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Briana Pierre

Prof. Leslie Wolcott

ENC 1102

18 March 2015

Annotated Bibliography

The broad-range of nursing is a continuously evolving profession in which innovations

are constantly brought into play in order to accommodate the increasingly complex healthcare

system. In this dynamic field, it is prevalent for nurse educators to analyze and modify education

curriculum, proposals, and programs that is vital to new and current practicing nurses. With

regard to advanced practicing nurses (APN) who are nurses who have at least have obtained a

master’s degree in nursing, recent studies have put an emphasizes on a new innovation related to

the credentials of advanced nursing practice. This innovation which has sparked a decade-long

conversation brought to attention by the American Association of Colleges of Nursing (AACN)

when it adopted a proposal to move the education and required credentials of APN’s from the

master’s degree to the doctoral level by the year 2015.

To further understand the driving force behind the AACN’s position on the potential

implementation on a required doctoral degree for current and future APN’s, this annotated

bibliography attempts to address both negative and positive viewpoints on this controversial

debate on the proposed doctoral level education requirement to pursue a career in advanced

practice nursing. The list of sources below provides many different perspective on this long-

lasting matter and is formulated from scholarly/academic journals. This issue sparks an interest

to future nurses, current advanced practicing nurses, nursing education programs, and the overall

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doctoral education program in general because this debatable subject has direct effects, whether

positive or negative on those who are most involved and no not pertain to those who do not wish

to purse or have an interest in the nursing profession. The professions of the contributing authors

to the academic journals in this field ranged from nurses who have gained credentials beyond the

post-graduate level in nursing to researchers who are experts in nursing informatics.

In this annotated bibliography, researchers, current and future advanced practice nursing

students, nurse education programs, and nurse educators will be made knowledgeable of the new

innovations that has the nursing community buzzing and the effects it has on the growing health

care industry.

Apold, S. (2008). The doctor of nursing practice: looking back, moving forward. Journal For

Nurse Practitioners, 4(2), 101-108.  

In this scholarly journal article, Susan Apold, vice president of academic affairs and dean

of faculty at College of Mount Saint Vincent in Bronx, NY and also the immediate past

president of the American College of Nurse Practitioners seeks to discuss the long-lasting

conversation and conclusion on the adaptation of the doctor of nursing practice as the

required credential for the advanced nursing practice profession. This article unfolds the

origin behind doctoral education, provides an explanation of the challenges and beneficial

aspects of a new doctoral degree for the advanced practice nursing education, and lastly,

suggest ways on moving forward in relation to the growing healthcare system. Opponents

of the potential DNP practice credential argue that if this new requirement is in-fact

implemented, it may prevent nursing faculty from having tenure which will enable them

from “participating in policy issues, decision-making on the college/university level,

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budget distributions, and other inquires that focuses on the overall growth, development,

and actually sustainability of nursing as a discipline in higher education.” Contrary to the

challenges this new development may face, there are also some advantages to this process

in which researchers argue that the DNP practice degree may increase knowledge to

improve the practice of nursing, leadership roles, and develop improvements in patient-

outcomes.

Boland, B., Treston, J., & O'Sullivan, A. (2010). Climb to new educational heights. Nurse

Practitioner, 35(4), 36-41.

In this scholarly article, the authors who all have the necessary post-master’s level

credentials in nursing seek to explain the dynamics of the doctoral level of advanced

nursing practices and informs future nurses who wish to practice in this particular level

on what to look for and what to be aware of when pursing the complexity of the doctoral

education program. The authors discuss potential of this innovation and argue that this

proposal can significantly influence the evolution of advanced nursing practice and has

an impact on current and future nurse practitioners. Much like most of the sources listed,

this article explains the informatics behind the doctoral program and analyzes the

implications it will have to undermine in the future. In the article, the author informs

those that hope to pursue this potential innovation of the essentials of the doctoral

education in advanced nursing practice. Emphasize is placed on examples of DNP

programs in the U.S. and what the institutions main focus and objectives

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Brar, K., Boschma, G., & McCuaig, F. (2010). The development of nurse practitioner

preparation beyond the master's level: what is the debate about?. International Journal

Of Nursing Education Scholarship, 7(1), 15P.

The authors in this scholarly journal article who are all experts in the nursing profession

explains the overview of the DNP in the U.S. makes a comparison to the way it has a

direct influence on the DNP program in Canada. In both countries, Brar et al. establishes

that the driving need for the DNP program correlates to the shortage of nurses educated at

the doctoral level and argues that the program can bridge gap in knowledge between the

master’s degree level and the PhD program. If this gap is not filled, researchers believe

that this can hinder the quality development of patient care. The debate in this article

focuses on using the doctoral program as an alternative to the PhD program in the states

and whether or not Canada should follow behind. The authors compare and contrast

between the DNP and the PhD in nursing. The PhD in nursing focuses on the research

and education aspect of nursing whereas the DNP concentrate more on the clinical

practices or clinical teachings. A major similarity between the two, the authors argues,

are that both programs is that both utilize content from research methods.

Chase, S., & Pruitt, R. (2006). The practice doctorate: innovation or disruption?. Journal Of

Nursing Education, 45(5), 155-161. 

The authors, Dr. Susan Chase who is an interim Assistant Dean for Doctoral Programs

and Associate Professor, Christine E. Lynn College of Nursing at Florida Atlantic

University and Dr. Rosanne Pruitt who is a Professor and Director at Clemson University

School of Nursing in Clemson, South Carolina describes the preparation of advanced

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nursing practice with a Doctor of Nursing Practice (DNP) degree as a “disruptive

innovation.” This scholarly article main objectives focuses entirely on the future

difficulties of this innovation in regards to future students, current practicing advanced

nurses, nursing colleges, and the overall education of a doctoral degree as a unit. The

American Association of College of Nursing (AACN) has proposed by the year 2015 that

all advanced practicing nurses be required to obtain a DNP degree as a credential,

however, the researchers in this article has set their own recommendations and opinions

in which they have proposed that the AACN entirely eliminate the 2015 deadline for the

innovation of a doctoral prepared nursing practice.

Chism, L. (2009). Toward clarification of the doctor of nursing practice degree. Advanced

Emergency Nursing Journal, 31(4), 287-297.

The author of this academic journal, Lisa Chiasm who is a DNP, APRN,BC, at the

Karmanos Cancer Institute in Michigan, much like the sources listed provides an

overview of the history of the doctoral education in nursing and sets out to inform those

interesting in the field on the competencies of the DNP in nursing. As in the article by

Brar et al., Chiasm addresses the confusion between the DNP and PhD programs and

distinguishes the two. The author explains the role DNP graduates play in regard to

emergency nursing settings which includes research and leadership.

Dracup, K., Cronenwett, L., Meleis, A., & Benner, P. (2005). Reflections on the doctorate of

nursing practice. Nursing Outlook, 53(4), 177-182.

Kathleen Dracup is a Professor and Dean at the School of Nursing,

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University of California, San Francisco, San Francisco, CA; Linda Cronenwett is a

Professor and Dean at the School of Nursing, University of North Carolina at Chapel

Hill, Chapel Hill, NC.; Afaf I. Meleis is a Professor and Margaret Bond Simon Dean at

the School of Nursing, University of Pennsylvania, Philadelphia, PA.; Patricia E.

Benneris a Professor and Thelma Shobe Endowed Chair in Ethics and Spirituality at the

University of California, San Francisco, San Francisco, CA. all seek address what they

believe are the potential consequences of adopting a practice doctorate within the

nursing profession in which they argue might be negative for the nursing profession, for

healthcare, and for society as a whole. The practice doctorate, in their professional

opinions threatens the number of nurses prepared at the PhD level and changes the

nature of university-based faculties of nursing.

Draye, M., Acker, M., & Zimmer, P. (2006). The practice doctorate in nursing: approaches to

transform nurse practitioner education and practice. Nursing Outlook, 54(3), 123-129.

Mary Ann Draye is an Assistant Professor, Director of the Family Nurse Practitioner

Program, at the University of Washington School of Nursing, Seattle, WA.; Michele

Ackeris a Senior Lecturer, Director of the Pediatric Nurse Practitioner Program at the

University of Washington School of Nursing, Seattle, WA.; Phyllis Arn Zimmer is a

Lecturer, Family Nurse Practitioner Program at the University of Washington School of

Nursing, Seattle, WA. All 3 authors of this scholarly journal article touches on how

turmoil in the healthcare system present renewed challenges to nursing. The authors

argue that these challenges may be good for the healthcare system in which gives the

opportunity to increase nursing’s capacity to provide leadership toward improving the

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health status of the nation through the innovation practice doctorate. The authors also

provide suggestions on how the AACN can go by implementing this innovation, for

example, curricula need to be carefully crafted, and that education and practice play

hand-in-hand in identifying the practice doctorate as the way to accomplish these goals.

Fain, J., Asselin, M., & McCurry, M. (2008). The DNP... why now?. Nursing Management,

39(7), 34-37.

At the University of Massachusetts Dartmouth, College of Nursing, James A. Fainis dean

and professor, and Marilyn Asselin and Mary McCurryare assistant professors all have

the necessary credential and are expertise in this field argues that the staffing shortage for

healthcare professionals is well recognized and the need will continue to grow for

advanced practice nurses. The authors describes the roles and responsibilities of DNP

nurses, the main purpose as to why the program is implemented, and discusses the need

for requirement of the DNP as the established credential. They also explain the

educational preparation behind the program.

Fulton, J., & Lyon, B. (2005). The need for some sense making: doctor of nursing practice.

Online Journal Of Issues In Nursing, 10(3).

In this article based on the issues that surround the doctorate-level of nursing practice,

Fulton & Lyon who are Doctors in Nurse Practice (DNP) attempt to ascertain whether the

on-going proposal of implementing a practice doctorates would pose an arising concern

for the method of nurse practice. With an interest in the educational and economic effects

on students and employers as well as its significance on the overall focus of the practice

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doctorate, the authors summarizes and reflects on the problematic implementation of the

practice of doctorate in nursing and proposes a more thorough debate involving all parties

before progressing further with this degree.

This is especially important in my discussion of including a doctorate degree in the

advancing roles of nurse practitioners because this article contributes to the on-going

debate of implementing such degree and seeks to emphasize the negative effects it has on

the ever-changing phenomenon of the healthcare system.

 Hathaway, D., Jacob, S., Stegbauer, C., Thompson, C., & Graff, C. (2006). The practice

doctorate: perspectives of early adopters. Journal Of Nursing Education, 45(12), 487-

496.  

Dr. Hathaway is Dean, Dr. Jacob is Executive Associate Dean, Dr. Stegbauer is Associate

Dean, Dr. Thompson is Professor of Acute and Chronic Care, and Dr. Graff is Assistant

Professor of Primary and Public Health and Chief of Nursing at the Boling Center for

Developmental Disabilities, College of Nursing, University of Tennessee Health Science

Center, Memphis, Tennessee. The emergence of the Doctor of Nursing Practice (DNP)

degree is being described as a “disruptive innovation” as mentioned in another source

that is altering the landscape of nursing and health care and creating a great deal of

controversy within and beyond the profession of nursing. This article proposes that the

DNP is not start of a recent controversy and that innovation begun in the late 1960s with

the advent of nurse practitioner programs. As expected with disruptive innovations, many

challenges face those who are early adopters and who forge ahead during the early phase

of innovation. As faculty and administrators of one of the early, second-generation DNP

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programs, the authors are fully aware of ongoing discussion and issues related to the

practice doctorate. This article shares the experiences of this group of early adopters and

their insights into controversies surrounding the DNP movement

Kaplan, L., & Brown, M. (2009). Doctor of nursing practice program evaluation and beyond:

capturing the profession's transition to the DNP. Nursing Education Perspectives, 30(6),

362-366.

Lenz, E. (2005). The Practice Doctorate in Nursing: an idea whose time has come. Online

Journal Of Issues In Nursing, 10(3)

In this article the practice and educational trends that led to the resurgence of interest in

the practice doctorate in nursing were reviewed. The characteristics of existing practice

doctoral programs and differences between practice and research-focused programs were

explicated. Potential benefits of the degree for health care and for nursing education were

detailed. Several of the issues that were taken into account in the development of the

AACN position paper on the practice doctorate were described. These included the scope

of the degree, the recommendations regarding a core curricular structure and content

areas for inclusion, and the controversial decision to recommend that the DNP be

established as the degree for advanced nursing practice. If the excitement, interest and the

number of institutions moving forward to develop DNP programs are valid indicators,

then truly the practice-focused doctorate in nursing is an idea in which they argue, whose

time has arrived.

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Mundinger, M., Cook, S., Lenz, E., Piacentini, K., Auerhahn, C., & Smith, J. (2000). Assuring

quality and access in advanced practice nursing: a challenge to nurse educators. Journal

Of Professional Nursing, 16(6), 322-329.

Primary care providers and a public seeking higher quality, cost-effective care, advanced

practice nurses will be measured not only by their comparative value in delivering

conventional primary care, but also by the uniqueness of their contributions to health

outcomes. These value-added skills, distinctive to nursing practice at all levels, include

health education, disease prevention, health promotion, community resource access, and

partnerships with patients. Government, private payors, and national and state regulators

all authorize increasingly independent practice by advanced practice nurses. When

advanced practice nurses assume such fully accountable primary care roles, their title and

certification should be distinctive to that level of practice. They argue that A Doctor of

Nursing Practice (DNP) degree would signal to the public that nurses at their highest

practice competence are at the same level as other health professionals holding

doctorates.

O'Sullivan, A., Carter, M., Marion, L., Pohl, J., & Werner, K. (2005). Moving forward together:

the practice doctorate in nursing. Online Journal Of Issues In Nursing, 10(3). 

In this article, the authors who are all experts in this field and who have obtained an PhD

in nursing shifts the focus of deciding if establishing the practice of a doctorate degree

would have an negative or positive outlook on the dynamics of nursing, but rather takes

an innovative approach that seeks to ensure the quality of nursing educational programs

as a whole. The author’s put an emphasis on the changing educational system for nurses

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that will accommodate the movement of an advanced and diverse healthcare system and

that will facilitate a more in-depth scope of practice for nurse practitioners. Nurse

practitioner primary objective focused on prevention of diseases and delivering quality

healthcare to a wide-range of people, but researchers are trying to slightly change this

aspect to include informatics, more knowledge, leadership, and a business outlook on the

demanding healthcare system as a unit. Integrating this newly implementation of a

doctorate degree and determining how to propel this phenomenon forward into

educational programs are what researchers are trying to establish as well.

This article is especially significant in my discussion of an implementation of a doctorate

degree into the practice of nurse practitioners because it shifts the focus of figuring out an

answer to the debate of whether or not this aspect holds a negative or positive effect on

the future of nurse practitioners, but researchers instead are far more interested in

determining ways to include the practice doctorate into the quality of nursing educational

programs as well as look for ways in which these programs can move along with the

continuously and growing dynamics of the healthcare system.

Sperhac, A., & Clinton, P. (2008). Doctorate of nursing practice: blueprint for excellence.

Journal Of Pediatric Healthcare, 22(3), 146-151.

The DNP curriculum contains content on leadership, management, and other topics that

are needed to address some of the issues in the health care system that are not typically

included in most master of science in nursing curricula, as well as additional essential

content and nurse practitioner competencies. As pediatric nurse practitioners and other

advanced practice nurses go forward in their careers, the DNP may have an impact on

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their role. In this article, the authors provide a background of the DNP movement,

changes in advanced practice nursing education, and the concerns of currently practicing

pediatric nurse practitioners prepared at the master's level will be addressed.

Swanson, M. L., & Stanton, M. P. (2013). Chief Nursing Officers' Perceptions of the Doctorate

of Nursing Practice Degree. Nursing Forum, 48(1), 35-44.

Wall, B., Novak, J., & Wilkerson, S. (2005). Doctor of Nursing Practice program development:

reengineering health care. Journal Of Nursing Education, 44(9), 396-403.

Dr. Wall is Assistant Professor and Interim Director of Graduate Studies in Nursing; Dr.

Novak is Professor, Associate Dean of the College of Pharmacy, Nursing, and Health

Sciences, and Head of the School of Nursing; and Dr. Wilkerson is Associate Professor

and Director of Doctoral Program Development, Purdue University School of Nursing,

West Lafayette, Indiana. They discuss in this article, the developmental process of a

Doctor of Nursing Practice (DNP) program that uses resources to create unique DNP

curriculum opportunities. Other schools may benefit from this experience in the

development of their own DNP programs. The program delivers an innovative curriculum

frompostbaccalaureate to doctorate, emphasizing health care engineering and

interdisciplinary collaboration among faculty, hospitals, community leaders, and

policymakers. policy residency, and cognate residencies in an area of specialization. The

seven core competencies recommended by the American Association of Colleges of

Nursing are incorporated into the curriculum.

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Webber, P. (2008). The Doctor of Nursing Practice degree and research: are we making an

epistemological mistake?. Journal Of Nursing Education, 47(10), 466-472.

Dr. Webber is Professor, Nursing, Shenandoah University, Winchester, Virginia d

discussion in the literature about whether Doctor of Nursing Practice (DNP) curricula

should prepare students to be principle investigators of research or whether this skill

should be left to other doctorally prepared nurses. Currently, nurse practitioners have to

rely on medical research to support their practice due to a lack of research and

researchers. Consequently, these practitioners run the risk of adopting practice values of

medicine rather than those unique to this specialty. Despite this risk, several national

organizations have recommended that DNP programs not prepare graduates to be

principle investigators. This decision poses several levels of concern, including failure to

analyze the adequacy of our current approach to research, the mixed messages presented

in the position statements of these national organizations, and the effects of the looming

doctoral faculty shortage.