26 November 2012

PhD or DNP? How to choose

 Before looking into doctoral programs, prospective nursing students should decide which route is right for them. Currently, two major nursing degrees are awarded at the doctoral level—the Doctor of Philosophy in nursing and the Doctor of Nursing Practice. In my discussions with BSN- and MSN-prepared nurses, there seems to be a little confusion about the two doctoral degrees. My advice is, do your research and know which degree you want before deciding what school to apply to. Put another way, looking at various schools of nursing and using this information to decide which degree you wish to pursue is not the proper way to make the decision. This is because the two degrees are vastly different and, depending on what you want to do with it, pursuing the wrong degree will be a complete waste of your time.

The PhD is a research-oriented degree. The DNP, on the other hand, is a practice degree, which can be likened to degrees obtained by physicians, dentists, pharmacists and optometrists or ophthalmologists. There are a few major differences between the PhD and the DNP. While everyone may not agree with my explanation, consider the following categorical differences.

Prestige
Because of their vast differences, the degrees should not be directly compared but, in general, the PhD is regarded as the more prestigious of the two. Of course, the PhD has been around longer and is more widely recognized. It is also the terminal degree in nursing, meaning that no higher degree is attainable. If you looked at nursing degrees from a step-chart perspective, they would look something like this:


The chart may be slightly misleading because, in pursuing nursing degrees, a person doesn’t have to go from one step to the next. For instance, the point of entry for a person seeking a nursing license can be a diploma, an associate degree, a bachelor’s degree or an entry-level master’s degree. Also, a nurse doesn’t have to obtain a master’s degree before pursuing a doctoral degree. Still, the chart is a good indicator of how each nursing degree is viewed with regard to prestige.

Two types of knowledge
While both degrees are designed to produce nurses who will contribute to the knowledge base of the profession, one thing is clear—the PhD-educated nurse is expected to create new knowledge. A PhD dissertation cannot be successfully defended without the generation of new knowledge. As nurses who are more focused on practice than research, those in DNP programs may or may not have generated new knowledge upon completing their capstone projects.

An easy way to differentiate between the two degrees is to see the PhD nurse as a knowledge-creator and the DNP nurse as a knowledge-applier. Where a PhD program focuses on understanding the philosophical and theoretical foundations of nursing and using these foundations to generate new knowledge, a DNP program focuses on taking knowledge available to the profession and transferring it to practical application.

Focus on hands-on-nursing
Obtaining a PhD requires no clinical hours at the bedside or direct patient care. Obtaining a DNP, however, typically does require some type of practice hours to prove a student’s competence in his or her specialty area. If you are studying to become a nurse educator, for instance, you may have to work in an academic or clinical education setting. Or, if you are obtaining your DNP to become a nurse practitioner or clinical nurse specialist, you will spend many hours under the preceptorship of an already licensed advanced practice nurse.

PhD students take courses such as philosophy and theory to stimulate abstract thinking about the nursing profession whereas DNP students take courses such as pathophysiology and nursing assessment, knowledge and skills more geared to nursing practice. I have seen PhD nurses work per diem or volunteer in order to maintain their nursing skills, provide community service or supplement their income, but never have I come across a PhD-prepared nurse who works full time providing direct patient care. DNP-prepared nurses, on the other hand, often work in patient-care settings as nurse practitioners, clinical nurse specialists, nurse administrators, nurse educators and nurse researchers. Both PhD and DNP nurses teach in academic settings.

Choose wisely
Whichever degree you choose to pursue, make your choice wisely. If you are in a PhD program but want to be a full-time nurse practitioner, you may find yourself miserable. If you are in a DNP program, but want to be a world-renowned neuroscience researcher, you may also be miserable. Although it is OK—and highly encouraged—to compare and contrast the two doctoral degrees in nursing, it is imperative to understand that neither degree is “better” than the other. They are complementary. Both are needed to keep patients safe and to continue advancing the practice of nursing.

I like to joke that the PhD is the attractive, older sister and the DNP the sassy, younger sister, but their momma and daddy love them both the same. I need my DNP “siblings” just as much as they need me. We are one big happy family.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

10 comments:

  1. Thank you for clarity. I think you have helped me make a very important choice.

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  2. I am not sure that I agree. I am working in my DNP. While I may not be granted all the rights my "big sister" has, it is due to the profession not being open minded enough. I do research, too. While it is not original, it is still research. How many times do we read an article that says further investigation must be done? I am the "further investigator."

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  3. Mary, you are welcome! Good luck on your journey!

    Anonymous, I am not disagreeing with you. As I stated above, DNPs can and sometimes do conduct research. Still, the DNP is not a research degree. Now that the DNP has gained popularity, it is important for potential doctoral students to understand the differences between the two degree and make informed decisions about which degree program to pursue. Neither degree is better than the other; they are simply different. I actually know a few nurses who, understanding the difference between the two degrees, opted to obtain them both.

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  4. If the DNP becomes the degree for ANPs, then autonomy will have to be a key concept in the practice of ANPs in the future.

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  5. Thank you for this awesome post. It actually inspired me to write my own about the same topic! It is important for us nurses to spread the word and advance our education!

    http://www.melissadecapua.com/blog/choosing-a-nursing-doctorate

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  6. Thank you for your perspective but as a DNP student, soon to graduate, I have not taken any of those classes you had mentioned as part of my DNP curriculum. I have taken theory, diversity, and a semester of biostatistics to help me understand and guide me as I was working on my DNP project. I had health policy, leadership, informatics, epidemiology, and now completing finance. I do not believe I am a younger sister. We are twins with our own unique background and educational experience, which allows us to bring different perspectives to the table.

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    1. It sounds like your DNP was not clinically-focused, although many are, as it prevents the need to first obtain a clinical MSN, then obtain a separate DNP. Herein lies the issue with the DNP degree—there is not much consistency across programs. This needs to change. Training for PhD programs is clear. When someone has a PhD, you have a very good idea of the type of education they received. With the PhD, it’s anybody’s guess. We have to do a better job of regulating DNP programs.

      Also, my reference to older/younger sisters isn’t a jab. Please don’t take it personally. The PhD has been around much longer than the DNP and is, by most accounts, more prestigious. They are not twins; not even fraternal twins.

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  7. Thank you for sharing. Its informative and full of information.

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  8. Thanks for sharing. I have known the two are both terminal degrees, but I always believed the PhD was higher than the DNP. This is mostly because it is better recognized in a university setting and academia is where I have worked for the past decade. I was chuckled at your joke about the attractive older sister and the sassy younger sister. I will be using this one! :-)

    Trayce J., PhD, MSN-Ed, RN

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