It has been 2 years since the Editorial Advisory Board of JOGNN adopted procedures to better differentiate reports of research, quality improvement, and program evaluation projects. These criteria were published in an editorial (Cook & Lowe, 2012) and are available to interested authors on JOGNN's website. The implementation of this decision has had positive results: informing readers of reports detailing innovative programs, describing current trends, and sharing implementation lessons learned in the Principles & Practice section of JOGNN. However, we also have noticed some lack of clarity in manuscripts that appears to be rooted in the faculty mentorship of students conducting practice-related capstone projects for the doctorate in nursing practice (DNP). Specifically, practice-change projects are sometimes presented as research projects, in which the generation of knowledge is confused with the application of knowledge.
The process for mentoring a doctoral student through completion of a culminating project was clearer when the only option for doctoral study in nursing was a research-focused doctorate based on knowledge generation. Faculty, most of whom had research doctorates themselves, mentored students through completion of a research-focused dissertation and dissemination in research-focused journals. Faculty had experience designing, implementing, analyzing, and disseminating the results of rigorously designed research projects and could mentor students by involving them in active projects as research assistants. The expectations for student outcomes were fairly consistent with the way faculty were educated and across the discipline. The only major innovation in dissertation procedures came with the implementation by some universities and Colleges of Nursing of an alternative dissertation format. This alternative format did not change the process of doing the dissertation research but allowed for a final dissertation document that incorporated manuscripts accepted or submitted for publication. This approach allows students to receive more intensive mentoring from faculty in developing and disseminating their dissertation manuscripts in research-focused journals.
Faculty roles are far more complex now, as faculty often are called upon to mentor traditional research-focused doctoral students at the same time as they are mentoring students enrolled in DNP programs. Students enrolled in DNP programs develop the skills needed to implement or apply the science generated by researchers (American Association of Colleges of Nursing, 2014). The focus of the DNP capstone project often is an evidence-based practice or quality-improvement project that may require knowledge and skills that many PhD-prepared faculty do not possess. Faculty also may be teaching joint research and theory classes to PhD and DNP students, which challenges them to clearly articulate the applicable content across doctoral programs while teaching the skills that differ by program.
Since the inception of the DNP 7 years ago, 241 programs have been implemented in the United States (Kirschling, 2014). This rapid growth required that research-focused faculty assume primary roles in the education and mentoring of DNP students while the cadre of DNP and practitioner faculty was increased. However, there was little agreement across programs or at the national level about the culminating capstone product for a DNP student. The American Association of Colleges of Nursing recently convened a Task Force on Implementation of the DNP to review the “current state of DNP scholarly products, including (a) resources needed to support development of quality DNP products, (b) recommendations for scholarship of DNP graduates, and (c) [to] identify [the] term to be used for DNP scholarly products” (Frantz, 2014, p.). The Task Force will report to the Board of Directors in June 2015.
Although this important discussion is occurring at the national level, what do DNP students need now to help them navigate their evidence-based practice and quality improvement projects? Ideally, expert mentors will be available with skill sets that include the ability to make research findings applicable in clinical and practice settings, knowledge of the particular patient population, and access to critical evaluative data that informs decisions related to design, implementation, and evaluation. Although PhD-prepared researchers have been educated in research methods and statistics, they may have less experience with the implementation and evaluation of practice-change projects. While the cadre of doctorally prepared faculty and practitioners with evidence-based practice expertise continues to increase, mentor teams might be an effective way to manage the increasing demand for mentors for the final DNP project.
Faculty need to increase their understanding and knowledge so they can mentor students appropriately to generate the knowledge needed to build nursing science or to apply knowledge to improve evidence-based practices. Two helpful resources are the procedures described by the Standards for Quality Improvement Reporting Evidence (SQUIRE) guidelines (Davidoff, Batalden, Stevens, Ogrinc, & Mooney, 2008) and the editorial by Cook and Lowe (2012). The SQUIRE guidelines identify 19 steps that authors can use to describe their projects and to guide project design and implementation. A concise summary of six key differences between research, quality improvement, and program evaluation projects is available in the editorial by Cook and Lowe (2012); these differences include generalizability, methods of inquiry, assumption of benefits, opt-in/opt-out ability, indicators of investigator intent, and the role of theory.
Actions can be taken within our academic organizations to support faculty development and expertise, and additional training might be needed in content areas that were not integral to all research-focused doctoral programs of the past. Such areas might include the foundations and processes of evidence-based practice, theory and processes for program evaluation, and procedures for quality improvement initiatives. Readers seeking additional information can refer to the detailed discussion of faculty development related to DNP programs by Sebastian and Delaney (2013). Faculty champions within an academic program can be identified to develop the courses, structure the student outcomes, and identify the resources needed for faculty development. Ideally, faculty who are prepared to work with research (PhD) and practice-focused doctoral (DNP) students will be able to help students understand and value their unique contributions to collaborative relationships, nursing science, and evidence-based care.