36 American Nurse Today Volume 12, Number 2 AmericanNurseToday.com

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Have you been toying with theidea of earning a doctoraldegree in nursing? Maybe

you want to pursue a career in re-search, teaching, or advanced prac-tice and you know that another de-gree can help you achieve thosegoals. You may, however, notknow whether you should go for adoctor of philosophy (PhD) innursing or a doctor of nursing prac-tice (DNP). A little research intoboth may help point you in theright direction. This article providesa brief history of doctoral educationin nursing and compares key as-pects of PhD and DNP degrees.

Looking backOver the past 70 years, nursing hasmade impressive progress as a disci-pline as well as a profession. Nursesbegan to earn research-focused PhDdegrees in the 1960s, typically infields like education or sociology,which led to the early developmentof nursing theory and research. Inthe 1970s, the growing demand bynurses for a nursing-specific PhDled many universities to developPhD in nursing programs.

Later in that decade, nursescholars identified the need for asecond nursing doctoral degreesimilar to practice-focused degreesin other disciplines. This led to thedevelopment of degrees such asthe doctor of nursing science(DNS) and doctor of nursing (ND)degrees. In 2004, the members ofthe American Association of Col-leges of Nursing (AACN) recom-mended that to clarify degree op-tions, the DNP should be the

degree associated with practice(“practice doctorate”). They alsorecommended transitioning to doc-torate-level preparation for ad-vanced nursing practice by 2015.

Doctoral education todayIn the United States, the nursingprofession generally recognizes twodoctoral degrees: PhD in nursingand DNP. In 2010, the Institute ofMedicine called for “a greater poolof nurses prepared to assume facul-ty and research positions” and rec-ommended “doubling the numberof nurses with a doctorate by 2020.”However, the proportion of nurseswith doctoral degrees remains lessthan 0.5%. As of 2015, the AACNreported that 322 institutions of-fered nursing doctoral programs inthe United States. Some institutionsoffer both PhD and DNP programs,while a few offer a dual PhD/DNP.(See Nursing doctoral degrees: howdo they compare?)

PhD in nursing If you choose the research-focusedPhD degree, you’ll graduate pre-pared to build nursing knowledgeby generating new evidencethrough research and helping tomeet the growing demand fornurse scientists and faculty. Contin-ued evolution of the nursing pro-fession depends on nurses who de-velop the science, steward theprofession, and educate new nurseresearchers.

In the past, most PhD in nurs-ing programs required full-timestudy, but now many offer part-time options. In 2016, nursing pro-

gram ad-ministrators reported that 43% ofthe 3,108 students in PhD programsattended part-time. The variousPhD programs offer multiple entrypoints and formats, with all gradu-ates completing research for a dis-sertation.

The DNPIf your goal is to achieve the highestlevel of education for nursing prac-tice, then a DNP program may bethe way to go. According to theAACN (2006), the DNP degree pre-pares “experts in specialized ad-vanced nursing practice…that is in-novative and evidence-based,reflecting the application of credibleresearch findings.” With a DNP, youcan lead system-level change to im-prove health outcomes.

Although the AACN’s initial 2015goal of doctoral-level entry to ad-vanced practice has been delayed,the DNP initiative has stimulateddiscussion and action within nurs-ing practice and education. Supportof the DNP by professional organi-zations varies. For example, threeorganizations (American Nurses As-sociation, American Association of

PhD or DNP? Defining thepath to your career destinationLearn how to choose the degree that’s right for you. By Deborah Lindell, DNP, RN, CNE, ANEF; Debra Hagler, PhD, RN, ACNS-BC, CNE, CHSE, ANEF, FAAN; and Kathleen Poindexter, PhD, RN, CNE

AmericanNurseToday.com February 2017 American Nurse Today 37

Nurse Executives, and AmericanCollege of Nurse Midwives) view itas one education option for ad-vanced practice. Others (NationalOrganization of Nurse PractitionerFaculties, National Association ofClinical Nurse Specialists [NACNS],Council on Accreditation of NurseAnesthesia Educational Programs[COA]) require a doctoral degreefor advanced practice. The NACNSand COA have established targetdates for requiring new clinicians intheir specialty to have a doctoraldegree.

You can pursue a DNP througha variety of formats. All DNP gradu-ates complete a specified amountof practicum as well as a practice-based project.

Selecting the right programChoosing between the PhD andDNP can be challenging. In fact,some graduates of nursing doctoralprograms are unable to distinguishthe roles of nurses with differentdegrees. In a study by Dreifuerst etal (2016), 22% of nursing PhDgraduates reported they begandoctoral study intending to be-come clinicians, while 13% of DNPgraduates said they began theirprograms intending to become re-searchers.

Consider these three factors whenchoosing your doctoral program• fit with your career goals• format of the academic program• balance between costs and avail-

able funding support.

Bednash suggests that “the fun-damental question is whether thenurse wants to develop the knowl-edge and skills to generate new sci-ence in an area of interest orwhether the nurse wants to takeexisting knowledge and use it toshape nursing practice and health-care.” (See The right questions leadto the right degree.)

While studying for a doctoraldegree can be a rewarding experi-ence, be prepared for the chal-lenges you’re likely to encounter. A study of DNP students andgraduates found that success de-pends on support from family,peer students, friends, and em-ployers; lifestyle changes, such asmaking work or school part-time

The table below provides an overview of doctoral degree options.

PhD with nursing focus DNP Dual doctorate PhD/DNP

Program purpose Focus on research Focus on clinical practice Combines leadership in advanced clinical practice with research to

Preparation as a leader and scholar Preparation as a leader and develop nursing scienceto generate external evidence clinician to generate internal through rigorous research evidence through quality

improvement and evidence-based practice

Program entry BSN to PhD BSN-DNP (or pre-RN MN/ Post-MSNPost-MSN PhD MSN-DNP)

Post-MSN (APN)

Typical program length 4-5 years post-master’s 2-3 years post-master’s 5+ years post-master’s (full-time study) (full-time study) (full-time study)

Accreditation PhD programs with a nursing focus Accredited by a nursing Accreditation according to PhDare not accredited by a nursing organization, such as CCNE, and DNP standardsorganization. The institution may ACEN, or CNEAbe regionally accredited by a higher education organization

Roles for the graduate Researcher, faculty member, Direct-care provider in Combines the role options of administrator in academic settings primary care or specialty both degrees

practice (with advance Researcher, executive in health practice certification)care organization

Faculty member, administratorin academic settings

Executive in healthcare organization

ACEN = Accreditation Commission for Education in Nursing, APN = advanced practice nurse, BSN = bachelor of science in nursing,CCNE = Commission on Collegiate Nursing Education, CNEA = Commission for Nursing Education AccreditationMN = master of nursing, MSN = master of science in nursing, PhD = doctor of philosophy, DNP = doctor of nursing practice

Nursing doctoral degrees: How do they compare?

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38 American Nurse Today Volume 12, Number 2 AmericanNurseToday.com

rather than both full-time; andperseverance.

Making the investmentRegardless of which path youchoose for your doctoral degree,PhD and DNP graduates must worktogether. The nursing professionneeds more doctoral-prepared lead-ers to collaborate on improvinghealth outcomes and strengtheninghealthcare systems, so this is a per-fect time for you to invest in yourfuture with a PhD or DNP.

Visit www.americannursetoday.com/?p=24994for a full list of references.

Deborah Lindell is associate professor and director ofthe Graduate Entry Nursing Program at Case WesternReserve University, Frances Payne Bolton School ofNursing in Cleveland, Ohio. Debra Hagler is clinicalprofessor and coordinator for the Scholarship ofTeaching and Learning in the College of Nursing &Health Innovation at Arizona State University inPhoenix. Kathleen Poindexter is director of the CNSAdult/Gerontology & Education Concentration atMichigan State University, College of Nursing in EastLansing.

Selected references American Association of Colleges of Nursing.AACN position statement on the practicedoctorate in nursing. October 2004. www

.aacn.nche.edu/publications/position/DNPpositionstatement.pdf

American Association of Colleges of Nursing.Fact sheet: The doctor of nursing practice(DNP). April 2016. www.aacn.nche.edu/media-relations/fact-sheets/DNPFactSheet.pdf

American Association of Colleges of NursingTask Force on Implementation of the DNP.The doctor of nursing practice: Current issuesand clarifying recommendations. August2015. www.aacn.nche.edu/aacn-publications/white-papers/DNP-Implementation-TF-Report-8-15.pdf

American Nurses Association. Position state-ment: The doctor of nursing practice: Ad-vancing the nursing profession. April 20,2011. www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/The-Doctor-of-Nursing-Practice-Advancing-the-Nursing-Profession.html

Bednash G, Breslin ET, Kirschling JM, et al.PhD or DNP: Planning for doctoral nursingeducation. Nurs Sci Q. 2014;27(4):296-301.

Dreifuerst KT, McNelis AM, Weaver MT, et al.Exploring the pursuit of doctoral educationby nurses seeking or intending to stay in fac-ulty roles. J Prof Nurs. 2016;32(3):202-12.

Fang D. Preliminary results of AACN doctor-al student roster survey, 2016. www.aacn.nche.edu/Downloads/IDS/AACNRoster2016.pdf

Mazurek Melnyk BM. The doctor of nursingpractice degree = evidence-based practiceexpert. Worldviews Evid Based Nurs. 2016;13(3):183-4.

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To ensure you choose the right program to meet your professional goals, ask your-self the following questions.• What specializations or areas of study are available?• What areas of expertise do the program faculty represent?• What academic resources support student success? • What types of financial support and scholarships are available?• What’s the typical program length for full- or part-time study?• What’s the program completion rate?• Where are previous graduates employed?• What’s the program format (traditional on-site, executive course, web-based)? • Is the program full-time or part-time?

If you are considering becoming an advanced practice registered nurse (APRN), also ask:• Are graduates eligible to apply for certification? • Does the specialty require a master of science in nursing (MSN) degree or doctor

of nursing practice (DNP)? If DNP, by what date? • What’s the degree requirement of the state in which you plan to practice? • What are potential employers’ degree requirements?

If your career goal is to be a nurse educator, also ask:• What are your potential academic employers’ degree requirements?

The right questions lead to the right degree

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By the numbers: Your pathto an advanced degree

Agraduate degree in nursing—whether it’s a master of science in nursing (MSN), doctorof nursing practice (DNP), or doctor of philosophy (PhD) in nursing—can open newhorizons for your career. And, with the trend towards more education, having that

advanced degree will help make you more marketable and may boost your earnings.

6 tips to graduate schoolsuccess:

1 Find a mentor.

2 Tap into your support system athome.

3 Don’t overbook yourself.

4 Participate in class.

5 Pay attention to your health: eat well, get enough sleep, andexercise.

6 Find friends to cheer you on.

You have many options forgraduate degree programsin the United States*.

289DNP programs

50states (plus District of Columbia,Guam, Puerto Rico, and the VirginIslands) with DNP programs

133PhD programs

214RN-to-MSN programs

*Source: American Association of Colleges of Nursing. 2015 data.