In October 2004, the members of the American Association of Colleges of Nursing (AACN) endorsed the Position Statement on the Practice Doctorate in Nursing which called for moving the level of preparation necessary for advanced nursing practice roles from the master's degree to the doctorate level. The AACN position statement calls for educating advanced practice registered nurses (APRNs) and other nurses seeking top clinical positions in Doctor of Nursing Practice (DNP) programs. The following talking points were developed to help explain this evolutionary step forward for nursing education.
Re-envisioning Graduate Nursing Education
- The changing demands of the nation's complex healthcare environment require that nurses serving in specialty positions have the highest level of scientific knowledge and practice expertise possible. Research from Drs. Linda Aiken, Mary Blegen, Carole Estabrooks, Christopher Friese, Olga Yakusheva,and others have established a clear link between higher levels of nursing education and better patient outcomes. See AACN's fact sheet on the Impact of Education on Nursing Practice.
- Some of the many factors which are accelerating momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of patient care; national concerns about the quality of care and patient safety; shortages of nursing personnel which demands a higher level of preparation for leaders who can design and assess care; shortages of doctorally prepared nursing faculty, and increasing educational expectations for the preparation of other health professionals.
- The National Academy of Medicine (Institute of Medicine), Joint Commission, National Advisory Council on Nurse Education and Practice, and other authorities have called for reconceptualizing health professions education to meet the needs of the healthcare delivery system. Nursing is answering that call by moving to prepare APRNs for evolving practice.
- In a 2005 report titled Advancing the Nation's Health Needs: NIH Research Training Programs, the National Academy of Sciences called for nursing to develop a non-research clinical doctorate to prepare expert practitioners who can also serve as clinical faculty. AACN's work to advance the DNP is consistent with this call to action.
- Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT) and Audiology (AudD) all offer practice doctorates.
Impact on Nursing Education and Practice
- Historically advanced practice registered nurses, including Nurse Practitioners, Clinical Nurse Specialists, Nurse-Midwives, and Nurse Anesthetists, were prepared in master's degree programs, some of which require a credit load equivalent to doctoral degrees in the other fields, including the health professions.
- DNP curricula expands learning essential to preparing expert clinicians and nurse leaders, including coursework focused onevidence-based practice, quality improvement, leadership, policy advocacy, informatics, and systems thinking.
- The transition to the DNP will better prepare APRNs for their current roles given the calls for new models of care delivery and the growing complexity of health care.
- The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhDand other research-focused nursing doctorates.
- The title of Doctor is common to many disciplines and is not the domain of any one health profession. Many APRNs currently hold doctoral degrees and are addressed as doctors, which is similar to how clinical psychologists, dentists, podiatrists, and other experts are addressed. Like other providers, DNPs are expected to display their credentials to ensure that patients understand their preparation as nursing providers.
- Nursing and medicine are distinct health disciplines that prepare clinicians to assume different roles and meet different practice expectations. DNP programs will prepare nurses for the highest level of nursing practice.
DNP Transition in Progress
- With 426 DNP programs now enrolling students nationwide, nearly 80 additional practice doctorates are also under development at U.S. nursing schools, including entry-level, post-baccalaureate, and post-master's programs.
- Since the position statement was endorsed by the AACN members in 2004, nearly 72,000 students have graduated with a DNP degree.
- In June 2022, AACN released findings from a two-year study in a report titled The State of Doctor of Nursing Practice Education in 2022, which provides a snapshot of the impact and reach of the DNP and features insights from employers, graduates, and program administrators. The authors found that the number of DNP programs and enrolled students has steadily increased with graduates are highly satisfied with their education. Across settings, DNP graduates add unique value in key areas such as evidence-based practice, organizational change, quality improvement, and leadership.
- The Council on Accreditation of Nurse Anesthesia Educational Programs supports doctoral education for entry into nurse anesthesia practice by 2025. As of January 1, 2022, all students matriculating into an accredited CRNA program were enrolled in a doctoral program.
- In 2018, the National Organization of Nurse Practitioner Faculties (NONPF) called for moving to the DNP degree as the entry-level preparation for NPs by 2025. NONPF has reaffirmed this position an April 2023 statement.
- The Commission on Collegiate Nursing Education (CCNE), the leading accrediting agency for baccalaureate and higher degree nursing programs in the U.S., currently accredits 354DNP programs (as of January 2023).
Last Update: July 2023
