Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Doctorates and Nurses

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Doctorates and Nurses

Article excerpt

INTRODUCTION

An increasing number of nurses have the post-nominal 'PhD' and even more display the pre-nominal 'Dr'; the latter not necessarily being earned as a result of the former. Therefore, the provenance of the doctoral title is an area of confusion in nursing. There is also the issue of equivalence between different routes to doctorate and efforts to make international comparison and rationalise this aspect of nursing education (Ketefian & McKenna, 2005). In addition, the degree of PhD is not earned by the same route; there are several models worldwide - not unique to nursing - and this raises further questions about the equivalence and utility, in nursing, of higher degrees leading to the coveted status of 'Doctor'.

We have already considered some issues around doctoral education in nursing (Kirkman, Thompson, Watson, & Stewart, 2006; Thompson, Kirkman, Watson, & Stewart, 2005) and some of these issues will be re-visited here. However, we are involved in doctoral education worldwide and the range of models, encompassing supervision, study, outputs, examination and purpose are of interest to us. There is, surely, virtue in the variety of routes into doctoral education in nursing but the concomitant variety of endpoints could be a cause for concern. When we meet a medical 'doctor' (a title, ironically earned by compliment) or a 'doctor' who is a dentist, we expect congruence between the title and the range of abilities we can expect. However, when we meet a 'doctor' who is a nurse - and this applies to few other professions - just what is 'in the tin' is not as apparent.

Therefore, we will consider the background to doctoral education in nursing, the various models that exist, the variation in examination procedures and what the doctoral education 'product' is like. We will draw on experience from the UK, Australia, the USA, the Far East and Europe. Our experience includes our own PhD study; our role as supervisors and examiners and, in the cases of Roger Watson and David Thompson, experience as an external examiner of taught doctorate programmes in the UK.

We are aware, as we write, that the adoption in the USA of the Doctor of Nursing Practice (DNP) as the entry into practice for advanced practice nurses is in dispute (Cronenwett et al., 2011; Meleis & Dracup, 2005); however, what is clear is that while this 'taught' doctorate focuses on both systematic inquiry and advanced clinical practice, there is no evidence that the DNPprepared graduate is a better provider of care nor is the scope of their inquiry changing the health care system. DNP programmes are spreading rapidly; however, in these difficult economic times, the pragmatic cost of preparing this graduate is under challenge. The 'pipeline' for graduates prepared at this level is tightening at the very time that there is an increased need for advanced nurses able to manage the increasingly older and more chronically ill US population (Cronenwett et al., 2011).

The recent widespread introduction of taught doctoral education (professional doctorates) in nursing in the UK is also notable. Our observation in the UK is that the popularity of taught doctoral programmes peaked very quickly after their introduction and that many now have problems recruiting and some have ceased to recruit. Of course, the UK and USA contexts are very different and contexts in other regions will vary. Nevertheless, we observe thriving PhD programmes in Australia, the Far East and Europe with the number growing in the USA (AACN, 2010); the PhD industry in nursing could not be described as thriving in the UK but it does provide a steady flow of graduates. We see little appetite for taught routes to doctorate in the Far East and no evidence of taught doctorates in China, Hong Kong and Taiwan. However, we do see PhD programmes here in addition to a considerable 'trade' in PhD students heading to the UK, Australia and the USA. Our point in referring to these issues is to indicate the importance of doctoral education in nursing across the world but also that the distribution of taught doctorate programmes is unevenly spread across the world. …

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