History of the DNP at FPB
The concept behind the DNP degree is not new. FPB first created and offered a practice-oriented nursing doctorate, the ND (Doctor of Nursing) degree, 30 years ago. Graduates were prepared as generalist nurses with expanded skills and knowledge. FPB was the first nursing school in the nation to offer a clinical doctorate.
The ND program was launched in 1979. The school has a long history of support and belief in the doctorate as the appropriate level of education for clinical nursing practice.
But why a specific practice-oriented doctorate? There are some who might argue that the PhD degree has long been available to nurses who wanted it. This misses the important point that there is a need for doctoral preparation for advanced clinical practice.
In the introductory chapter of her recently published book, The Doctor of Nursing Practice and Clinical Nurse Leader, Joyce Fitzpatrick, PhD,MBA, RN, Elizabeth Brooks Ford Professor of Nursing—who served as Dean of FPB from 1982 to 1997—explains, “It is important to note that the widespread development of PhD programs in nursing did not occur until after the first professional doctorate was developed in 1979. The expansion of PhD programs in nursing occurred in the mid-1970s. Prior to 1975 there were only three PhD programs in nursing, located at New York University, the University of Pittsburgh, and Case Western Reserve University. In addition to these three PhD programs, there were four other doctoral programs in nursing, three of these were DNSc/DNS degree programs focused on research and one was an EdD program, focused on preparing faculty and academic administrators.
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“From 1975 to 1990 there was a rapid expansion of PhD programs, and a concomitant demand for faculty prepared at the doctoral level to teach in these programs. This societal change was accompanied by the development of research in nursing, including the establishment in 1985 of the National Center for Nursing Research (NCNR) at the National Institutes of Health (NIH).
“... In 1993, the NCNR became the National Institute of Nursing Research, a movement that generated support from the entire nursing leadership community and serves as a landmark in nursing collaboration for change.
“[While] the initial proposal for the [FPB] program was for [creation of the ND as the] entry-level practice in nursing ... by 1990, due to several factors, including a shortage of nurses that had occurred shortly after the initiation of the ND program, it was apparent that professional doctorate entry-level nursing was not going to occur on a national level. A reassessment of the ND program occurred at Case Western Reserve University, and the decision was made to modify the program so that all graduates were not only prepared for entry-level clinical practice but also were required to be expert practitioners.
“In 1990 the [FPB] ND program was changed from an entry-level program to a post-masters clinical doctorate so as to prepare clinicians at the most advanced level of clinical nursing practice ... All students enrolled in the program were required to complete a master’s degree in nursing to progress to the ND level.
“Students were eligible to take the NCLEX-RN exam after the first two years of the program if they entered without nursing degrees. An active recruitment effort was initiated to enroll nurses with master’s degrees in nursing into the ND program. [B]etween 1990 and 2005 several hundred master’s-prepared nurses graduated with ND degrees from the program [at FPB]. This model of post-master’s course work focused on expert nursing practice for APNs was similar to the current model of DNP education developed through AACN and other professional nursing organizations.”
The result is that while the ND survived for a time, it did not retain its position as an entry-level practice degree. The sheer enormity of the nursing workforce made requiring doctoral preparation to enter practice unworkable, notes Dr. Fitzpatrick. During her tenure as Dean, the ND was changed from a three- to a four-year degree, and master’s level preparationwas required as part of the program. “In 1990, our ND program became similar to what the AACN is now recommending as the DNP,” Dr. Fitzpatrick says.
The Doctor of Nursing Practice (DNP) degree is the successor to the ND degree. The DNP at FPB is as unique and innovative today as the FPB ND was in the 1970s. So while the DNP is a new name, innovation from the FPB nursing curriculum is nothing new. As FPB pioneered the ND, the school continues to pioneer the development of the future of nursing in the 21st century—the DNP.
