ANCC would like to thank all of you who participated in our DNP survey in April this year. That survey collected your views on the implications of the doctor of nursing practice (DNP) on the future of nursing certification.
We received 4284 responses, which provide a truly broad and inclusive base for assessing current understandings and views on this important issue. The survey was posted on the ANCC website, as well as announced through many other nursing organizations including other certification boards.
The demographic profile of respondents was overwhelmingly white, non-Hispanic (92%) and female (94.3%). More than two-thirds (69.6%) were in the 40 – 59 years age group. Of the 3060 respondents (71.4%) who indicated that they work in an advanced practice role, 76.7% identified themselves as NPs, 11.9% as nurse midwives, 10.8% as CNSs, and less than 1.0% as nurse anesthetists.
For all respondents, the original entry to practice was the BSN for the majority (54.8%), while for 16.5% it was a nursing diploma, and 19.2% began their preparation with an associate’s degree. However the highest educational preparation attained for the overwhelming majority (70.3%) was a master’s, while 22.6% had some type of doctor’s degree. Interestingly 7% of respondents (245 individuals) indicated that their highest educational preparation was the DNP; so it appears that the survey did achieve reasonable representation from graduates of these new programs also.
The major question asked by the survey was ‘What do you envision as the desired future for certification of nurses holding the DNP degree in the year 2015?’ A majority of respondents (59.7%) expressed a preference for a single comprehensive end-point certification, with DNP degrees required for entry into all advanced practice nursing; however, over 40% felt a system of staged certification was preferable; this would mean students who enter (as registered nurses) into accredited DNP programs would sit for national certification examinations at one or more points during the DNP program in addition to a final Board examination (related to general and/or specialty clinical practice) following completion of the program. This approach is similar to the model used in medicine.
Respondents also differed in their opinions on what certification bodies should do now. Slightly over 50% felt certification bodies should begin creating separate DNP and master’s level certification exams. Another quarter of respondents felt certification bodies should follow a ‘wait and see’ approach, while the remainder felt certification bodies should begin creating a single certification examination at the DNP level by moving the current master’s level examinations to doctoral level.
The survey allowed for additional open-ended comments and the thousands of responses received provided an excellent inventory of the many current views and concerns regarding the DNP. While the survey was focused specifically on the subject of the relation between the DNP and nurse credentialing, the open-ended comments often expressed sentiments on more general issues.P>
Many individuals wrote that they were grateful for being asked to provide their thoughts and feedback. Many felt valued by having their input included in the information gathering and decision-making process. It also became clear that there remains a significant amount of confusion surrounding the raison d'être for the DNP, its value, its intended constituency, and what it will mean for those who do not pursue one. A substantial number of individuals expressed some anger or concern that nursing is again splintering the ranks, and some felt the concept of the DNP devalued them and implied that what they provide currently is inadequate.
ANCC believes that continuing efforts need to be made to communicate and clarify understanding of the DNP by those it will impact. We will continue to work with the educational, regulatory and certification bodies represented in our thought leader group in order to facilitate cooperation toward creation of a consensus ‘statement of assurance’; this ‘statement of assurance’ would aim to reassure individual nurses and key stakeholder groups that their interests will be taken into consideration, that there will be a reasonable period of transition to accommodate current students and faculty, and that current practitioners would be grandfathered in both licensing and certification requirements should changes occur in those areas. These are goals that cannot be achieved or guaranteed without continuing close cooperation between the nursing organizations and leaders represented in our representative thought leader group. The groups who were asked to be involved (or representatives from these groups) in the initial review and revision of the ANCC DNP survey (invited leaders) included : AACN (East) AACN (West), AANA, ANA, APNA, ACNP, AANP, AONE, ACNM, ABNS, ASTDN, AONE, CCNE,CGEAN, NLN, NLNAC, NCSBN, NACNS, NONPF, NCC, NBCRNA, APNA, ISPN, ONS, PNCB, Quad Council). ANCC looks forward to continuing to work with these leading organizations to achieve clarity and transparency in DNP-related credentialing changes for the benefit of all nurses.
Better communication will result in more input from nurses, greater acceptance, and greater solidarity within the nursing profession. Many current master's programs are so robust that they offer enough credits and clinical hours to equal a DNP program. ANCC believes that nurses should receive the credit and recognition that they deserve, whether for their certification or educational achievements.
Ultimately ANCC believes that the movement from the master’s level graduate programs to doctoral level programs will evolve over several years with nurses educated at two different levels and credentialed at one for certification purposes. Differences if any between MS and DNP prepared grads will evolve over time.
If you have comments or feedback that you wish to share on this issue, please feel free to send it to ANCCcomm@ana.org.