Talk:Doctor of Nursing Practice
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NP Discussion under DNP Article
[edit]I suggest that the last two paragraphs under the "Controversy in the United States" section be moved to the nurse practitioner page. While they are accurate for the most part (I could nitpick some of the details of the "Nurse practitioner vs Physician Assistant" paragraph), they do not deal specifically with the DNP -- these issues are broader, and apply to all NP's (both those with doctorates, and those with masters). DoctorEric (talk) 15:52, 20 February 2013 (UTC)
New edits to Criticisms Section, 29 January 2011
[edit]It seems that time and time again there has been a desire by some to list a comparison of the educational requirements of a physician in contrast to an NP or a DNP. While in most instances the discussion of one profession's education in the section of another is a bit odd, and indeed all of the previous posts to that effect have been removed because they both 1) had no direct relevance to the DNP and 2) were posted with the sole purpose to further a political based motive and to "show" that DNP education is somehow inadequate by comparing it to physician education. Such indeed was the post made by Nebrfan at 16:05, 29 January 2011.
Instead of reverting the post, however, I decided to undergo an edit of the post which really took a number of revisions to get it to a more neutral and appropriate level. I think there is some value to leaving a brief and fair comparison of physician vs DNP education, since the DNP is such a new roll, and to understand something that is new often takes a comparison to something similar but different. And, hopefully, by having such a comparison we will get beyond the recurrent vandalism of this section by some individuals who feel the need to emphasize the education requirements of an entirely separate, but related, profession. syncnotes 04:15, 30 January 2011 (UTC)
Removal of Criticisms section posted by 128.172.28.45 on 19 March 2009
[edit]Here is a complete description of why I removed this entire section, line by line.
“The main reason for implementation of the DNP degree is to achieve full autonomy for nurse practitioners independent of physician collaboration or oversight.[6] “
- This is true. However, the source is a document about Certified Registered Nurse Anesthetists only. It does not, by itself, construct any type of criticism, and as you will see, it is one of the few facts in this section, all of which are not critical of NPs.
“The Pearson Report, an annual report published in the American Journal for Nurse Practitioners, was issued in February 2009 describing how nurse practitioners should approach lobbying their state legislatures to push for full autonomy. In the report, the main justification was an analysis of malpractice claims in the National Practitioner Data Bank to show that NPs have much lower rates of malpractice than MDs or DOs. “
- Note there is no link to the Pearson Report. It is available at http://www.webnp.net/downloads/pearson_report09/ajnp_pearson09.pdf. The specific quote this previous author is evidently referring to is: “NPs must use these malpractice and malfeasance ratios and figures to show legislators that the rationale for physician supervision over NPs is unfounded.”
“Such an analysis is flawed not only because malpractice suits rarely target NPs and more often target collaborating or supervising physicians, but also because there has been a growing trend among state boards of nursing for under-reporting malpractice claims against NPs.[7]”
- This sentence is based upon a biased interpretation of the Pearson Report’s legitimacy. Further, the Pearson Report does not say anything about malpractice suits “rarely” targeting NPs and more often targeting physicians. Further, reference #7 cited to back up this statement about under-reporting of malpractice in fact claims the OPPOSITE of what this wiki author wrote. To quote the actual source:
- “Malpractice insurers’ profitability in covering APNs has dropped, perhaps because more nurses are being sued these days.”
- ”APNs should be aware that if they practice with a physician who is under- or uninsured, the nurse might become the deep pocket — the one who is covered for the highest amount and, therefore, is the more attractive to name in a lawsuit.”
"In California, thousands of nurses were discovered to have felony convictions while still retaining an RN license in contradiction of state law.[8]"
- This is true. However, it is a fact about RNs. Yes, NPs need to retain a RN license, but generalizing this fact about RNs to their more well-educated counterparts is a biased and unfounded interpretation. The next sentence is also biased and does not have any facts to back it up:
“Such lax oversight by boards of nursing has lead many to question the ability of boards of nursing to adequately police NP practice.[citation needed]”
- Who are the “many” who are questioning the ability of boards of nursing to adequately police NP practice? There is no source I can find that compares facts to back up this opinionated statement.
"In addition to the criticisms offered against both the expansion of NP scope of practice as well as state boards of nursing, there is little uniformity among DNP programs.[citation needed]"
- Again, this has no factual basis and has no citation.
"There are DNP granting programs offered online[9], and many programs contain few extra clinical training that would seemingly justify the granting of the doctorate level degree.[dubious – discuss][10][11][12]"
- Already marked as dubious, this statement again uses opinion and its sources do not back up the opinion. Sources 10 and 11 simply refer to internet pages that show programs use online training as part of a DNP curriculum.
"In addition to the non-uniformity in training[citation needed] and the overall lack of clinical training[citation needed],
- Again, no factual basis.
"…recently the Council for the Advancement of Comprehensive Care together with the National Board of Medical Examiners administered a certification exam to recent graduates of Columbia's DNP program."
- Yes, there was such a certification examination. However, from that exam’s website: “The Comprehensive Care exam is not intended to replace the national certification exams that lead to recognition for state licensure as an APRN.”
"The exam was based on step 3 of the United States Medical Licensing Exam but had fewer questions and fewer complicated scenarios."
- This information can be found nowhere on the examination’s website and thus has no factual basis. However, the website, at http://www.abcc.dnpcert.org/faq.shtml, does state that the exam is based upon an examination for physicians. NPs are NOT physicians. This examination is designed to be an optional certification and it is nonsensical to apply it to NPs as a requirement to prove competence.
"The fail rate of the exam was 50%, lending weight to many of the criticisms of the current model for DNP education.[13]"
- Yes, the fail rate was 50%. This does not “lend weight” to criticisms in any way that is factually based. The local news article cited by this wiki author as #13 simply includes an opinionated interview with one physician and is certainly not a factually-based source.
So that is why this ENTIRE criticism section is being deleted, AGAIN. I will delete it every time it is reposted if done so without changes and I will monitor this site very, very carefully. I am absolutely not opposed in any way to FACTUALLY BASED, UNBIASED sources which can be used to construct a criticism section on this page. Until an author can add this type of criticism this existing section will remain removed. Please feel free to write me if you have any questions about my substantiations as above; I am more than willing to back up my work unlike the authors who made this section in the first place.
Bryan Hagenb (talk) 04:09, 8 May 2009 (UTC)
- Thanks for this detailed rationale. The comments are sourced, and editing them is better than wholesale deletion. Why not try to re-work it? JJL (talk) 04:13, 8 May 2009 (UTC)
- JJL, my rationale seemed pretty clear as to why this should remain off the page. Please do not undo my edit without substantiating your reasons. The comments are biased and do not belong in a wikipedia article. If there are reliable, peer-reviewed sources that can back up the previous claims, then please cite them and be specific. If you can somehow disprove my rationale as posted above please share that here before reinstating the entire biased criticism section. As it stood before it was removed, it provided an unfair, one-sided, and obviously biased point of view, and should not be left public as-is. Hagenb (talk) 04:29, 8 May 2009 (UTC)
- The material is sourced. It's better to edit and present both sides--a balanced point of view. You've removed a lot of material. Please try editing it and improving instead. JJL (talk) 12:40, 8 May 2009 (UTC)
- JJL, by reading my explanation above it is obvious that the material is not sourced and is in fact deceptive. The sources do not represent the writing and thus saying "The material is sourced" is inaccurate. I cannot find a way to edit this in a way that will leave any criticism left because the only criticism consisted of lies and bias. In the same vein, restoring material proven to be biased is no different from vandalizing the page. Thus, I will not restore it and I ask that you refrain as well. I feel I explained that very carefully and in plain language already. However, I will thoroughly research and present a criticism section in the next week or so that will present things accurately - if for nothing else than to prevent this trash from being restored again. Hagenb (talk) 03:25, 9 May 2009 (UTC)
- What is obvious to you is not necessarily obvious to me, nor to the editor(s) who added the material initially. (For example, in your last point your comments above seem to support the point made, in light of WP:RS.) Are you familiar with WP:CONSENSUS and WP:TRUTH? Editing the material rather than deleting "lies and bias" and replacing it with "accurate" material may not be the most collegial approach--and accusing those who disagree with you of vandalizing the page certainly isn't a helpful approach. JJL (talk) 04:38, 9 May 2009 (UTC)
- JJL, I feel this is turning personal and I certainly do not intend so. I apologize if this is the impression you have. I simply do not understand how the bias is difficult to see in the original contribution. Regardless, in thinking about this criticism section I came to the realization that a more general critique would be more appropriate in the Nurse Practitioner article, as it seems that the debate is over autonomy and practice limitations of NPs and not specifically DNPs. There certainly are many more resources that would substantiate an even-handed debate when not restricted to the relatively new DNP level of education, as the practice standard now is still at the Masters level. Perhaps leaving this particular article without critique would make more sense. Hagenb (talk) 05:22, 9 May 2009 (UTC)
- I think you're right that many of these are actually criticisms that are at least equally shared by the master's and DNP degrees, and that makes sense. But there are some that are specific to the degree here and that should be mentioned; I've read several stories like this [1], for example. JJL (talk) 13:04, 9 May 2009 (UTC)
- I have carefully researched critique of the DNP and posted what I have written as a subheading instead. What do you think, JJL (and others?) My goal has been to present a more even-handed critique that does not inflate or misinterpret resources, and all those I used are from peer-reviewed, reputable publications. I hope this provides a more accurate basis for further expansion of this section as other users see fit. Hagenb (talk) 07:34, 18 May 2009 (UTC)
Discussion of the Criticisms section can certainly continue here, but section blanking isn't a fruitful response. JJL (talk) 01:52, 22 August 2009 (UTC)
- I'm now reverting the continued unexplained blanking as simple POV vandalism. JJL (talk) 02:06, 22 August 2009 (UTC)
Criticisms section
[edit]Added a criticisms section since the DNP programs are off to rocky starts and there is a lot of political tension currently in the medical community. The turf war between NPs and physicians is still ongoing and to ignore it in an article about the DNP degree is pretty ridiculous.128.172.28.45 (talk) 19:04, 19 March 2009 (UTC)
I have challenged its neutrality. Conclusions such as "and many programs contain few extra clinical training that would seemingly justify the granting of the doctorate level degree" are specious, inappropriate, and not supported by your citations. Your reference to online DNP programs is pure scare-mongering. If you want to impugn the integrity and quality of online DNP programs, find a specific program and criticize it. The mere fact that it is an online program means nothing by itself. Likewise, the ability of the state of California to properly screen its RNs for criminal records is irrelevant to the quality and implementation of DNP programs across the country. The test results you speak of are similarly irrelevant to the quality of DNP programs. DNPs are not physicians and they are not trained according to the medical model; they do not practice medicine. The certification exam you mentioned only measures if test-takers are eligible to be certified by the Council for the Advancement of Comprehensive Care. It has no bearing on the overall knowledge of the DNP holder, and is not an evaluation of any degree program. You are dishonorably attempting to discredit the DNP by using scare tactics, weasel words, guilt by association, and suggesting but not outright saying that the DNP is a flawed or poorly designed degree.(Sendanna (talk) 18:34, 21 March 2009 (UTC))
No one has come forth to dispute Sendanna's stance on the neutrality of the "Criticisms" section that was evidently posted by an unregistered user. I completely agree with the assessment that the text was negatively biased, unsubstantiated, and unverifiable. I was unable to find a way to salvage the existing text, and therefore I have removed this entire section. Hagenb (talk) 01:22, 4 May 2009 (UTC)
Just a heads up, Link #7 is dead — Preceding unsigned comment added by 67.185.152.212 (talk) 06:41, 24 March 2014 (UTC)
Inappropriate statement
[edit]I agree that anyone but a physician being addressed by the title "doctor" may be confusing for the patient, but that in no way means that nurses who have earned the Doctorate of Nursing Practice should not be addressed professionally as "Dr. So-and-So." Ideally, the decision on this policy should be left up to individual facilities, but that probably won't be the case. I suggest that if patients have a Doctor of Nursing Practice as their primary care provider, they probably know that fact already; if the staff is sure that a patient doesn't, then the DNP should introduce herself as "Dr. So-and-So, a nurse practitioner. I am not a medical doctor." Medicine does not hold a monopoly on the title "doctor." Also, I love the "DNP is not licensed to practice medicine" comments. Guess what- an MD isn't licensed to practice nursing, either! This professional gamesmanship is infuriating!(Sendanna (talk) 18:50, 21 March 2009 (UTC))
The statement "It should be noted that the DNP is not equivalent to an M.D., and nurses with DNP degrees should not be addressed as "Doctor" in a clincial setting" is up to great debate. When did it become taboo for someone with an advanced dregree (doctorate) not to be addressed as doctor? Why is the clinical setting so worrisome? As an advanced practice nurse for over 17 years, I have interacted with PharmDocs, psychologists, physical therapists (DPT), and many other PhD types that work in radiation oncology, radiology, lab, clinical research, etc... all in a clinical setting, and all appropriately addressed as doctor. This is actually a very common thing and a matter of respect. Of course the DNP is not equivalent to the MD, but neither are the many other types of doctorate degrees found in hospitals or the "clinical setting." Furthermore, it is not uncommon in the academic setting for PhDs to be considered one notch above those clinical MDs. Who's going to tell all the doctors not to use the "d" word! Eclipse Anesthesia 20:24, 16 June 2007 (UTC)
Try to look at it this way: Someone who has an "M.D." degree refers to himself/herself as a "physician", and someone who holds a "D.D.S." or "D.M.D." degree refers to himself/herself as a "dentist", while someone who holds a "D.P.M." degree refers to himself/herself as a podiatrist. People who call themselves physicians, dentists, podiatrists, or optometrists are all recognized to be "doctors". But try and apply this logic to someone with a DNP degree. What does someone with a DNP call themselves? A "nurse", or a "nurse practitioner". No matter how you slice it, nursing is not a branch of medicine (like medicine, dentistry, podiatry, etc.) that warrants a doctoral degree. And if it did, then it would be a specialty of medicine. But lets be honest here: the DNP degree seeks to eliminate that pesky little problem that NPs and CRNAs have had of not having the title of "doctor". What they don't realize, and what they don't realize that the public realizes, is that there's a difference between someone who is "a doctor" and someone who holds a doctoral degree.DrSandman (talk) 19:03, 10 November 2008 (UTC)Dr.Sandman
- I think a more appropriate statement would be that a DNP is not licensed to practice medicine and is not an equivelent to a physician; that would solve the problem, no? Gtadoc 19:13, 25 June 2007 (UTC)
- It appears that the page has been edited to reflect this, and reads much better.Eclipse Anesthesia 12:31, 29 June 2007 (UTC)
Every state is different. In most states a mere NP with only a masters level education may preform as a primary care provider in the place of a medical doctor and are not subjugated to working under someone with an MD. An NP may prescribe medications, admit his/her patients to hosptials, refer patients and order any necessary tests or lab work. In my experience with working in a hosptial setting the staff (including MDs) wouldn't dream of calling a DNP, DNSc, or PhD in nursing anything less than Doctor. Every medical doctor I have encountered had respect for advanced nurses with a terminal degree. 76.105.150.19 08:42, 7 October 2007 (UTC)
- Of course DNPs should be called "doctor"s. DNP=Doctor of Nurse Practicing, not Doctor of Medicine, thus it is right to say DNPs are not equaivalent to MDs (only MDs & DOs are full physicians), but you cannot say DNPs are not docotors. Because essentially, the word doctor does not mean physician. There're pretty much doctor degrees in every health care field including optometry(OD), dental(DDS/DDM), medicine(M.D), audiology(Aud.D), pharmacy (Pharm.D), physical therapy(DPT), occupational therapy (DOT), naturopathy (ND), chiropractic (DC), podiatry (DPM), psychology (Psy.D)etc etc, and doctors only mean that they are the experts in their area of study, and medicine is not optometry, or pharmacy, or vice versa. I don't think who ever wrote "DNPs should not be called doctors in clinical settings, same as Ph.Ds" has ever been to a hospital. In cancer centers, Medical Physicists are also addressed as "docotors", because THEY ARE! THEY ARE DOCTORS OF PHILOSOPHY IN MED. PHYSICS! Radoncology (talk) 18:55, 3 October 2008 (UTC)
It is true that you "may" use the title "doctor" if you hold a "doctorate" of any sort. (i.e. it is fine to use this term when giving a lecture within the University environment) However, many places "especially hospitals" have laws on whom can and cannot use the term in a clinical environment. Just because a Nurse with a DNP, DNSc, or PhD degree can be called doctor doesn't mean they "should" within a hospital environment as it can be misleading. How would you feel as a patient when you are distressed and someone walks in the room with scrubs and a white coat and introduces themselves as your "doctor". DNP does not equal MD, true as we can all agree.. and we must equally agree that if that is true, that it is not a good idea to present yourself to laypersons (patients) in a manner which may mislead them to believe you are a physician. Agree? Jwri7474 (talk) 04:49, 4 October 2008 (UTC)
- A professional doctoral degree is not a Ph.D! An MD is a professional doctoral degree! You have to understand the difference first. Professional doctorate is a professional doctor degree while Ph.D is a doctor degree in research (same as MD, doctorate in medicine). Other doctors are not MDs doesn't mean that they can't be called doctors. Dentists are not MDs either, in fact they're not even full physicians (only MDs & DOs are full physicians), but people still call them doctors because THEY ARE DOCTORS.Radoncology (talk) 15:59, 4 October 2008 (UTC)
- Indeed: A professional doctoral degree is not a Ph.D, and many other countries do not refer to people with a US professional doctorate (or the local equivalent) as doctors at all. In Germany, the corresponding word is "Arzt" (physican/US M.D., "Zahnarzt"--Dentist/US DDS, etc.). The title of "doktor" is reserved for those with a true, academic doctorate, and a US M.D. who tried to claim that title here could get himself into trouble (depending on the exact circumstances of the use). This leaving aside the issue of US grade inflation, in general, which makes many Europeans view any US degree with some amount of skepticism94.220.251.117 (talk) 22:57, 26 September 2009 (UTC)
By the way... also physicians, chiropractors, dentists, podiatrists, etc in other countries that follow the British system who graduate with "bachelors degrees" can also be called doctor. Example: Dr. Joe Smith, MBBS or Dr. James Wall, BDS etc. Jwri7474 (talk) 04:51, 4 October 2008 (UTC)
- So what's your point? Professional doctorate does not equal Ph.D...Radoncology (talk) 15:59, 4 October 2008 (UTC)
I know it's hard sometimes to distinguish the physician doctors from the non-physician doctors. That's why you often find in clinical settings that people just use the word "physician" & "clinician". If someone says physician, then everybody knows he/she is talking about an MD/DO doctor, if he/she says clinician, then everyone knows he/she is talking about a non-physician doctor, which can be a Psy.D, Pharm.D, NP, etc.Radoncology (talk) 05:29, 5 October 2008 (UTC)
FYI: Seven US states (Georgia, Illinois, Maine, Missouri, Ohio, Oklahoma, and Oregon) have statutes or regulations prohibiting a nurse practitioner (NP) or other non-physician health professional from using the title "Doctor." Many other states also have provisions in law allowing non-physician healthcare professionals to use the title "Doctor" only if they also include their specific title of licensure or specialty (example: NP, physical therapist, etc) during all patient communication within a clinical environment. The American Medical Association (AMA) also has identified use of the professional title of "Doctor" as a topic for legislative initiative on behalf of its membership. Resolution 211, passed by the AMA House of Delegates, states that nurses and other "nonphysicians" with doctoral degrees should not mislead patients "to believe that they are receiving care from a doctor/physician." The resolution states further that the AMA resolves to work with individual states to "identify and prosecute those individuals who misrepresent themselves as physicians to their patients." So, take that for what it is. Jwri7474 (talk) 12:16, 5 October 2008 (UTC)
Also, resolution 214 states, "AMA adopted a policy that those nurses who are Doctors of Nursing Practice must only be able to practice under the supervision of a physician and as part of a medical team with the final authority and responsibility for the patient under the supervision of a licensed physician." Jwri7474 (talk) 04:01, 6 October 2008 (UTC)
First, the term "Dr" is an academic distinction while the terms "physician", "nurse practitioner", "dentist", and others are professional distinctions. The claim by the AMA and their supporters that "Dr" only applies to those holding a Doctorate of Medicine or Doctorate of Osteopathy (after the late 1960s when the AMA recognized DOs) is nonsensical on it's face - the term "Dr" has applied to the highest academic degree for hundreds of years. Second, Nursing is not a subspecialty of Medicine and neither is Pharmacy, Public Health, Psychology, et cetera; these are all fields within Healthcare, not fields within 'Medicine'. Finally, the AMA is not now, nor has it ever been, the final arbiter on healthcare although it frequently claims itself to have such a role. AMA resolutions 211 and 214 are simply the latest attempts by the AMA to claim control over Healthcare and to eliminate competition from other providers (see the AMA claims against DOs, Chiropractors, Optometrists, CRNAs, Psychologists, and yes NPs, et cetera in which the AMA has consistently lost in court for more examples of the attempt to restrict trade by the AMA). —Preceding unsigned comment added by 152.131.9.197 (talk) 19:10, 13 December 2008 (UTC)
- I think what it comes down to is this, do CRNAs, NPs, etc. place the care of their patient, and the honesty of of the patient relationship as a priority? Or do they put their ego above their patients? It should be really simple, everyone should just identify exactly who they are in a medical setting. I want to know, as a patient, if I am being treated by a nurse (NP) or a physician. I want to know if I am being treated by a consultant, or a first year resident. I want to know if the random advice I just got was from a pharmacist or a physician. All of that should be made clear to patients, and its unethical for any person to try to mislead anyone: a NP trying to mislead a patient into thinking they are or practice at a same lvl of a physician would be just as guilty as an intern who told a patient they were the attending surgeon. Why does no one want to be straight with their patients?ChillyMD (talk) 18:30, 18 July 2009 (UTC)
- That's a heck of a straw man argument. It is possible to care about patient care and want professional recognition and equality for DNPs.Mavirikk (talk) 01:25, 23 November 2009 (UTC)
The only person with a doctorate not allowed to use the "Doctor" honorific is a Juris Doctor. A DNP, MD, DO, OD or PhD (etc) may refer to themselves as "Doctor". I see no problem with it. If a physician is over-seeing a DNP and doesn't want them to be able to call themselves a doctor maybe they shouldn't both; have hired a doctor, and hired a person who will practice in their stead at a lesser quality (if that's their rationale). I came to the talk page to say I seperated the sections because its very US only, this needs to be globalized further - I did what I could for now Pulmonological (talk) 11:38, 22 December 2011 (UTC)
- Well, a Juris Doctor can use the title "Doctor" (there is no law against it); it's just extremely lame to do so, so none of us do! That being said, nurses wanting to be called "doctor" in a hospital are ridiculous. That's like a pharmacist walking around calling herself doctor, in a hospital. Confusing, unhelpful, and potentially dangerous. Pure ego.170.141.177.135 (talk) 16:26, 15 April 2013 (UTC)
- Actually, you see a LOT of "Doctors" in hospitals who aren't physicians. Aside from MDs, you have your PhDs, Dentists (who occasionally come in for surgery), Optometrists, PharmDs, etc. When it comes to dealing with patients, regardless of who's talking to the Patient, you always state your field/specialty when you introduce yourself. The standard introduction is "Hi X, I'm Dr. Y, I'm a Physician/Pharmacist/Surgeon/Radiologist/Optometrist" etc. It has nothing to do with ego, just standard practice. The people working there are aware of the other's positions, and I've never actually experienced any confusion due to someone being referred to as "Doctor". Everyone's got their own field and their own work. In fact, when you see a group of "Doctors" making their rounds, there's usually 1-2 PharmDs and a specialist PhD with them.
- Having said all that, I've never personally seen DNPs who refer to themselves as Doctors, but it may very well exist. --99.225.103.12 (talk) 22:24, 9 June 2013 (UTC)
Bias in tone
[edit]This page should be marked for NPOV. Clearly, this article was significantly edited by a Caucasian female NP. The tone, inflection and syntax are obvious. ~JB — Preceding unsigned comment added by 67.81.224.14 (talk) 04:27, 28 May 2013 (UTC)
Hello IP user(talk),
It has been shown that a majority of wikipedia editors are males, so by your own observation there is bias in most articles. Beyond this the article has citations for a majority of the document. Blanksamurai (talk) 20:04, 5 June 2015 (UTC)
Title controversy
[edit]An unregistered editor recently removed a section from this article that described "an interdesciplinary controversy over the use of the salutation or title “Doctor” being used within the clinical setting by holders of the DNP." Although he or she was correct that the only reference in that section is now dead, he or she also indicated in the edit summary that "a google search was unable to find a reputable source for this discussion." I conducted my own quick Google search and was able to come up with many sources, including ones from The New York Times (2011), HealthcarePOV (2014) (no, I've never heard of it, either!), and Clinical Advisor (behind a paywall). There are many other sources that indicate that at worst this was an issue in the immediate past that might warrant a brief mention in this article. If there are laws on the books that specifically address this issue (as claimed in some of these sources and the text deleted from this article) then that should be mentioned, too. But I'll leave this to others with more time and interest in this topic. ElKevbo (talk) 20:05, 10 May 2016 (UTC)
External links modified
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New Controversy Section
[edit]New section added. It is specific to the USA DNP and it cited throughout (I think). Would welcome further citations to ensure it is evidence based Imaginarium Monkey (talk) 10:16, 24 March 2022 (UTC)
- I've edited this section to nudge towards a neutral POV. The article is still fairly poor throughout and US centric. 185.58.164.47 (talk) 09:22, 12 April 2023 (UTC)
The 1-year DNP requirement in the US
[edit]That is misquoting. The 1-year requirement is after an MSN degree (see the source), which usually takes 7 semesters after a bachelor's degree. In effect, the total requirement is close to 9 semesters after a bachelor's degree, in line with doctorate requirements in other fields. 99.13.228.225 (talk) 00:21, 17 April 2022 (UTC)
European doctorate is 3-5 years, after a 1-3 year masters. The DNP is short when compared internationally to doctorates. Imaginarium Monkey (talk) 21:36, 26 July 2022 (UTC)
Not all DNPs are patient-facing
[edit]Controversy section was very obviously written by a disgruntled person, probably a physician. Firstly, the DNP isn’t a response to the MD/DO. The section assumes that all DNP-educated nurses serve in direct, clinical/bedside roles (i.e. nurse practitioners) when that just isn’t true. DNPs also act as executives, administrators, owners, chief officers, managers, etc., and they do not “tread” on physicians in those capacities. This section also does not share any detail or background on the very real and tangible ways that nursing institutions, accreditors, boards, and individuals are working to improve the image, credibility, and rigor of these degrees. I believe that people deserve a comprehensive view of any given issue so I’d argue that a reasonable effort needs to be made to present, not only the problem, but also what’s being done to solve the problem. In general, this section can explain the flaws that nursing education has to overcome without throwing the entire profession away as cheats and imposters. 76.150.36.106 (talk) 16:54, 9 January 2023 (UTC)
- I have edited to make tone for neutral. 185.58.164.47 (talk) 09:23, 12 April 2023 (UTC)
Fourth terminal Nursing degree is not mentioned
[edit]There is another terminal nursing degree. Doctor of Nurse Anesthesia Practice (DNAP) 2601:100:4180:1D73:71D1:5C0B:2556:EA3 (talk) 14:47, 23 October 2023 (UTC)
NPOV issues regarding educational requirements
[edit]There are extensive WP:NPOV issues with this article regarding the educational requirements to be awarded a DNP.
Clinical hour requirements misrepresentation: The AANC, which publishes the document outlining the requirements for DNP programs, states: "DNP competencies, programs should provide a minimum of 1,000 hours of practice post-baccalaureate as part of a supervised academic program (p. 19). All DNP students, including those in post-master’s programs, are expected to complete a minimum of 1,000 post-baccalaureate practice hours." The current indication that DNP programs "may" require "in some cases as many as 500 hours," with 500 being implied as the maximum, is misleading. Further, the claim that "the required clinical practice hours to be accepted on a DNP course can be as little as zero hours" references a 2021 study by Dobrowolska et al., which in turn references a 2011 study by Wolf et al. (Clinical Experiences for Doctor of Nursing Practice Students—A Survey of Postmaster's Programs). The Wolf et al. study is purely about post-master’s DNP programs for students that already have an MSN. The "0" required clinical hours was in reference to additional clinical hour requirements beyond the clinical hours a student already completed from their MSN. Nowhere in any of the referenced material did it state that any DNP programs allowed for students to obtain a DNP with a "0" clinical for a BSN student entering a DNP program.
If the clinical hour requirements of DNP are going to be discussed, it needs to state that 1,000 clinical hours are required per AANC guidelines. If someone wants to add, in a NPOV way, that some of these hours can be completed during an MSN, I do not object.
Minimum time to complete misrepresentation: The article currently states: "the DNP is also unique in that it is significantly shorter at one year’s duration than a standard doctoral degree anywhere in the world (e.g. 3-5 years in Europe or 4-6 years in the USA)." To support this, it cites the European Commission webpage that discusses Swiss PhD programs in general (nothing about nursing) and also a webpage from Franklin University about doctoral programs in general (mentioning DNPs as one of these). Franklin University's website did not state anywhere that a DNP could be earned in a year; in fact, it stated that the programs they offered allowed students to "earn their doctorate in as little as three years." There are a few programs that allow students to earn a DNP in about a year after completing their MSN, which often takes 2 years; however, as noted above, it is inaccurate to imply that a DNP can be obtained in a year without an MSN. This is especially ironic considering the article then goes on to criticize the DNP for not requiring master’s education. The article, with no references, claims that "it has been argued that the DNP lacks academic credibility due to the fact that the schools awarding the qualification may be accepting nurses with little or no postgraduate experience."
The current article clearly pushes a non-neutral point of view and, at best, misrepresents sources and misleads readers about the requirements for a DNP (implying a DNP, without any other postgraduate training, can be obtained in one year with no clinical hours).
I propose removing the entirety of the "International Perspective" section in the introduction (which appears to be misplaced in the introduction section anyway) and heavily modifying or even eliminating the "Comparison to other doctorates" section. Wikipedialuva (talk) 08:52, 15 May 2024 (UTC)
- In general, it is not non-NPOV to state that there has been criticism. If there is information that you feel should be included to better balance the discussion, you need to provide references to this information, not just state it. Having said that, there are clearly issues with this article as it stands.
- European doctoral degrees are normally 3+ years post-master's, so if the DNP can be done in 1 year post-master's it is clearly shorter than these. However, US professional doctorates are never equivalent to what the rest of the world calls doctorates – which are always research doctorates: the criticism implicit in the comparison to European doctoral degrees applies equally to the US MD, for example. This appears to be WP:UNDUE.
- When it comes to the issue of pre-requisite hours, the first paragraph in the 'Comparison to other doctorates' section appears to be NPOV. The information is clearly presented in the work cited under the heading of "What are the main issues debated in the available literature to date?". The degree has clearly been controversial, so to avoid discussing these criticism would be non-NPOV. The statement that "In other cases where clinical hours are required to gain the DNP, these can include clinical hours undertaken as part of a prior degree" is backed up by what you have said above, so doesn't appear to be controversial. If the requirement of a total of 1000 clinical hours across the DNP and previous degrees can be verified with a reference, it should be added to this paragraph to balance it.
- The second paragraph of the Comparison section, however, looks to stray into WP:OR by looking up the requirements for other degrees in specific instances, generalising from these, and drawing conclusions from a comparison of these to the DNP. This should be removed.
- The third paragraph is a decidedly non-NPOV presentation of two sources that present a factual comparison of the DNP and PhD that does not support the claim that "it has been argued that the DNP lacks academic credibility". It simply isn't a research doctorate. This should be re-written.
- Splitting the lead into sections is weird. If there are differences in what a degree entails across the world, it would be fair to put these here, rather than concentrate on a single country, but the comparison of the DNP to international meanings of the doctorate is out of place, even if technically accurate. We don't put in the lead of the MD degree that other countries don't regard the US MD as a doctorate. This section appears to be WP:UNDUE and should be removed. It would be good (per the 'internationalize' tag) to include information on the DNP outside of the US.
- I've addressed these points and removed the POV tag. Robminchin (talk) 15:58, 17 May 2024 (UTC)
- @Robminchin: I appreciate your edits and now feel that your edits to the article have made the article well within the NPOV range expected of Wikipedia articles. Thank you for doing such a great job with the page; the edits were well-supported, neutrally worded, and well-considered, as was your response here.
- I also want to note that, after performing further research, I believe that many of the accounts and IPs that added a significant portion of the NPOV information may have been sockpuppets. I have filed a sockpuppet investigation (with evidence from several different pages) against several usernames and IPs. (see: Wikipedia:Sockpuppet investigations/Imaginarium Monkey)
- Thanks again for your help and for doing such great work! Wikipedialuva (talk) 06:00, 18 May 2024 (UTC)