leaders focus their skills on implementing the evidence through innovation in clinical practice and evidence-based health policy.
There has been much debate in the US about the relative merits of different types of doctoral level study for advanced practice nurses and nursing leaders, and the discourse continues regarding how each might fit within the healthcare system. There are currently a wide variety of clinical DNP programs available for advanced practice specialty nursing and also DNPs specifically for leadership and policy. 2 The DNP graduates I applauded as they walked across the stage yesterday were mid-career leadership and policy DNPs. Examples of their evidence-based projects include “Building an Evidence Based Succession Planning Tool for Chief Nursing Executives” – Stephan Davis; “Design of an Evidence-Based Mentorship Program for Inpatient Nurse Practitioners” – Kimberley Ennis; ”Development and Validation of an Electronic Medical Record Information Prioritization Tool for Evidence-Based Diabetes Management” – Caroline Piselli; and “Implementing the Point of Care Integrated Breast Cancer Screening Model” – Jill Muhrer. Implementing evidence-based models of care through the development of innovative tools, programs and policies was a consistent project theme.
There was much excitement around the contribution each new DNP graduate had made to their clinical community, healthcare organization and patient population – each making a difference and leading the way to strengthen the profession for the future and making improvements in population health. It will be interesting to see how DNP programs are shaped over time and exciting to see how these new nurse leaders are able to use their expanded skillset to increase the pace at which we are able to implement evidence-based healthcare delivery for the future.
American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. Washington, DC: http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf
American Association of Colleges of Nursing. (August 2015). The Doctor of Nursing Practice: Current Issues and Clarifying Recommendations. http://www.aacn.nche.edu/aacn-publications/white-papers/DNP-Implementation-TF-Report-8-15.pdf
American Association of Colleges of Nursing (July 2014) Doctor of Nursing Practice (DNP) Talking Points http://www.aacn.nche.edu/dnp/about/talking-points
Allison Shorten PhD RN RM FACM
Yale School of Nursing