|
Indicators
of Quality in Research-Focused
Doctoral Programs in Nursing
Position
Statement: Schools
of nursing must consider the indicators of quality in evaluating
their ability to mount research-focused doctoral programs.
High quality programs require a large number of increasingly
scarce resources and a critical mass of faculty and students.
The Indicators of Quality in Research-Focused Doctoral Programs
in Nursing represent those indicators that should be present
in a research-focused program.
There
is considerable consensus within the discipline that while
there are differences in the purpose and curricula of PhD
and DNS programs, most programs emphasize preparation for
research. Therefore, AACN recommends continuing with a single
set of quality indicators for research-focused doctoral
programs in nursing whether the program leads to a PhD or
a DNS degree.
Research-focused
doctoral programs prepare students to pursue intellectual
inquiry and conduct independent research for the purpose
of extending knowledge. In the academic community, the PhD,
or Doctor of Philosophy degree, is the most commonly offered
research-focused degree. However, some schools for a variety
of reasons may award a Doctor of Nursing Science (DNS or
DNSc) as the research-focused doctoral degree. Individuals
educated in research-focused doctoral programs are traditionally
prepared to pursue careers in research and teaching. Graduates
of these programs also are prepared to pursue careers in
the fields of nursing and health care administration and
policy. The purposes of the research-focused doctoral degree
are to prepare for a lifetime of intellectual inquiry, creative
scholarship, and research; provide preparation that leads
to careers in government, business, and industry as well
as academia; and result in extension of knowledge (CGS,
1977).
Professional
doctoral programs are relatively new in nursing. The
distinguishing factor of these programs is the emphasis
on research application. Graduates of the professional degree
program are prepared to function in advanced practice roles,
as well as administrative, executive, public policy, and
teaching roles.
The
Nursing Doctorate (ND) degree prepares individuals for
practice and is not a research-focused degree.
Indicators of Quality in Research-Focused Doctoral Programs
in Nursing
Faculty
I.
Represent and value a diversity of backgrounds and intellectual
perspectives.
II.
Meet the requirements of the parent institution for graduate
research and doctoral education; substantial proportion
of faculty hold earned doctorates in nursing.
III.
Conceptualize and implement productive programs of research
and scholarship that:
A.
Are developed over time and build upon previous work;
B. Are at the cutting edge of the field of inquiry;
C. Are congruent with research priorities within nursing
and its constituent communities;
D. Include a substantial proportion of extramural funding;
and
E. Attract and engage students.
IV.
Outcome indicators of productive programs of research and
scholarship include:
A.
Extramural grant awards in support of research or scholarship;
B. Peer-reviewed publications of research, theory, or philosophical
essays;
C. Presentations of research, theory, or philosophical essays;
D. Scientific review activities such as with NIH study sections
and other grant application review groups;
E. Editorial review activities;
F. State, regional, national, or international recognition
as a scholar in an identified area; and
G. Evidence of influence on science policy throughout the
field.
V.
Create an environment in which mentoring, socialization
of students, and the existence of a community of scholars
is evident.
VI.
Assist students to understand the value of programs of research
and scholarship that continue over time and build upon previous
work.
VII.
Identify, generate, and utilize resources within the university
and broader community to support program goals.
VIII.
Devote a significant proportion of time to dissertation
advisement; generally each faculty member should serve as
the major adviser/chair for no more than 3-5 students during
the dissertation phase.
Programs
of Study
The
emphasis of the program of study is consistent with the
mission of the parent institution, the discipline of nursing,
and the degree awarded. The faculty's areas of expertise
and scholarship determine specific foci in the program of
study. Requirements and their sequence for progression in
the program are clear and available to students in writing.
Common elements of the program of study are outlined below.
I.
Core and related course content - the distribution between
nursing and supporting content is consistent with the mission
and goals of the program, and the student's area of focus
and course work is included in:
A.
Historical and philosophical foundations to the development
of nursing knowledge;
B. Existing and evolving substantive nursing knowledge;
C. Methods and processes of theory/knowledge development;
D. Research methods and scholarship appropriate to inquiry;
and
E. Development related to roles in academic, research, practice,
or policy environments.
II.
Elements for formal and informal teaching and learning focus
on:
A.
Analytical and leadership strategies for dealing with social,
ethical, cultural, economic, and political issues related
to nursing, health care, and research;
B. Progressive and guided student scholarship research experiences,
including exposure to faculty's interdisciplinary research
programs;
C. Immersion experiences that foster the student's development
as a nursing leader, scholarly practitioner, educator, and/or
nurse scientist; and
D. Socialization opportunities for scholarly development
in roles that complement students' career goals.
III.
Outcome indicators for the programs of study include:
A.
Advancement to candidacy requires faculty's satisfactory
evaluation (e.g., comprehensive exam) of the student's basic
knowledge of elements I-A through I-E identified above;
B. Dissertations represent original contributions to the
scholarship of the field;
C. Systematic evaluation of graduate outcomes is conducted
at regular intervals;
D. Within 3-5 years post-completion, graduates have designed
and secured funding for a research study OR within 2 years
post-completion, graduates have utilized the research process
to address an issue of importance to the discipline of nursing
or health care within their employment setting;
E. Employers report satisfaction with graduates' leadership
and scholarship at regular intervals post-completion; and
F. Graduates' scholarship and leadership are recognized
through awards, honors, or external funding at 3-5 years
post-completion.
Resources
I.
Sufficient human, financial, and institutional resources
are available to accomplish the goals of the unit for doctoral
education and faculty research.
A. The
parent institution exhibits the following characteristics:
1)
Research is an explicit component of the mission of the
parent institution;
2) An office of research administration;
3) A record of peer reviewed external funding;
4) Post-doctoral programs;
5) Internal research funds;
6) Mechanisms that value, support, and reward faculty
and student scholarship and role preparation; and
7) A university environment that fosters interdisciplinary
research and collaboration.
B.
The nursing doctoral program exhibits the following characteristics:
1)
Research active faculty as well as other faculty experts
to mentor students in other role preparations.
2) Technical support for:
(a)
Peer review of proposals and manuscripts in their development
phases;
(b) Research design expertise;
(c) Data management and analysis support;
(d) Hardware and software availability; and
(e) Expertise in grant proposal development and management.
(a)
Faculty research needs;
(b) Doctoral student study, meeting, and socializing;
(c) Seminars; and
(d) Small group work.
C.
Schools of exceptional quality also have:
1)
Centers of research excellence;
2) Endowed professorships;
3) Mechanisms for financial support to allow full-time
study; and
4) Master teachers capable of preparing graduates for
faculty roles.
II.
State-of-the-art technical and support services are available
and accessible to faculty, students, and staff for state
of the science information acquisition, communication, and
management.
III.
Library and database resources are sufficient to support
the scholarly endeavors
of faculty and students.
Students
I.
Students are selected from a pool of highly qualified and
motivated applicants who represent diverse populations.
II.
Students' research goals and objectives are congruent with
faculty research expertise and
scholarship and institutional resources.
III.
Students are successful in obtaining financial support through
competitive intramural
and extramural academic and research awards.
IV.
Students commit a significant portion of their time to the
program and complete
the program in a timely fashion.
V.
Students establish a pattern of productive scholarship,
collaborating with researchers in nursing and other disciplines
in scientific endeavors that result in the presentation
and publication of scholarly work that continues after graduation.
Evaluation
The
evaluation plan:
I.
Is systematic, ongoing, comprehensive, and focuses on the
university's and program's specific mission and goals;
II.
Includes both process and outcome data related to these
indicators of quality in
research-focused doctoral programs;
III.
Adheres to established ethical and process standards for
formal program evaluation, e.g., confidentiality and rigorous
quantitative and qualitative analyses;
IV.
Involves students and graduates in evaluation activities;
V.
Includes data from a variety of internal and external constituencies;
VI.
Provides for comparison of program processes and outcomes
to the standards
of its parent graduate school/university and selected peer
groups within
nursing;
VII.
Includes ongoing feedback to program faculty, administrators,
and external
constituents to promote program improvement;
VIII.
Provides comprehensive data in order to determine patterns
and trends and
recommend future directions at regular intervals; and
IX.
Is supported with adequate human, financial, and institutional
resources.
Background
In
order to meet its social responsibility to enhance the health
of people through the discovery and dissemination of knowledge,
the American Association of Colleges of Nursing (AACN) has
established indicators of quality for research-focused doctoral
programs in nursing. Despite steady growth in the number
of doctoral programs, graduations have remained relatively
flat. At the same time the profession faces a serious future
shortage of nursing faculty and an increased demand for
doctorally prepared nurses for administrative and clinical
positions. Therefore, nursing must explore a range of options
for increasing the number of doctoral graduates.
AACN
first developed a set of indicators for quality doctoral
education in 1986. A revised set of indicators was approved
by the membership in 1993. In 1999, in order to remain current
and in response to concerns over an impending shortage of
doctorally prepared faculty, a rapid growth in the number
and types of doctoral programs in nursing, and concern regarding
resources available to support the increased number of programs,
the AACN Board of Directors appointed a task force to revise
the quality indicators for doctoral programs and address
differences among PhD, DNSc/DNS/DSN (hereafter referred
to as DNS), and ND degrees.
To
address the charge, the task force gathered input from a
number of sources. First, 1999 AACN Doctoral Conference
participants, in small discussion groups, provided feedback
on the relevance and appropriateness of the current indicators
and made suggestions for revision. Participants expressed
general satisfaction with the 1993 indicators but sought
greater specificity, greater emphasis on outcomes to be
achieved, and recognition of all types of doctoral programs.
The nursing and higher education literature and consultants
in higher education provided a second source of input for
the work of the task force. Consultants included Marilyn
Baker of the National Research Council, National Academy
of Sciences, and Marsha Landolt, representing The Pew Charitable
Trusts' Re-envisioning the PhD project. Third, in
November 1999 the task force conducted surveys of all nursing
schools with doctoral programs or proposed doctoral programs
and a convenience sample of non-academic settings employing
doctorally prepared nurses. Fourth, a representative of
the task force participated in the Pew Re-envisioning
the PhD project working conference (April 2000) and
the Third Biennial International Conference on Professional
Doctorates (September 2000). Finally, a forum was conducted
at the Fall 2000 AACN Semi-annual Meeting (October 2000)
to review the draft indicators.
The
Research Versus the Professional Degree
Despite
the fact that American graduate education is a model for
other nations, there has been a growing concern, in both
the academic and practice arenas that PhD programs may have
become too focused on scholarly research to the neglect
of all other faculty responsibilities and non-academic careers.
This concern led to the Pew Foundation sponsored project,
Re-envisioning the PhD, designed to rethink the design
of doctoral education to address the shortage of academic
positions in most fields and the fact that PhD graduates
are often viewed as ill-prepared for jobs outside of academe
(Nyquist, 1999). Among the major problems uncovered through
the project, some affect nursing doctoral programs: program
completion rates, relevance of preparation for careers other
than in academia, lack of diversity in the student body,
and requirements for completing the degree. A number of
other significant problems encountered by other disciplines
do not affect nursing: over-production of PhDs, long periods
of post-doctoral training, a scarcity of academic positions
for graduates, and overuse of doctoral students to teach
undergraduate courses. A major emphasis of the conference
was the need to diversify the career paths beyond the traditional
research role for which students are prepared, especially
for teaching and positions outside of academe.
Examination
of the flaws in PhD education has taken a somewhat different
path in Europe and Australia. There the model of PhD education
is a research-only program with little or no course work
and an apprenticeship relationship between the student and
the major advisor. The emphasis is on developing disciplinary
knowledge and not on its application or on the role the
student will fill upon graduation. Education, business,
and a number of other professional fields have identified
needs for knowledge development that is more directly applicable
to the problems encountered in the day-to-day practice of
the profession.
A
growing number of European and Australian fields are responding
to perceived gaps in PhD education by developing professional
doctorates. Unlike the PhD programs, these programs include
substantial course work, and dissertation research is driven
largely by problems encountered in the practice world. Students
are primarily seasoned professionals who seek the doctorate
to gain skills needed to solve problems in the work world
or for career advancement within a bureaucracy.
Distinctions
between research and professional doctoral degrees have
been a subject of continuing debate within U.S. higher education
circles as well. In 1966, the Council of Graduate Schools
(CGS) endorsed the position that "the professional
doctor's degree should be the highest university award given
in a particular field in recognition of completion of academic
preparation for professional practice, whereas the PhD should
be given in recognition of preparation for research whether
the particular field of learning is pure or applied (CGS,
1966, p.3)." Later the CGS (1977) proposed that the
purposes of the PhD are to prepare for a lifetime of intellectual
inquiry, creative scholarship, and research; provide preparation
that leads to careers in government, business, and industry
as well as academia; and result in extension of knowledge.
Nursing
Doctoral Education
Historically,
the growth of PhD education in the U.S. paralleled the growth
of professional organizations that exerted pressure for
licensure and standards. This led to university-based education
for professionals and sowed the seeds for professional doctorates
such as the EdD, DPH, DNS, and others (Downs, 1989).
In
nursing, the bias has been toward research-oriented preparation.
Stevenson and Woods (1986) summarized the development of
doctoral education in nursing as including four generations
of research-oriented doctorates:
-
1900-1940
EdD or other functional degree
-
1940-1960
PhD in basic or social science with no nursing content
-
1960-1970
PhD in basic science with minor in nursing
-
1970-present
PhD in nursing or DNS
The
literature contains numerous references to the high degree
of similarity between PhD and DNS degrees in nursing. Grace
(1989) observed that the structure and content of nursing
doctoral programs, particularly the PhD and DNS, became
very similar in the 1970s and 1980s with a common core of
research, theory, and integrative science.
Downs
(1989) was able to detect some subtle differences between
the two types of programs, concluding that the DNS programs
had more clinical content, and the PhD programs included
more statistics and research-focused content. However, Downs
also completed an informal review of Nursing Research topics
by PhD and DNS authors and found essentially the same number
of manuscripts on clinical topics by both types of authors.
Since
1970, most new programs have led to PhD degrees in nursing.
Many of the DNS programs have been converted to PhD programs
as programs have evolved and gained acceptance in academic
circles. New DNS and ND programs also have opened so that
the proportion of PhD and DNS programs launched has remained
relatively constant across the decades (see Table 1a and
Table 1b).
Table
1a. Trends in Nursing Doctoral Programs Started by Type
and Decade
|
Degree
Offered |
Decade
beginning: |
Program
Totals |
EdD |
PhD |
DNS/DNS/DSN |
ND |
| 1930 |
2 |
1 |
1 |
0 |
0 |
| 1940 |
0 |
0 |
0 |
0 |
0 |
| 1950 |
1 |
0 |
1 |
0 |
0 |
| 1960 |
3 |
0 |
1 |
2 |
0 |
| 1970 |
20 |
0 |
14 |
3 |
3 |
| 1980 |
30 |
0 |
25 |
5 |
0 |
| 1990 |
26 |
0 |
22 |
3 |
1 |
Table 1b. Total Number of Nursing Doctoral Programs in
1999-2000 Academic Year
|
Degree
Offered |
| Academic
Year |
Program
Total * |
EdD |
PhD |
DNS/DNSc/DSN |
ND |
| 1999-2000 |
78 |
1 |
64 |
9
** |
4 |
* Indicates number of doctoral programs and not schools;
several schools have had more than one program.
**
The total number of DNS programs is less than the sum of
programs since a number of schools have closed their DNS
programs (Source: AACN, 2000a&b).
Current Situation
Recent
literature does not address the differences or similarities
between the purposes, content, or quality indicators of
the PhD and DNS degrees awarded in nursing. Despite earlier
recommendations from leaders in nursing and higher education
that differentiated the two types of degrees, few differences
have evolved. Both the PhD and DNS degree programs, in almost
all instances, are research-focused doctoral programs. The
content and course requirements may vary slightly and the
emphasis may be on empirical versus applied research, but
the focus of the program is to prepare students to pursue
intellectual inquiry and conduct independent research for
the purpose of extending knowledge.
In
a 1999 AACN survey of schools of nursing offering PhD and
DNS programs, of the 58 (74%) respondents, only one school
offered both PhD and DNS degree programs. This school indicated
that there were not separate faculties for the two programs
but did require different course work, and an internship
was required for the DNS program. In other responding schools
the DNS degree was being phased out as the PhD program was
approved and offered. Still other institutions offering
the DNS degree would offer the PhD if possible. Some schools
had long-standing DNS programs and included a strong emphasis
on research training.
In
order to gather information on the current and potential
use and roles of doctorally prepared nurses in the health
care delivery system, task force members conducted interviews
with a convenience sample of nurse executives from non-academic
health care delivery organizations. From these interviews,
a fairly consistent picture emerged. The number of doctorally
prepared nurses per institution was small (0-4) and these
individuals were most frequently employed in managerial,
evaluation, or educational roles with relatively few in
clinical positions. However, several respondents noted a
desire to employ additional doctorally prepared nurses,
particularly for clinical and research positions. No respondents
foresaw the doctoral degree as a requirement for any organizational
positions in the near future.
Despite
the addition of 52 doctoral nursing programs in the 1980s
and 1990s, there were just 200 more graduates in 1998 than
in 1989, and most of that growth occurred prior to 1992.
In 1998 the average number of graduations from the 70 existing
doctoral programs was less than 6 per program. This slow
rate of growth in graduates portends a serious shortage
of doctorally prepared faculty. Berlin and Sechrist (1999)
provided evidence that the current nursing faculty workforce
is aging rapidly and more than a third (38.1%) of doctorally
prepared nurses work in settings other than schools of nursing.
The median age of graduates of doctoral programs in nursing
was 45.7 years with 6.5 % of graduates age 55 or older.
The
rapid growth of nursing doctoral programs throughout the
1980s and 1990s created concern for some nursing leaders
that the number of doctoral programs may have exceeded the
faculty and research funding resources available to support
quality programs. In 1997, Hinshaw and Berlin analyzed AACN,
National Institutes of Health (NIH), and library databases
and conducted a survey of school of nursing research offices
to identify the characteristics of excellent doctoral programs.
Using the AACN quality indicators (AACN, 1993) and the National
Institute of Nursing Research (NINR) definition of a research-intensive
environment, they identified a number of variables that
correlated with being a ranked school in the U.S. News
and World Report rankings of schools of nursing. These
variables included the proportion of doctorally prepared
graduate faculty, the number of NIH grants and publications,
the presence of a general research office and centers of
excellence, the number of students, the proportion of full-time
students, and the duration of the doctoral program. Not
correlated with receiving a high ranking were the proportion
of tenured and doctorally prepared faculty, and Carnegie
classification of the institution. In a multivariate analysis,
only the number of publications and the duration of the
program were selected as important predictors of rankings
(Hinshaw & Berlin, 1997).
APPENDIX A
AACN
Task Force to Revise Quality Indicators for Doctoral Education
Chair
Sandra
Edwardson, PhD, RN
University of Minnesota
Members
Jane
Kirschling, DNS, RN
University of Southern Maine
Barbara
Hazard Munro, PhD, RN, FAAN
Boston College
Ellen
Rudy, PhD, RN, FAAN
University of Pittsburgh
Nancy
Fugate Woods, PhD, RN, FAAN
University of Washington
AACN
Staff Liaison
Joan
M. Stanley, PhD, RN
Director, Education Policy
APPENDIX B
References
American
Association of Colleges of Nursing. (1993). AACN Position
Statement: Indicators of quality in doctoral programs in
nursing. Washington, D.C.: Author.
American
Association of Colleges of Nursing. (2000a). Enrollment
and graduations in baccalaureate and graduate programs in
nursing. Washington, DC: Author.
American
Association of Colleges of Nursing. (2000b). Institutions
offering doctoral programs in nursing and degrees conferred.
(Unpublished data). Washington, D.C.: Author.
Berlin,
L. E., & Sechrist, K.R. (1999). Projecting the shortage
of doctorally prepared nursing faculty: A supply problem
of international concern. Centennial Conference, International
Council of Nurses, June 28, 1999.
Council of Graduate Schools in the United States. (1966).
The doctor's degree in professional fields. A statement
by the Association of Graduate Schools and the Council of
Graduate Schools in the United States. Washington, D.C.:
Author.
Council
of Graduate Schools in the United States. (1977). The doctor
of philosophy degree: A policy statement. Washington, D.C.:
Author.
Downs,
F. S. (1989). Differences between the professional doctorate
and the academic/research doctorate. Journal of Professional
Nursing, 5(5), 261-265.
Grace,
H. K. (1989). Doctoral education in nursing: Issues in doctoral
education in nursing. Journal of Professional Nursing,
5(5), 266-270.
Hinshaw,
A.S., & Berlin, L. E. (1997). The future for quality
doctoral nursing programs - Are the resources there? Presentation
at AACN Doctoral Conference, January 31, 1997.
Nyquist,
J.D. (1999). Re-envisioning the Ph.D. http://weber.u.washington.edu.
Seattle, Washington: Center for Instructional Development
and Research, University of Washington.
Stevenson,
J. S., & Woods, N. F. (1986). Nursing science and contemporary
science: Emerging paradigms. In G. E. Sorensen (Ed.), Setting
the Agenda for the Year 2000: Knowledge Development in Nursing
(pp. 6-20). Kansas City, Missouri: American Academy of Nursing.
| 
