Focus on…Education

PhD or DNP? Defining the path to your career destination

Have you been toying with the idea of earning a doctoral degree in nursing? Maybe you want to pursue a career in research, teaching, or advanced practice and you know that another degree can help you achieve those goals. You may, however, not know whether you should go for a doctor of philosophy (PhD) in nursing or a doctor of nursing practice (DNP). A little research into both may help point you in the right direction. This article provides a brief history of doctoral education in nursing and compares key aspects of PhD and DNP degrees.

Looking back

Over the past 70 years, nursing has made impressive progress as a discipline as well as a profession. Nurses began to earn research-focused PhD degrees in the 1960s, typically in fields like education or sociology, which led to the early development of nursing theory and research. In the 1970s, the growing demand by nurses for a nursing-specific PhD led many universities to develop PhD in nursing programs.

Later in that decade, nurse scholars identified the need for a second nursing doctoral degree similar to practice-focused degrees in other disciplines. This led to the development of degrees such as the doctor of nursing science (DNS) and doctor of nursing (ND) degrees. In 2004, the members of the American Association of Colleges of Nursing (AACN) recommended that to clarify degree options, the DNP should be the degree associated with practice (“practice doctorate”). They also recommended transitioning to doctorate- level preparation for advanced nursing practice by 2015.

Doctoral education today

In the United States, the nursing profession generally recognizes two doctoral degrees: PhD in nursing and DNP. In 2010, the Institute of Medicine called for “a greater pool of nurses prepared to assume faculty and research positions” and recommended “doubling the number of nurses with a doctorate by 2020.” However, the proportion of nurses with doctoral degrees remains less than 0.5%. As of 2015, the AACN reported that 322 institutions offered nursing doctoral programs in the United States. Some institutions offer both PhD and DNP programs, while a few offer a dual PhD/DNP. (See Nursing doctoral degrees: how do they compare?)

PhD in nursing

If you choose the research-focused PhD degree, you’ll graduate prepared to build nursing knowledge by generating new evidence through research and helping to meet the growing demand for nurse scientists and faculty. Continued evolution of the nursing profession depends on nurses who develop the science, steward the profession, and educate new nurse researchers.

In the past, most PhD in nursing programs required full-time study, but now many offer part-time options. In 2016, nursing program administrators reported that 43% of the 3,108 students in PhD programs attended part-time. The various PhD programs offer multiple entry points and formats, with all graduates completing research for a dissertation.


The DNP

If your goal is to achieve the highest level of education for nursing practice, then a DNP program may be the way to go. According to the AACN (2006), the DNP degree prepares “experts in specialized advanced nursing practice…that is innovative and evidence-based, reflecting the application of credible research findings.” With a DNP, you can lead system-level change to improve health outcomes.

Although the AACN’s initial 2015 goal of doctoral-level entry to advanced practice has been delayed, the DNP initiative has stimulated discussion and action within nursing practice and education. Support of the DNP by professional organizations varies. For example, three organizations (American Nurses Association, American Association of Nurse Executives, and American College of Nurse Midwives) view it as one education option for advanced practice. Others (National Organization of Nurse Practitioner Faculties, National Association of Clinical Nurse Specialists [NACNS], Council on Accreditation of Nurse Anesthesia Educational Programs [COA]) require a doctoral degree for advanced practice. The NACNS and COA have established target dates for requiring new clinicians in their specialty to have a doctoral degree.

You can pursue a DNP through a variety of formats. All DNP graduates complete a specified amount of practicum as well as a practice-based project.

Selecting the right program

Choosing between the PhD and DNP can be challenging. In fact, some graduates of nursing doctoral programs are unable to distinguish the roles of nurses with different degrees. In a study by Dreifuerst et al (2016), 22% of nursing PhD graduates reported they began doctoral study intending to become clinicians, while 13% of DNP graduates said they began their programs intending to become researchers.

Consider these three factors when choosing your doctoral program

• fit with your career goals

• format of the academic program

• balance between costs and available funding support.

Bednash suggests that “the fundamental question is whether the nurse wants to develop the knowledge and skills to generate new science in an area of interest or whether the nurse wants to take existing knowledge and use it to shape nursing practice and healthcare.” (See The right questions lead to the right degree. )

While studying for a doctoral degree can be a rewarding experience, be prepared for the challenges you’re likely to encounter. A study of DNP students and graduates found that success depends on support from family, peer students, friends, and employers; lifestyle changes, such as making work or school part-time  rather than both full-time; and perseverance.

Making the investment

Regardless of which path you choose for your doctoral degree, PhD and DNP graduates must work together. The nursing profession needs more doctoral-prepared leaders to collaborate on improving health outcomes and strengthening healthcare systems, so this is a perfect time for you to invest in your future with a PhD or DNP.

Deborah Lindell is associate professor and director of the Graduate Entry Nursing Program at Case Western Reserve University, Frances Payne Bolton School of Nursing in Cleveland, Ohio. Debra Hagler is clinical professor and coordinator for the Scholarship of Teaching and Learning in the College of Nursing & Health Innovation at Arizona State University in Phoenix. Kathleen Poindexter is director of the CNS Adult/Gerontology & Education Concentration at Michigan State University, College of Nursing in East Lansing.

Selected references

American Association of Colleges of Nursing. AACN position statement on the practice doctorate in nursing. October 2004.

American Association of Colleges of Nursing. Fact sheet: The doctor of nursing practice (DNP). April 2016.

American Association of Colleges of Nursing Task Force on Implementation of the DNP. The doctor of nursing practice: Current issues and clarifying recommendations. August 2015.

American Nurses Association. Position statement: The doctor of nursing practice: Advancing the nursing profession. April 20, 2011.

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

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

Fang D. Preliminary results of AACN doctoral student roster survey, 2016.

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

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