Assessing postgraduate outcomes of research-intensive nursing science PhD programs: Methods and metrics

BackgroundAcross disciplines and within higher educational systems, assessing postgraduate outcomes is essential for evaluating doctoral programs, including research-intensive nursing science doctoral programs. However, there are limited reports regarding methods and metrics related to postgraduate longitudinal evaluation of research-focused nursing doctoral programs.PurposeThe purpose of this paper is to summarize studies in the area of postgraduate outcome assessment and provide recommendations regarding outcome methods and metrics for evaluating the effectiveness of research-focused nursing doctoral programs.MethodsPubMed/Medline, CINHAL Complete, and Google Scholar databases were searched using key words including PhD program, doctoral program, longitudinal evaluation, evaluation, program evaluation, PhD alumni survey, education outcomes and PhD program outcomes. We excluded non-English and full-text articles that were not available for review.DiscussionBased on a review of the literature, there are few reports on methods and questionnaires for postgraduate outcome assessment. There is a critical need to develop standardized core metrics/questions, longitudinal assessments, and a shared data repository. The latter will allow for comparisons across nursing doctoral programs.ConclusionRobust standardized longitudinal assessment of nursing doctoral programs is a necessary step for comparison across programs and re-envisioning the nursing doctoral education of the future.     

A theoretical framework to promote minority PhD and DNP student success in nursing education

BackgroundNursing PhD and DNP programs lack diversity and cultural responsiveness and, as a result, minority students are underrepresented in these programs. Stressors specific to being a member of a minority population, defined as minority stress, contribute to a range of barriers for ethnic/racial minority, male and LGBTQ PhD and DNP students. There is an urgent need for faculty and administrators to support minority doctoral student success by taking proactive steps to identify and begin to deconstruct these barriers. Doctorally-prepared nursing faculty serve as mentors and role models for doctoral students, provide exemplars for how to use scientific humility to research health inequities, implement evidence-based practice and develop the next generation of nurse scientists. Combating educational inequities for minority doctoral students is a first step in advancing health equity beyond academia.PurposeThe purpose of this paper is to develop a theoretical synthesis to promote minority PhD and DNP student success in academia.Theoretical frameworkThe minority doctoral student success (MDSS) framework was developed using Schneider's attraction-selection-attrition framework, key concepts from the literature, and professional and personal experience to capture the minority doctoral student experience. A systems approach was used to identify multi-level influences on the minority student experience, including antecedents at each stage of the academic journey, and how minority stress and opportunity inherently affect the process.ConclusionsDiversity is essential to reimagine nursing doctoral education. This theoretical framework provides an approach to understanding the minority PhD and DNP student experience and the role of faculty and the academic organization in mediating barriers and creating opportunities to enhance diversity, equity, and inclusion.     

DNP and PhD scholarship: Making the case for collaboration

BackgroundThe Institute of Medicine calls for meaningful collaboration between doctor of nursing practice (DNP)- and doctor of philosophy (PhD)-prepared nurses to improve health outcomes.PurposeThe purpose of this paper is to answer the questions: 1) how do Colleges of Nursing influence DNP and PhD collaboration for faculty and students? 2) how does DNP and PhD collaboration in an academic setting impact health care practices and patient outcomes?MethodsTwo examples of DNP and PhD collaboration (one faculty and one student) are presented.ResultsShared faculty responsibilities and a supportive organizational culture influenced collaboration between faculty and students. Research and practice roles can complement and strengthen each other while improving health outcomes.ConclusionColleges of Nursing should build processes and culture that encourage faculty and students to collaborate across doctoral programs. Successful intraprofessional collaboration has the potential to positively impact healthcare quality, and outcomes, while advancing the nursing profession.     

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.     

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.     

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.     

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.     

Reconceptualizing the core of nurse practitioner education and practice

Purpose: The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice.
Data sources: Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education.
Conclusions: The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of nursing is in health promotion, both in healthy persons and in those dealing with chronic illness. Current master's programs do not prepare NPs to assume high-level practice focused on health promotion and disease management using the latest theoretical developments in health behavior change, behavioral sciences, exercise physiology, nutrition, and medical anthropology. Although these are touched upon in most NP programs, they do not represent the core science of NP education and need to be a critical part of any DNP program.
Implications for practice: Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.     

A preliminary study of current situation and competences of doctoral nursing education in Taiwan: A multi-methods research design.

AimTo explore the status and overall competency of Taiwan’s doctoral nursing programs.BackgroundTaiwan has 11 universities offer doctoral degree programs in nursing from 1997 to 2020. As the demand for educators of higher nursing education increases, whether the nursing talent requirements have been satisfactorily fulfilled.DesignA two-stage data collection based on a multi-methods survey was conducted.MethodsThe first stage from December 2017 to the end of December 2019, involved collecting admission brochures for 12 doctoral nursing programs provided by 11 universities and 14 Internet databases. In the second stage, convenience sampling was performed to recruit 115 graduates of national doctoral nursing programs to collect data through a self-administered questionnaire online survey from July to the end of September 2018.ResultsA systematic review of the vision and core competencies of each university revealed a general emphasis on nursing knowledge, research, leadership, international perspective and competence, innovation, social practice and policy. More specifically, universities aim to cultivate five core competencies in students, for example, nursing knowledge, scientific and innovative research capabilities and participation in the formulation and promotion of nursing policies. Of the 115 graduates of national doctoral nursing programs surveyed, the online questionnaire revealed that more than half of the respondents were aged 41–50 years (n = 62, 53.9%), 81.8% occupied a teaching position and most had 2.4–9.8 years of study in the program (mean = 6.09 ± 1.81 years). Respondents who completed a doctoral nursing program in Taiwan could learn orderly teaching, research and leadership capabilities with scored 4.12, 4.11 and 3.65, respectively.ConclusionsThe overall orientation of the doctoral nursing programs in Taiwan aligns approximately with global trends in nursing. This study suggests that international and national resources should be incorporated into the cultivation of various competencies and curriculum quality control; moreover, industry, academia and the government should hold regular meetings to formulate suitable evaluation mechanisms.     

Completion and attrition of nursing PhD students of the 2001 to 2010 matriculating cohorts

PurposeTo examine completion and attrition of students in nursing PhD programs.MethodsTotal 5,391 students who matriculated into nursing PhD programs in 2001 to 2010 were selected from the AACN database.FindingsThe completion rate of the students was 74.2% and the attrition rate was 22.7%. On average, it took 5.7 years for the students to graduate and 3.7 years for the students who left without graduating to drop out. The mean age at matriculation and graduation was 42.4 and 47.5, respectively. Male students, part-time students, students of post-baccalaureate programs, students who were not faculty or held a part-time faculty position, students of the 2001 to 2010 matriculation cohorts, and students in PhD programs with 25% or more of the courses taught online were more likely to experience attrition.ConclusionThe study findings provide useful information for the nursing education community to better address the issue of nursing PhD shortage.     

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.     

Breaking new ground? The dual (PhD-DNP) doctoral degree in Nursing

Purpose1) Provide background information on the PhD-DNP dual doctoral degree, specifically historical perspectives and existing programs; 2) Describe one PhD-DNP program as an exemplar to illustrate program data challenges and solutions; and 3) Discuss the national landscape of the dual doctoral degree program.Principal resultsPhD-DNP dual doctoral degree programs have existed for 10 years; there are five known programs nationally. Reported here for one dual doctoral degree program are data collected from the program's inception (2010) through 2019. These data include demographic program characteristics, time to degree, and achievements during and after the program. Challenges pertaining to mentorship, progression to degree, socialization and student productivity also are described. Strategies for moving the dual degree forward nationally depend on a collaborative effort for data generation and collection from existing PhD-DNP programs. These data can be instrumental for seeking funding for dual doctoral degree programs.ConclusionsThe dual PhD-DNP degree has not yet gained a foothold nationally. There is demand for the program by nursing doctoral students and availability of these programs is slowly increasing. National nursing leaders and organizations can consider developing metrics and collecting data that will lend support to future funding initiatives for the dual degree.     

Opportunities and challenges presented by recent pedagogical innovations in doctoral nursing education

The demand to expand the nurse scientist pipeline over the past decade has generated numerous pedagogical innovations in nursing doctoral education. A PhD nursing education summit was held at the University of Pennsylvania in October 2019 to discuss pedagogical innovations. The main pedagogical innovations discussed by Summit attendees included: 1) the expansion of both 3-year PhD programs and BSN to PhD programs; 2) changes in learning opportunities and curricula content; and 3) the role of postdoctoral fellowships. This overview examines the numerous opportunities and challenges generated by these innovations. Opportunities include producing scholars with research careers that are potentially longer than historically seen in the nursing profession, as well as the emergence of unique educational and mentoring opportunities both during and after doctoral studies. Challenges involve the impact condensed program timelines have had on both the content and delivery of curricula, as well as the research expertise and skillsets of nursing PhD program graduates. There is a need to conduct a national coordinated evaluation of PhD program using shared metrics in order to better evaluate the effect of these pedagogical innovations on the development of nurse scientists, and ultimately, the discipline.     

Troublesome knowledge for entry-level PhD nursing students: Threshold concepts essential for the research-focused doctorate

BackgroundEvidence supports that PhD doctoral students experience conceptually difficult knowledge, or troublesome knowledge, during their studies. These areas of troublesome knowledge are often associated with threshold concepts, those ideas specific to a discipline that must be understood to advance ways of thinking and making knowledge in the discipline.PurposeTo examine troublesome knowledge identified by a group of PhD nursing students during an introductory course and to consider threshold concepts related to that knowledge.MethodDesign: Case study research methodology.Sample: 18 entry-level PhD nursing students recruited with convenience sampling.Data collection: Content analysis was used to analyze data collected from student reflective learning journals. Journal data was triangulated with formative and summative faculty assessments of student learning.ResultsThree essential threshold concepts for entry-level PhD nursing students were identified: developing new ways of knowing, constructing researcher and writer identity, and positioning within the nursing research community. Analysis indicates that entry-level students found the threshold concept of constructing researcher and writer identity most troublesome.ConclusionA PhD introductory nursing course which includes metacognitive activities, scaffolding of assignments, and early positioning within the research community can assist students with mastery of threshold concepts for the research-focused doctorate.     

From vision to action: Next steps in designing PhD programs of the future

Declines in PhD enrollment, funding and support for PhD students, and the quality and quantity of the nursing research pipeline has fueled the concern about providing high-quality education in research-focused nursing doctoral programs. To address the challenges and opportunities facing research focused PhD education, the University of Pennsylvania School of Nursing convened an invitational summit, Re-Envisioning Research-Focused PhD Programs of the Future, of research-intensive institutions. Both as a dissemination strategy and as an effort to engage perspectives from other Schools with PhD programs, we presented a summary of the Penn Summit discussion at the AACN Doctoral Education Conference (AACN Doctoral Conference). Focused discussions at both events further identified opportunities for research focused PhD programs, including recruiting undergraduate students, establishing research-focused partnerships, creating clear evaluation methods. AACN Doctoral conference participants also discussed the need to discuss and identify competencies, common subject areas, and financial resources for PhD students and graduates. This synthesis of discussions, considerations, and challenges affecting research-focused doctoral programs of nursing serve as a basis and catalyst for further discussion and action to ensure PhD research focused programs are preparing successful nurse scientists of the future.     

Alignment of a PhD program in nursing with the AACN report on the research-focused doctorate in nursing: A descriptive analysis

Those involved in preparing the next generation of nurse scientists face numerous challenges, including but not limited to: relatively older age at completion of doctoral studies, insufficient funding for full-time PhD students in nursing, inadequate funding for nursing research, and the limited number of well-funded mentors in nursing doctoral programs. These issues have limited the number of students enrolled in PhD nursing programs and graduates to supply the research faculty of the future and generate nursing science. This phenomenon persists despite numerous calls to increase the number of PhD doctoral students and graduates and expedite the PhD process without compromising educational integrity. This article describes the BSN-to-PhD Pathway and the Accelerated (3 year) Pathway to the nursing PhD at an established research doctoral program that required a shift in the approach to student recruitment, curriculum development, and timely progression. Implications for practice and research are discussed.