Recently I had a communication with a valued and seasoned colleague about the development of doctor of nursing practice programs. Her input triggered a thought that I believe is one of the underpinnings of success in DNP education and practice. The thrust of the communication was to think like a regulator when developing a program, rather than as an advocate for the DNP degree.
Is curriculum development a process that is exclusive of advocacy? Some may believe it to be, which brings to mind the question of the foundation for DNP education. The goal of the DNP degree is to produce terminally-prepared professionals who can impact outcomes. That seems simple enough, but the path to achieving it is complex and varies among institutions. Structures are in place to assure quality at many levels.
Regulation vs. Advocacy
Are advocacy for DNP growth and development and the regulation of education mutually exclusive? Are these two efforts complementary and mutually supportive? I have been part of several university DNP programs, both in development and implementation as faculty. Amazing displays of brilliance take place in all educational institutions as supported by the structure and delivery of curricula-not to mention the gifted faculty.
To a large degree, the success of a program must be attributed to the regulator and accrediting bodies requiring the educational institution to demonstrate an expected level of quality and self-evaluation. The question that cannot be answered precisely is how regulation is improving practice. Is the work of the regulatory organization assuring quality of practice, or is it assuring a consistency that addresses the lowest common denominator of curricular expectations?
These questions may not interest DNP graduates involved in practice; they are no longer dependent on or interacting in the world of academia. The number of DNP graduates in practice outside of academia is growing every day. Still, discussion of academic preparation is firmly on the radar for our profession and those who struggle with best practices to assure that high-level, quality professionals graduate from their programs.
Are we as a discipline focusing on post-graduation practice that improves outcomes? Are outcomes and practice the topics of the day, or is academic process still the main topic for all stakeholders? I believe that academia is the topic today and practice has not yet received an adequate opportunity to grow. However, this is changing as we mature and demonstrate our contributions and collaborations to improve healthcare outcomes.
Focus on the Future
These machinations and abstractions about how our discipline is growing can be discussed for many years to come. I hope we are keeping an eye on the future of DNP practice with the expectation that we have a strong cadre of terminally prepared colleagues who can work together to address urgent and pending issues.
This is not a process that is exclusive to the DNP-prepared professional. In isolation, this degree is of little value. However, with a concerted and strategic partnership with others in the nursing profession, we can work together to produce better outcomes. I am referring to PhD-prepared colleagues. This slice of doctorally prepared nurses is working primarily in academia. The DNP-prepared professional is well-positioned in both academia and the practice environment. We have a great opportunity to collectively address the needs of patients, patient populations and delivery systems to improve practice outcomes.
Not Mutually Exclusive
Revisiting the idea of regulation vs. advocacy, I do not see them as exclusive of one another. Yet the folks who regulate may benefit from a demonstration of accomplishments of the DNP graduate. We all serve our patients to improve health outcomes, and the charge of regulators is to assure preparation of professionals with the skills and knowledge to assure change.
Are DNP-prepared professionals on the boards of these regulatory bodies? When DNP degree curricula are being developed or refined by universities, are the voices and expertise of DNP-prepared professionals part of the review in order to assure a trajectory that improves practice? I hope that academics are not developing programs merely to satisfy the current expectations of these regulatory agencies, but instead are involving professionals with the degree who can address substantive changes in program development. This is a part of our work and an essential part of our discipline. We must embrace the challenge.
David G. Campbell-O'Dell is the director and president of Doctors of Nursing Practice, Inc: www.DoctorsofNursingPractice.org