Although the doctor of nursing practice (DNP) degree is a generalist degree, many DNP programs are developing curricula with a specialist focus. The Essentials of Doctoral Education for Advanced Nursing Practice clearly guide curricula to include coursework on leadership, research methodology, evaluation and implementation of evidence-based practice, information technology, and population health.1 However, many graduate students entering a DNP program are looking to further develop their skills in specific areas.
The list of DNP programs is consistently updated to include all existing DNP programs around the country (http://www.aacn.nche.edu/dnp/DNPProgramList.htm).2 Prospective students will need to visit this list and research certain programs to find which include subspecialty preparation.
One example of subspecialization through a DNP program includes a focus on leadership. This may be described by DNP programs as "executive track" or "health systems leadership track." The coursework within a leadership focused track may provide more concentrated coursework to prepare DNP graduates for a leadership role such as systems management, marketing and finance. Florida State University has such a program, which is called the "health systems leadership" track.
After completion of a subspecialty track focused on leadership, a DNP graduate should be better prepared for a career in nursing or hospital administration. Given that the Essentials for Doctoral Education for Advanced Nursing Practice are designed to move a graduate toward leadership in nursing, this may be a good fit for many DNP students. Students who wish to move in an administrative or leadership direction would be prepared to do so especially with more preparation in systems management, finance and marketing. In the past, many nurses returned for an MBA to be better prepared to fulfill nursing leadership roles. Currently, with the development of the DNP degree and further development of DNP programs with leadership tracks, more nurses may feel that this type of degree will prepare them for roles in nursing leadership.
Another type of specialization within DNP programs includes a focus on education. The American Association of Colleges of Nursing (AACN) recommends that in order for DNP graduates to fulfill nursing faculty roles, additional preparation is necessary through pedagogical coursework.1 A DNP program with a focus in pedagogical preparation would better prepare DNP graduates to pursue roles as educators and help reduce the nursing faculty shortage. This type of preparation would also help to reduce the barriers that may still exist for DNP graduates seeking tenure-track positions in academia.
Of interest, Loyola University has also developed two additional subspecialties within their DNP program supported by grant funding through the Health Resources and Services Administration. One track is called "Healthcare Quality Using Education in Safety and Technology" and focuses on outcome performance management or healthcare informatics. DNP students interested in informatics or leadership roles focusing on quality and safety may pursue this type of DNP subspecialty track. The second track is called "Population-Based Infection Prevention & Environmental Safety" and focuses on prevention which is population focused. DNP students who wish to focus on population health and systems leadership and pursue roles such as infection preventionist would benefit from this subspecialty track.
Healthcare Technology Track
Additionally, DNP programs also offer information technology tracks that would provide additional preparation in this area. Information technology is becoming a sought-after specialty for nurses and per the Institute of Medicine, is a much needed skill set in today's healthcare environment.3-6
Although the DNP degree was originally conceptualized as a generalist degree, the needs of a changing healthcare environment require specialized skills in many different areas. Nurses are stepping up to the challenges and providing high-quality, patient-centered care directly and indirectly. Specialization in leadership, education, population health and information technology are much needed skills to achieve better patient outcomes for individuals and healthcare systems.
1. American Association of Colleges of Nursing. The essentials of doctoral education for advanced nursing practice. www.aacn.nche.edu/publications/position/DNPEssentials.pdf.
2. American Association of Colleges of Nursing. DNP program list. www.aacn.nche.edu/dnp/DNPProgramList.htm.
3. Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000.
4. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
5. Institute of Medicine. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press; 2003.
6. Institute of Medicine. The future of nursing: leading change, advancing health. Washington DC: National Academies Press; 2011. www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx.