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Introduction   

If you are considering pursuing higher education and advancing your education and career goals, this course will provide valuable insight. It is meaningful to consider the differences between the DNP (Doctor of Nursing Practice) and PhD (Doctor of Philosophy) in Nursing degree programs. The course will compare the DNP and PhD degrees in nursing, highlighting each of their advantages and career path opportunities. The goal is to help nursing professionals make informed decisions about their educational journey based on their personal and professional goals.  

Understanding the Doctor of Nursing Practice (DNP) 

The American Association of Colleges of Nursing (AACN) describes the Doctor of Nursing Practice (DNP) degree as the terminal graduate degree for advanced nursing preparation. This recommendation includes but is not limited to clinical nurse specialists, nurse anesthetists, nurse midwives, and nurse practitioners (1).  

DNP programs have experienced robust growth with DNP educational programs in the United States, increasing fourfold in the two decades. The AACN released its Position Statement on the Practice Doctorate in Nursing in October 2004. The purpose of the DNP degree is to “prepare nurse leaders at the highest level of nursing practice to improve patient outcomes and translate research into practice” (2).  

Curriculum and Focus on DNP Programs 

The focus of DNP programs is the development of systems leadership, quality improvement, and translation of evidence into clinical practice.  

DNP curriculum focuses on the following eight essential elements (3): 

1. Scientific underpinnings for practice 
2. Organizational and systems leadership for quality improvement and systems thinking  
3. Clinical scholarship and analytical methods for evidence-based practice  
4. Information systems/technology and patient care technology for the improvement and transformation of healthcare   
5. Healthcare policy for advocacy in healthcare   
6. Interprofessional collaboration for improving patient and population health outcomes 
7. Clinical prevention and population health for improving the nation’s health  
8. Advanced nursing practice 

Clinical vs. Research Emphasis 

The DNP has a strong emphasis on clinical practice, specifically translating evidence into practice (12).  

Here is an example of what this may look like in practice: 

A DNP-prepared Intensive Care Unit (ICU) advanced practice nurse (APN) is alarmed by the increasing trend of patients experiencing pressure ulcers on the unit. She collects some informal data by speaking with various staff nurses inquiring about their approach to preventing pressure ulcers in their patients. The APN finds a high level of inconsistency in the approaches nurses are using. Not all of their interventions are evidence-based. The DNP APN performs a literature review to identify the highest quality evidence-based techniques in pressure ulcer prevention. She also locates evidence to determine the most appropriate framework for educating ICU nurses.  

To mitigate the occurrence of pressure ulcers and ensure a unified evidence-based approach to pressure ulcer prevention, the NP develops a competency-based education program to standardize evidence-based practice (EBP) pressure ulcer prevention techniques used by staff nurses on the unit. To measure the impact and efficacy of the education program, the APN implements several rounds of Plan-Do-Study-Act (PDSA) cycles to collect data and identify areas of improvement.  

After the final PDSA cycle, the APN found that rates of pressure ulcers among patients on the unit fell drastically and nurses reported high levels of satisfaction implementing the new EBP protocol.  

This example demonstrates how DNP nurses translate evidence from the literature into clinical practice to improve systems, patient outcomes, and quality of care (11).  

Typical Duration and Structure of DNP Programs 

There are several entry points into a DNP program based on the degree(s) the student already has.  

You can begin a DNP program with the following degrees: 

• Bachelor of Science (nursing or non-nursing) 

• Master of Science (nursing or non-nursing) 

These entry points dictate the specific curriculum plan a student will follow for the duration of the program. All DNP students must achieve the AACN’s “Essentials of Doctoral Education for Advanced Nursing Practice” (3).  

DNP students focus on a specialized area of nursing practice. For example, areas of study may include adult/gerontology, pediatrics, health systems leadership, and advanced population health.  

Interestingly, not all areas of specialized DNP practice result in licensure as a nurse practitioner. Some Advanced Nursing Practice DNP curriculums focus on preparing nurse practitioners while others do not. Non-nurse practitioner DNP programs of study include health systems leadership, nursing informatics, and advanced population health nursing (14). Regardless of DNP specialty, all students must acquire 1,000 post-baccalaureate practice hours. 

The length of the DNP program depends on the point of entry.  

On average BSN-DNP programs are 36 months of full-time study during traditional academic calendar years (3). MSN-DNP programs may be completed in a minimum of 12 months but depend on the individual student’s history of graduate coursework and clinical hours.  

An academic advisor will assist students in planning coursework and clinical hours.  

Understanding the Doctor of Philosophy (PhD) in Nursing 

The AACN defines the Doctor of Philosophy (PhD) degree as a “research-focused degree that prepares individuals to create, translate, and communicate new knowledge as leaders within institutions of higher education and outside academia” (4). PhD-prepared nurses design and carry out research to generate new evidence and scientific findings.  

Curriculum and Focus of PhD programs 

There are two primary domains of PhD programs: Develop the Science and Steward the Discipline (4).  

Develop the Science 

PhD nurses are expected to use professional ethics and judgment in carrying out original research and communicating those findings to professional and general audiences. They discover ways that new research can impact policy, nursing practice, future research, and the nursing profession.  

Cultural humility is a cornerstone of PhD nursing research. They are leaders in developing culturally competent research and scholarship.  

PhD nurses find gaps in existing research and then develop new studies to fill those gaps.  

Steward the Discipline 

PhD nurses are thought leaders in nursing. They are dedicated to the integrity of the nursing profession. The PhD-prepared nurse elevates the profession through scholarly leadership.  

The primary role of the PhD nurse scientist in academia is to generate research and disseminate those findings. PhD nurses hold faculty positions as they support the teaching, service, and mentorship goals of the academic institution. They also work to secure grant funding to support their research (4).  

A practice-oriented approach to nursing research may involve working with health systems to identify research gaps to meet their target patient needs and outcomes. Some clinical practice roles for PhD nurse scholars include those focused on EBP, clinical training, and the development of clinical research within the context of a healthcare system (10). 

Duration and Structure of PhD programs 

Similar to the DNP, PhD in Nursing programs have various points of entry, and program plans depend on a student’s academic history and career goals (5).  

Program length varies among academic institutions. The AACN reports that the average time for a post-master student to complete the PhD program is 5 years. BSN-PhD students complete the degree in 5.7 years on average (4, 7).  

Comparing DNP and PhD Programs 

PhD nurses are nurse scientists who generate new evidence by designing and leading research studies. DNP nurses translate that new evidence into nursing practice. PhD and DNP nurses often collaborate in academic and healthcare settings to generate and translate evidence-based nursing practice (13).  

Lisa Neal-Boylan’s “PhD or DNP? That is the Question” is an excellent short read that highlights the practical differences between these two degrees (9). Many of these differences are addressed below.  

Advantages of Pursuing a DNP 

You will have greater career opportunities and enhanced clinical practice skills. Your expertise as a DNP nurse prepares you to take on leadership roles in health policy and quality improvement. You are well positioned to address healthcare system needs, from the bedside to system policies and procedures (8).  

Advantages of Pursuing a PhD 

As a PhD nurse scientist, you will be an expert researcher. Your research may span quantitative or qualitative studies and is driven by your area of interest and passion (12). Research that you generate contributes to nursing science. You may have a career nestled in academia, where your work will include generating research, disseminating your work through peer-reviewed publications, securing grant funding, and teaching and mentoring students. You may work in other areas of research and policy development, including healthcare systems (10).  

Personal and Professional Considerations 

Self-assessment: Identifying individual career goals and aspirations. 

Take a moment to think about your career goals. Are you more drawn to practice at the bedside or in the community? Do you wish to improve nursing practice by implementing evidence-based practice? Do you feel frustrated when you know a system or policy isn’t working because it isn’t based on the evidence? Or are you intrigued by the scientific process? When you read research studies, do you wish you were the nurse conducting the research? Since graduating, do you miss academia and wish you could be involved in scholarly work as your career?  

Gauge your interest. If you are interested in clinical practice in its many forms, ranging from bedside to population health and healthcare policy, the DNP may be the right degree for you. If you are drawn to designing, carrying out, and analyzing research and its implications for nursing practice, then the PhD may be a better fit (6).  

Consider long-term career objectives. Where do you see your nursing career in 5 years? 10 years? Your future goals and aspirations will provide insight into the best direction for your higher education.  

Explore institutional and mentorship support. Consider whether the institution you work for will support your pursuit of higher education. If you earn a DNP, is there potential to grow into a new DNP nursing role within the health system you already work for?  

Tap into PhD or DNP nurse colleagues that you are connected to. Reach out to your alma mater or another academic institution to learn more about formal mentorship and academic guidance offered to students interested in pursuing a DNP or PhD.  

Conclusion

This course introduces you to the ins and outs of the differences between a DNP and PhD in nursing. If you are considering an advanced nursing degree, use this information to guide your choice. DNP or PhD: Which one is right for you? 

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