In 2004, members of the American Association of Colleges of Nursing (AACN) voted to endorse a position statement identifying the doctor of nursing practice (DNP) degree as the most appropriate degree for advanced-practice registered nurses (APRNs) to enter practice (AACN, 2004). This position represents a change from the current standard, the master of science in nursing (MSN) degree, adding between one and two additional years of education (on a full-time basis). As opposed to research-focused doctorates, the DNP focuses on scholarship in the practice setting, innovation and testing of care delivery models, practice improvement, examination of health care outcomes, and...

This report uses a mixed-method approach to address the key objectives of the project. Specifically, we use data from three sources: AACN Annual Survey data, data from an online survey fielded for this project, and key informant interviews with leaders from nursing schools. This chapter of the report describes the data and how we collected them, as well as the methods we used to analyze them.

AACN provided data from their Annual Survey, which is fielded every year between September and early November and obtains responses from more than 90 percent of U.S. nursing schools offering graduate level nursing education....

This section describes the past, current, and expected status of nursing schools with respect to their DNP program offerings—focusing on offerings for entry-level APRN education. We also briefly discuss schools’ offerings of MSN-to-DNP programs. The chapter primarily relies on data from the AACN Annual Survey, but includes additional data from the program-offering questions in the RAND/AACN Online Survey.

There has been rapid growth in the number of DNP programs over time (see Figure 3.1). In a previous report, AACN demonstrated that DNP programs have experienced more than a tenfold growth in the last seven years (Kirschling, 2014).

This steady...

In this chapter, we discuss the reasons underlying schools’ APRN program offerings characterized in Chapter Three. Schools face a number of factors at once, some working toward and some working against adoption of the DNP, and specifically the BSN-to-DNP option. Generally, when the factors pushing toward adoption are stronger than those pushing against, the school would adopt the BSN-to-DNP. We observed and heard from schools in all possible situations - for example, some facing very difficult barriers but also strong facilitators that pushed them toward offering the BSN-to-DNP, some with few barriers that faced a very easy decision, and some...

Based on the findings in the earlier sections of this report, we derive the following conclusions and recommendations. These are grouped into subsections mirroring the order of discussion in the body of the report.

The DNP continues to expand steadily. Each year since 2006, roughly 30 additional nursing schools have joined the ranks of those offering a DNP program. In 2013, among 408 schools offering APRN education, 30 percent offered a BSN-to-DNP for at least one APRN role and more than 50 percent offered an MSN-to-DNP program. Factoring in those who state they are planning BSN-to-DNP programs, nearly half will...

In this section, we present five case studies highlighting various aspects of schools’ experiences with DNP programs in greater depth than in the previous sections of this report. We paid particular attention to issues with transitioning an MSN program to a BSN-to-DNP one, overcoming resource, faculty, and institutional barriers as noted earlier in the report, and in sustaining programs. The schools highlighted are at various points in their processes, and facing various sets of facilitators and barriers; thus, the discussions focus on different aspects of the programs that were relevant in each particular case.

Our first case study is of...