309CHAPTER 14

Curriculum Planning for PhD and Other Research-Focused Doctoral Nursing Programs

Nancy A. Stotts

OBJECTIVES

Upon completion of Chapter 14, the reader will be able to:

OVERVIEW

Nurse scientists are the major product of research-focused doctoral programs, including the doctor of philosophy (PhD) and doctor of nursing science (DNS) programs. These programs are designed to enhance the health of the population by preparing graduates to conduct, disseminate, and translate research. They extend knowledge of the discipline through research (AACN, 2010). The purpose of the research-focused doctoral programs in nursing, the curriculum, and evaluation of its quality are addressed, and issues common to research-focused programs are discussed.

THE ROLE OF THE RESEARCH-FOCUSED DOCTORAL PROGRAM IN NURSING

Research-focused doctoral programs prepare students to pursue intellectual inquiry and conduct independent research that results in extension of knowledge (AACN, 2010; Melnyk, 2013). From a theoretical perspective, PhD programs are theory based and focus on testing theory, while DNS programs are oriented more toward clinical 310practice research (Keithley et al., 2003; Robb, 2005). However, AACN does not differentiate the PhD from DNS program and it is often difficult to tell the difference in the programs based on their curricula. Clearly the commonality in the program designations is the focus on original research that has potential to contribute to the body of knowledge in the discipline. The PhD in the scientific world is the entry-level preparation needed to develop an independent program of research (AACN, 2010). Graduates are scholars (Melnyk, 2013; Walker, Golde, Jones, Bueschel, & Hutchings, 2008), although the nature of the knowledge and how it contributes to the field is unique to each candidate and may reflect the explicit foci within the various schools.

In reality, the designation as a PhD or DNS program often is determined by the school’s specific mission and philosophy as well as by institutional criteria for research doctoral program approval. While holding the highest academic degree in the field, nurses from research-focused institutions are prepared and expected to be leaders in nursing as demonstrated by their role in knowledge generation and dissemination, professional organizations, and policy. In fact, graduates of research doctoral programs have been called the stewards of the discipline, those entrusted with preserving the past as the basis for the future of the discipline (AACN, 2010; Walker et al., 2008).

In the United States, there are 125 research-focused programs that offer a nursing PhD/DNS. In 2012, the year of the most recent AACN data, 4,909 students were enrolled and 601 students graduated. Forty-two states have research-focused doctoral program in nursing; eight states and two territories have none. The number of research-focused program as well as enrollment is stable and growing slowly. Neither the number of programs nor enrollment has increased as rapidly as that of the doctor of nursing practice (DNP) programs (AACN, 2012a). Of the enrollees, 75% are White, indicating that one in four is non-White (AACN, 2012a). Race/ethnicity of enrolled students varies greatly by state (range 4–100% White) (AACN, 2012b). Male students comprise 6.8% of the research-focused doctoral program student body (AACN, 2012a).

There remains a shortage of faculty, illustrated by the fact that 7.6% of full-time budgeted nursing faculty positions are vacant in the United States. Vacancies range from 1 to 20 and the average is 1.8 per school. In addition 6.6% of schools report no full-time vacancies but need additional faculty (Fang, 2013). Slightly fewer part-time (6.8%) than full-time faculty positions are available, with a mean of 1.1 part-time vacancies per school and a range of 1 to 38 vacancies per school. In the schools that responded to an AACN survey, hiring for 2012 through 2013 was precluded by lack of funds for salaries (64.1%), unwillingness of administration to commit to full-time positions (51.5%), inability to recruit due to marketplace competition (35.9%), and lack of qualified applicants (26/2%) (Fang, 2013). The most critical faculty recruitment related issues are limited number of doctorally prepared faculty (32.9%), noncompetative salaries (27.6%), and having faculty with the right specialty mix (19%) (Fang, 2013).

Lack of faculty impacts student enrollment; students are not being accepted into programs due to lack of faculty (AACN, 2012a). In addition, the faculty in nursing education is aging. Across the various levels of nursing programs, the mean age of professors is 61.0 years, associate professors is 57.5 years, and assistant professors is 51.8 years (AACN, 2012a). Clearly a cadre of new faculty is needed 311to replace the aging and soon to be retiring faculty (AACN, 2012a; Meleis, 2005; Meleis & Dracup, 2005).

Most graduates from research-focused programs work in academia where scholarly activity/research, service to the university and profession, professional competence, and teaching are core criteria for tenure and promotion. Recognizing responsibilities across these various areas, there is no question that research is the focus of research-intensive doctoral education. Pedagogical preparation requires additional course work and practice that focuses on teaching to develop skills and knowledge commensurate with role expectations (AACN, 2010). Similarly, preparation in health policy may require additional coursework and practice.

PhD/DNS graduates work in research-intensive or teaching-intensive universities. In the research-intensive university, the most highly rewarded activity is research and scholarship. New PhD/DNS faculty members are expected to develop a program of research that is externally funded, publish in peer-reviewed journals, develop a national and, eventually, international reputation as a scholar, provide scientific critique and review for journal articles and grants, and influence policy (AACN, 2010; Billings, 2008; Cleary, Hunt, & Jackson, 2011). The expectation is that they will mentor and teach PhD/DNS students who subsequently will become faculty who are research scientists. Leadership in the profession, a national reputation (and eventually international), and service to their institution are markers of a successful faculty member at a research-intensive university.

In teaching-intensive programs, PhD/DNS faculty members teach and mentor pre-licensure students as well as graduate students. Scholarly activity is required but may be more broadly defined than in the research-intensive university and may include writing textbooks, conducting externally funded quality assurance or education-focused studies, and publishing clinically focused papers. Committee service in the university and leadership in professional organizations and the community are also usual expectations in these schools.

Some graduates work in industry, government, and policy. While their roles vary, they are hired for their expertise and leadership capacity, much of which is the product of their doctoral education. In industry, they may work in clinical research and direct or monitor research studies. In government, they may assume a role in the National Institute of Nursing Research as well as various other agencies (e.g., Veteran’s Administration or a branch of the military). Doctorally prepared nurses may work in policy to affect public, industry, or government opinion on health-related issues (e.g., smoking).

Postdoctoral work often follows graduation from a research-focused doctoral program (AACN, 2010; Nolan et al., 2008). Postdoctoral study focuses on increasing depth in research expertise to help develop a robust program of research. Activities during postdoctoral study may include learning a new method, extending expertise in substantive content, publication of papers from the dissertation, and writing research grants to fund future research. Those who have completed a postdoctoral program are better prepared to enter academia and successfully complete the research related milestones of obtaining external funding and publishing in peer-reviewed journals than PhD/DNS-prepared nurses who have not gone on for further preparation (National Research Council, 2005).

312THE CURRICULUM

The curriculum of each research-focused doctoral program is unique and is based on the school’s mission and philosophy as interpreted and implemented by the faculty. Usual core coursework includes the history and philosophy of nursing science, theories that guide the discipline and practice, research methods, advanced statistics, substantive nursing in a specific area of expertise, and role-related content (e.g., pedagogy). Depending on the program, required content may include mentoring, leadership, interdisciplinary research teamwork, and health policy. Cognates from supporting disciplines, such as sociology or physiology, often are required. The faculty, their program of research, funding success, and area of expertise are recognized as pivotal as are the resources available such as an office of research (Bevil, Cohen, Sherlock, Yoon, & Yucha, 2012). The variability in the curriculum among programs is seen in the requirements in research-focused doctoral programs. Surveys of research-focused doctoral programs show that a research practicum was required by 77.1%, attendance at a professional meeting by 36.8%, presentation at a professional meeting by 21.1%, and submitting a paper for publication by 31.6%. Dissertation format also was quite variable where traditional format was utilized by the majority of schools (61.4%), while the publication of at least one paper was required by a few schools (6.9%); and some schools (30.7%) allowed either approach (Minnick, Norman, & Donaghey, 2013).

FIGURE 14.1 Pathways to research-intensive doctoral programs in nursing.

313With the focus of doubling the number of doctorally prepared nurses by 2020 (IOM, 2010), there is concern about capacity issues and whether the goal of increasing the number of graduates will threaten the quality of their educations (Gill & Burnard, 2012; Henly, 2013). To address the capacity issue, AACN (2010) proposed articulation and facilitation of multiple entry points to the research-focused doctoral program. Figure 14.1 diagrams the proposed pathways. Implementation of the schemata requires changes in traditional perspectives and discussion about the value of requiring clinical practice as the basis for the research doctorate.

From a process perspective, most programs require coursework and then a formal evaluation of substantive knowledge prior to students undertaking their original research projects. All programs have a process by which the research topic is approved by the faculty and the quality of the dissertation research evaluated.

PROGRAM EVALUATION

The quality of research-focused doctoral nursing programs is established and maintained by the individual programs. There is no professional accreditation for research-focused doctoral programs. However, quality indicators are provided by AACN (2010) to guide the evaluation of these programs. Evaluation criteria are divided into categories of faculty and administration, students, resources and infrastructure, and evaluation plan. Table 14.1 provides examples of quality indicators cited in the AACN (2010) document. Programs often supplement these measures with their own indicators. For example, for a state supported program, one rubric might be the proportion of state residents in the student body and/or the number of international students enrolled.

TABLE 14.1 EXAMPLES OF QUALITY INDICATORS IN RESEARCH-FOCUSED DOCTORAL PROGRAMS IN NURSING

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