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Overview of doctoral education in nursing in an international context
Doctoral Education in Nursing
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
OVERVIEW
1) Canadian Scene
2) International Context
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Snapshot of the Current Canadian Situation
Sources
1) CASN/CN A Student & Faculty Survey (2007-2008)
2) Preliminary data Doctoral Forum Environmental Scan (2010)
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Annual Student and Faculty Survey
Purpose: to support health human resource planning
Data include:
Admissions & graduates of doctoral programs, program delivery modalities, faculty qualifications
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Doctoral Forum Environmental Scan2010
Purpose: to help inform the development of a Canadian vision for doctoral education in nursing
Data includeProcesses, delivery modalities, success factors
and challenges
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Student & Faculty Survey2007-2008
• 88 of 90 CASN members responded.
• 13 schools had PhD programs
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Number of Doctoral Programs
• 11.0% of schools (13 schools) offered PhD programs.
Doctoral
Dalhousie University √
McGill University √
Université Laval √
Université de Montréal √
Université de Sherbrooke √
McMaster University √
University of Ottawa / Université d’Ottawa √
University of Toronto √
University of Western Ontario √
University of Alberta √
University of Calgary √
University of British Columbia √
University of Victoria √
Canada Total 13
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Admissions2007-2008
• Admissions to doctoral programs increased 5.1%
Number of Admissions
0
150
300
450
600
750
900
Master’s 758 850 866 946 977
Doctoral 65 76 78 78 82
'03-'04 '04-'05 '05-'06 '06-'07 '07-'08
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Number of Doctoral Programs 2010
• 15 schools offer PhD programs.
Doctoral
Dalhousie University √
McGill University √
Universiié Laval √
Université de Montréal √
Université de Sherbrooke √
McMaster University √
University of Ottawa / Universite d’Ottawa √
University of Toronto
Queens University√
University of Western Ontario √
University of Saskatchewan
University of Alberta√
University of Calgary √
University of British Columbia √
University of Victoria √√
Canada Total 15
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Doctoral Forum Environmental Scan2010
6 CASN members with a PhD program have responded (40%)
• 3 established 10 yrs ago or more,
• 1 established 1-2 years ago,
• 1 established 2-4 years ago,
• 1 established 4-6 years ago.
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Enrollments
• Total in the six doctoral programs is 184
(In 2007-2008 student & faculty enrolment in doctoral programs was 380)
Program Completion• Average length of time to completion estimated
was 3 to 5 yrs (but 2 programs too recent to compute this)
[1]
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Practice Academic OtherMost Some Few Most Some Few Most Some Few
0 4 1 5 1 0 0 0 1
The 6 respondent schools
• identified the majority of their doctoral students as
planning on a career in Academia
• some students were identified as planning on a career
path in the practice setting.
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Delivery Models Used (check all applicable):
Interdisciplinary
Fast trackin
gDistant
deliveredResidency
basedCollabora
tiveOthe
rY N Y Y N N
N Y N Y N
full-time enrolment only
N N N Y N NN Y N Y N NY Y N Y N NY N N Y N N
3 3 1 6 1 1
• All 6 have a residency based program.
• 3 provide an interdisciplinary delivery program.
• 3 offer a fast track option
• 1 offers distance delivery
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Program Strengths Identified•Quality of faculty •Diversity of options for learners/tailoring to learner needs•Fast track option from Masters to PhD•Small classes/Seminars/Small groups•Residency based/engagement with faculty and peers
Program Challenges Identified•Intensive demand for resources (faculty, library, staff)•Limited scholarships to offer•Applicants would increase if distance and part time options were available•Students continue to work while enrolled in full-time studies.
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Admission Process Success FactorsAdmission deadline moved earlier to increase timeline of
offersStreamlined admission ratings to focus on priority indicators Students identify a supervisor in advance of admissionApplicants matched to supervisor before admissionStraightforward admission processPiloting admissions in September and January Careful screening of applicants to ensure they are a good fit.Will consider late applications if there is space
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Admission Process IssuesCoordinating admission process with SGS Rating procedure and training of admission ratersLocating suitable supervisor for students unfamiliar with program No standard approach among faculty in deciding to take studentNeed for sufficient faculty with a broad range of interestsStudents don’t apply for external funding to support thesisAssisting students to find suitable supervisorsEnsuring applicants who will be successful are selected Admission deferrals
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Comprehensive Exams
All six programs require both a written and an oral exam:
Between 12–18 months in the program – must be completed by 24 months After completing all course work - usually 10-16 months after commencing the programIn the summer or fall term after two terms of course work Up to 28 months from commencement of programWhen the student’s proposal is ready for defenseAfter all coursework and before the proposal defense
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Number of students per supervisor
3 (but faculty with a training national Chair had 5-
6)No more than 6 Less than 3 (including master theses)3 to 44Faculty limit number to 5
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Supervision Success FactorsStudents secure faculty agreement for supervision beforeapplying Good fit between student and supervisor research interests, Campus educational resources for junior faculty developsupervisory skills Mentoring of junior faculty by senior faculty sit (eg sit oncommittee)Traditional approach to supervisionResearch development seminars/ forums for faculty &students on topic related to successful research Proposal defense must occur by the end of year 3 Co-supervision if one or more are new to PhD supervision
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
INTERNATIONAL CONTEXT
Global synopsis
Evolution in U.S.A
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
273 doctoral programs in 31 countries in 2003
• USA (30%)
• UK (19%)
• Australia (6%)
• Canada & Korea (both 4%)
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
International Network for Doctoral Education in Nursing (INDEN)
• Created in 1995
• Non incorporated group of Nurse educators
• Met first in 1997 in Vancouver
• Currently list doctoral programs in nursing in 34 countries (417 programs)
• Identify great variation in doctoral education
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Countries with Doctoral Programs in Nursing (INDEN)
Argentina Finland Namibia Switzerland
Australia Germany Netherlands Taiwan
Belgium Greece N. Zealand Thailand
Brazil Hong Kong Nigeria Turkey
Canada India Norway U.K
Chile Ireland Philippines U.S.A
Columbia Japan Poland Venezuela
Czech Rep Korea South Africa
Egypt Mexico Sweden
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
PhD most common nursing doctoral degree
Element shared internationally -
PhD requires work that is:• independent • sustained• rigorous• original• cutting edge Kirkman et al. (2007). Nurse Education in Practice, 7 (3), 150-156
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Ketefian et al. (2005) Nursing & Health Science, 7(3), 150-156
Non research focused
• Professional or practice
Research focused
• Pan American Model• European Model
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Kirkman et al. (2007). Nurse Education in Practice, 7 (3), 150-156
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
AACN in the USADNP
• Prepares nurses at highest level of practice
• Faculty have high level of expertise in area of practice
• Content - AACN essentials
PhD/DNS/DNSc
• Prepares nurse researcher
• Faculty have a program of research
• Content - theory, research methodology
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
DNP in the USA• Oct 2004 strong majority of AACN member
Schools supported a Position Statement on DNP• Entry level for ARNP by 2015 was endorsed• 2 Task Forces created
– DNP essentials; – DNP Roadmap• Currently 72% schools with ARNP programs offering
DNP (120) or planning to (161)
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
DNP Essentials• Scientific underpinnings for practice• Organizational & systems leadership for quality
improvement & systems thinking• Clinical scholarship & analytical methods for evidence-
based practice• Information systems/technology • Health care policy for advocacy in health care• Interprofessional collaboration for improving outcomes• Clinical prevention & population health• Advanced nursing practice
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Hybrid Models
• Combine specialized professional practice component with a clinical dissertation
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TEST TITLE
Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Arguments for DNP
• Need for greater scientific knowledge (complexity)
• Rapidly expanding knowledge base
• Parity with other disciplines
• Increased remuneration• Will increase doctorally
prepared nurses
Critiques of DNP Position
• Evidence that Master’s prepared NP perform very well
• Length of training will result in professional shortage
• Will outprice their effectiveness
• Effect on PhD enrollments
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
United States
• Drexel University Model DrNP • initiated 2005• modeled after the DrPH (Doctor of Public Health)
and the PsyD (Psychology Doctorate) degrees, but it is an academic doctorate (similar to the PhD) in that a clinical dissertation is required.
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Australia University of Queensland Defines the Professional
(Practice) Doctorate as:• coursework programs which allow experienced professionals
to return to study to improve their professional practice through the application of research to current problems and issues. This qualification combines coursework and research, with a component of not less than 33% and not more than 66% research. The doctoral research should make a significant contribution to the knowledge and practice of the profession.
• (http://www.uq.edu.au/international/? page=978&pid-978&ntemplate=415 – retrieved May 17, 2010)
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Summary
• 15 PhD programs in Canada (“taught course - research” or “Pan American model”)
• Internationally, the PhD is the most common doctoral type but a myriad of non PhD programs exist
• Non PhD programs fall on a continuum regarding research required, and degree of practice specialization
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Invest in nursing faculty supply and nursing program infrastructure Foster innovative initiatives to sustain an appropriately prepared nursing workforce
Invest in nursing research and knowledge translation
Conclusion
Key challenges facing doctoral education in nursing
1) How do we enhance the development and advancement of nursing knowledge?
2) Should we bridge nursing practice and nursing research through doctoral education?