Choose your doctorate

Aims and objectives. The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking ‘could this possibly be for me'? This paper will try to help the reader decide which if any option to take. Background. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. Method. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities’ advertising material. Conclusions. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and academic support and is more practice orientated. It is suggested that the move towards doctoral programmes for nurses will present one of the most important evolutionary changes in the practice of nursing. Relevance to clinical practice. It is suggested that doctoral education for nurses will increase in prevalence and that this process of change is already underway. Doctoral education will provide practitioners with the experience and skills required to conduct research and further develop practice. For individual practitioners, doctoral education will enhance self‐confidence in an increasingly technical and complex arena and in a practice discipline that is becoming ever more politically charged. The professional doctorate appears to be particularly suited to senior nurse practitioners. What remains is for us to accept this new challenge and to shape its development for the benefit of the practice of nursing.     

Motivations and challenges of Israeli nurses on their journey to a PhD: A qualitative study

AimThis qualitative study aimed to examine the motivations and challenges encountered by Israeli nurses during their journey to achieve a doctoral degree (PhD).BackgroundThe increasing numbers of nurses studying for a doctoral degree may contribute to improving nursing education, expanding the body of knowledge and promoting the status of nursing as a research profession. However, many countries have reported a shortage in nurses with doctoral degrees.DesignQualitative content analysis study using semi-structured interviews.MethodsSixteen senior nurses (mean age 47.35 years, 75% women) who completed their doctoral studies in the past five years were interviewed. The interviews were transcribed and their content was analyzed inductively. COREQ checklist was used to report the study.ResultsThe ability to persevere in doctoral studies was related to the support provided by the learning environment as well as to family support. External barriers were related to administrative bureaucracy, tedious search for a mentor, unsupportive workplace and socio-economic burdens. PhD studies were perceived as a means for self-fulfillment, while major motivators were aspiration for professional advancement, a responsibility for promoting the image of nursing and a lack of recognition by colleagues.ConclusionsNurses study for doctoral degrees in order to advance their career and achieve personal fulfillment, as well as to increase the prestige of the nursing as profession. To allow nurses with PhD to fulfill their abilities and to advance the nursing profession, their research and academic support should be increased, and appropriate professional positions should be developed.Tweetable abstractThis study highlights the facilitators of doctoral studies such as family and academic support, a strong need for personal and professional fulfillment, and a desire for professional change, and obstacles such as academic and bureaucratic barriers, low wage increases, and a lack of recognition of nursing by the medical world.     

Professional doctorate and professional nursing practice

The professional doctorate degree in nursing is a novel approach to gaining a doctoral qualification other than the traditional Doctor of Philosophy (PhD) degree. This taught programme aims at linking theory and practice innovations in addressing clinical nursing problems. This paper outlines the evolution of the professional doctorate in the USA, the UK and Australia and its differences from the traditional PhD. I argue that nurses enrolled in this course work programme will not only have the opportunity to pursue studies at the doctoral level, but it will also facilitate nurses to challenge and share their experiences in solving practice problems in a collegial manner. By understanding the broader perspective of an environment dominated by scarce resources and intricate socio-political relationship, nurses will be able to influence policy decisions and ultimately improve the standard of health care and enhance the professional status of nursing. It may even reduce the antagonism of the anti-intellectual environment of the workplace through practice-oriented research.     

Difficult professional choices: deciding between the PhD and the DNP in nursing

Although the PhD has been the traditional doctoral degree in nursing, nurses now have a choice between that degree and the Doctor of Nursing Practice (DNP) degree. An Internet-based exploratory survey of DNP students (n= 69) investigated the motivation of nurses to pursue doctoral education, factors that influenced the decision between the two degrees, rationale for choosing the DNP program, and career plans after graduation. A majority reported considering the PhD but decided the DNP would be more appropriate for their professional and personal goals. Nursing education was ranked as an important career intention for 55% of respondents, dispelling the concern that the DNP will increase the shortage of nursing faculty. The results indicate that the DNP degree is a desirable option for clinically oriented nurses considering doctoral education and provides nurses with a choice of educational pathways for their professional careers.     

Following the Path; A Grounded Theory Study Regarding Doctoral Roles

BackgroundDecades after the AACN (2004) position statement regarding the clinical doctorate, the DNP, shows ongoing dialogue without professional consensus regarding the two terminal degrees. The lack of understanding and confusion surrounding the two doctoral degrees in nursing subsequently projects a negative image about the profession; suggesting a lack of cohesiveness; promotes an environment of distrust, thereby creating confusion for the public about the nursing profession.PurposeThe purpose of this qualitative research was to develop a substantive theory about the perceptions and the attitudes of doctoral nurses regarding their roles.MethodAn adapted approach of Strauss and Corbin's grounded theory methodology was used. Sampling was purposive, snowball, and theoretical. Theoretical sampling with an expert group validated concepts, themes, and categories.ResultsThe main categories of advancing, collaborating, transforming, and stewarding emerged from the data. The basic social process of Following the Path identified and explained the meaning ascribed by DNP and PhD nurses about their doctoral roles.ConclusionsThe theoretical framework provides information about the DNP and PhD nurse. The findings support evidence the nursing profession is moving forward towards self-definition. Acceptance and need for the doctoral roles were identified. Understanding the perspectives of the doctoral nurses in the profession has identified forward movement in practice and cohesion of the nursing discipline.     

Why Rush will keep the DNSc.

Surveys of research-intensive doctoral programs in nursing reveal few differences between the doctor of nursing science (DNSc) and the doctor of philosophy (PhD) degrees in nursing. Yet the proportion of DNSc programs relative to PhD programs in nursing has declined progressively over the past 10 years. Recently, Rush University College of Nursing formed a task force to examine whether Rush should continue to offer the DNSc degree or change to a PhD in nursing program. Task force members interviewed 21 nurse leaders representing 18 universities granting doctoral degrees in nursing about their perceptions of the DNSc and PhD in nursing degrees, the focus of their doctoral programs, why their nursing school chose the degree it currently offers, and whether Rush should retain the DNSc degree. This article describes the results of those interviews, how their comments helped the task force re-evaluate its goals for doctoral education, and the rationale for ultimately choosing to retain the DNSc degree.     

The transitioning experiences of internationally-educated nurses into a Canadian health care system: A focused ethnography

Background

Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK.

Methods

Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation.

Results

Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills.

Conclusions

Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students.     

After the Doctorate: A qualitative study investigating nursing research career development in Jordan

There is a dearth of research exploring the development of postdoctoral nursing research careers in non‐Western contexts. This paper reports on a qualitative study of Jordanian graduates of UK PhD programs. Interviews were held with 16 graduates who worked in the nursing faculty of seven different universities in Jordan. Participants reported that their doctoral degree had equipped them with confidence and enthusiasm for developing a research career. Mentorship, leadership, and peer support were identified as essential to supporting ongoing research activity. Access to these sources of support was variable and participants also described a range of institutional and organizational structures that directly or indirectly discouraged them from developing research productivity. This research suggests that support for postdoctoral novice researchers is an important area for further attention – for Jordanian universities, for UK PhD supervisors (and their associated academic departments), and for the wider nursing community.     

Professional and academic destination of masters in nursing graduates: a national survey

Master's degrees, especially in the form of coursework master's programmes are becoming the main conduit for continuing professional education to the professions. However, there is a paucity of literature on the academic or professional destination of nurses following the completion of master's degrees in nursing. A cross-sectional postal survey of 322 graduates from masters in nursing programmes in Ireland was undertaken. Former students were surveyed regarding their professional and academic destinations subsequent to graduation. The majority of graduates were employed in clinical nursing followed by a substantial number working in the area of nurse education, mainly at the grade of college lecturer. The vast majority of graduates had achieved promotional grades following the master's degree. A minority of graduates indicated a desire to undertake further study at degree level. Those that did were following or intended to follow PhD level studies. However, the majority of graduates did not view the degree as a pathway to a PhD but as an integral part of their continuing professional education and related to clinical practice. There is a reversal of the trend seen in Ireland and the UK in the mid to late 1990s in which the majority of graduates followed career pathways in nurse education. Although there has been an increase in the number of nurses completing master's level education over the last five years unemployment of underemployment of graduates is not yet an issue.     

Practical and philosophical considerations in choosing the DNP or PhD in nursing

The two terminal degrees in nursing, the Doctor of Nursing Practice (DNP) and Doctor of Philosophy (PhD), are complementary degrees in moving the discipline of nursing forward. The role of nurses with either doctoral degree is discussed related to the overall stewardship of the nursing profession. Core elements and key differences between the two degrees will be delineated. Factors affecting practical decision-making about either degree will be discussed, including the choice of which degree as well as funding doctoral education. Finally, future directions for the two degrees in the nursing profession will be discussed.     

A prebaccalaureate PhD option: shaping the future of research-focused doctoral education

The future of PhD education in nursing is at a crossroads. Our current practice of primarily enrolling post-master's students with years of clinical experience is not producing an adequate number of graduates who are able to make significant and sustained contributions to nursing research. Therefore, it is timely to consider educational innovations that encourage a different population of students to consider doctoral research training. A prebaccalaureate or early-entry option to the PhD in nursing is a means toward this end. At the University of Wisconsin-Madison, a select group of prenursing students and students beginning the nursing major are offered an early admission to PhD education. A key component of the Early Entry PhD Option is immediate and intensive research training with an established nurse faculty researcher. In this article, the authors describe the curriculum of a prebaccalaureate, research-focused doctoral option and its early results.     

Looking back at the doctorate: a qualitative study of Jordanian graduates from PhD programs in the UK

Many countries develop their nursing capacity by sending nurses overseas to gain their doctorates. There is a lack of research on their subsequent experience and career development. Focusing on the Jordanian and UK contexts, this qualitative study explored the doctoral and postdoctoral experience. Interviews were held with 16 PhD nursing graduates in Jordan. The participants had studied in 12 different universities in the UK and now worked as faculty members in seven Jordanian universities. The data were analyzed thematically. The participants reported that the most difficult task (but also the most significant achievement) was the transition to autonomous scholarship. They also described a profound personal transformation as a result of living in another country. However, very few of them could cite examples of how they were using their skills now to influence their current practice within their faculty roles. This suggests a possible under-use of the skills, new perspectives, and enthusiasm that new doctoral graduates bring back home with them. Future research should focus on identifying ways to support and develop doctoral nursing graduates to maximize their potential on their return home.     

Experiential clinical learning for newly licensed PhD students: Transforming nursing PhD education through academic-practice partnerships

The growing national and international need for nurse scientists to transform health care has encouraged advances in nursing doctoral programs. The Hillman Scholars in Nursing Innovation, a program integrating BSN and PhD education, inspired the creation of the Hillman Clinical Fellowship (“Fellowship”). The Fellowship helps students transitioning from the BSN to PhD gain clinical experiences as newly graduated registered nurses, thus mitigating a common concern that students are naïve about the clinical setting. In collaboration with a practice partner, the Fellowship fosters development of clinical skills consistent with Patricia Benner's Novice to Expert Model. Fellows build clinical skills concurrent with the development of research proficiencies in the PhD program. This Fellowship can be adapted by other schools seeking to introduce curricular innovations that address the needs of early career PhD students, enhance academic-practice partnerships, and meet the growing need for more clinically focused PhD prepared nurses.     

Development of nurse education in Saudi Arabia,Jordan and Ghana: From undergraduate to doctoral programmes

Doctoral programmes in nursing have a long history in the US where traditional research based PhDs and more clinically based doctoral programmes are common. In the rest of the world PhDs are better accepted though professional doctorates with a thesis component are common in the UK. In countries with newly established or planned doctoral programmes in nursing the research PhD seems the degree of choice. Here we discuss developments in Jordan, Saudi Arabia and Ghana.This study used official documents, strategic plans, curriculum developments and other documentary evidence from Saudi Arabia, Jordan and Ghana. We compared doctoral programmes and development with other countries by reference to the literature.We offer the example of public health and non-communicable diseases in particular as one area where doctorally trained nurses applying international standards in collaboration internationally may be of benefit.     

Making explicit the development of PhD-prepared nurses to steward the discipline

Leadership is a core curricular element of PhD programs in nursing. Our PhD faculty began a dialogue about being a leader, a steward of the discipline. We asked ourselves: (a) What expertise do PhD prepared nurse needs to begin to steward the discipline? (b) How do faculty engage PhD nursing students to assume responsibility for stewarding the discipline? Lastly, (c) How do we work with PhD nursing students to create their vision for how their work contributes to stewarding the discipline, from doctoral coursework throughout their career? We support the need for PhD graduates to have the skills to generate knowledge, conserve that which is important, and transform by disseminating new knowledge to a broad audience. Examples of nurses stewarding the discipline when pioneering research, critiquing traditional approaches to inquiry or trends in nursing practice, and developing policy, are highlighted along with examples of how PhD nursing students begin to steward the discipline.     

Competencias de investigación en las especialidades de Enfermería

Since nursing became an university degree in 1977, there have been several regulations to develop specialties, all of them agreeing on the need to include skills in research. Indeed, the relevance of acquiring these skills in all current disciplines has led to Royal Decree 99/2011, which regulates the official PhD courses, and recognises specialist nurses as qualified to access PhD studies.Nowadays, students from six of the seven specialties included in the Royal Decree 450/2005 on nursing specialties, are performing their training. The acquisition of research skills is seen as an opportunity and a challenge. However, the organizational structure of training facilities (multiprofessional teaching units) and the incorporation of nurses as clinical tutors, who initiated this teaching activity, deserve special attention to ensure the correct acquisition of research skills in the training of specialist nurses.     

Barriers for BSN students to pursue a PhD in nursing and recommendations to address them: A scoping review

BackgroundIncreasing the BSN-PhD pipeline could address the shortage of nursing faculty to conduct research, develop nursing science, and train new nurses and faculty.PurposeTo identify barriers to BSN students’ pursuit of PhD education, and to compile recommendations to increase their numbers.MethodsThis scoping review follows PRISMA guidelines, including articles in English that discussed barriers to BSN students’ pursuit of PhD education and recommendations to address them.FindingsBarriers to pursuing a PhD include misunderstanding PhD education and its impact on population-level health, insufficient funding for PhD studies, and perceived need for clinical experience. BSN program recommendations include education on doctoral and postdoctoral options, mentorship, and hands-on research experiences. PhD programs should be accessible, fully funded, and address students’ perceived need for clinical experience.DiscussionThe nursing profession must take coordinated action across individual, interpersonal, program, policy, and cultural levels to increase the pipeline of well-prepared BSN-PhD students.     

A study to identify the attitudes and needs of qualified staff concerning the use of research findings in clinical practice within mental health care settings

In 1972 the Report of the Committee on Nursing recommended that nursing should become a research-based profession Although, it is acknowledged that research has made a significant contribution to the body of nursing theory since then, it has had little impact on clinical practice The present study is a small exploratory survey to assess the attitudes and needs of qualified nurses working within mental health care settings concerning the use of research findings in practice A total of 150 questionnaires were sent to trained nurses working within a defined geographical area in the south-east of England and 118 were returned, giving a response rate of 78% The main findings suggest that although the vast majority of nurses in the study have a very positive attitude towards research, very few actually make significant use of research findings to enhance their clinical practice Some of the variables that seem to contribute to this state of affairs are lack of the necessary research appreciation skills to critically evaluate research findings and apply them in practice, not enough relevant research studies available in the clinical areas, and inadequate support from managers However, most of the nurses in the study said that they would be involved with research activities if the time was provided for them to do so     

Doctoral-prepared nurses in the Veterans Health Administration: A cross-sectional survey

BackgroundDoctoral-prepared nurses with diverse skillsets are required to meet nursing care needs in a complex and changing healthcare environment. A better understanding of the roles of doctoral-prepared nurses in Veterans Health Administration (VHA) workforce will help leverage their expertise to meet the needs of Veterans.PurposeAssess the current roles of doctoral-prepared nurses within the VHA.MethodA cross-sectional survey was used to collect information on doctoral-prepared nurses within the VHA in 2016. Multiple strategies were used to identify doctoral-prepared nurses to recruit for an online survey. Survey invitations were sent electronically to unique individuals identified (N = 2403).ResultsResponses were received from 1015 nurses (42.2% response rate), with 929 nurses with a doctoral degree identified. DNP/DNAP degrees were most common (55%), followed by a PhD or DNS (33%). Significant differences were noted between nurses in different doctoral education categories across four main roles: research, clinical, educational, and administration.ConclusionsThis survey generated the first comprehensive list of VHA doctoral-prepared nurses. Findings are being used by the VHA Office of Nursing Services to align degree types, duties of different positions, functional statements, and position expectations. Results support the continued need for collaboration between nurses with PhDs and DNPs to achieve research and clinical goals.