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Briana Pierre
Prof. Leslie Wolcott
ENC 1102
23 March 2015
Annotated Bibliography
The broad-range of nursing is a continuously evolving profession in which innovations
are constantly brought into play in order to accommodate the increasingly complex healthcare
system. In this dynamic field, it is prevalent for nurse educators to analyze and modify education
curriculum, proposals, and programs that is vital to new and current practicing nurses. With
regard to advanced practicing nurses (APN), nurses who are nurses who have at least have
obtained a masters degree in nursing, recent studies have put an emphasizes on a new
innovation related to the credentials of advanced nursing practice. This innovation has sparked a
decade-long conversation brought to attention by the American Association of Colleges of
Nursing (AACN) when it adopted a proposal to move the education and required credentials of
APNs from the masters degree to the doctoral level by the year 2015. Outside of the normality
of delivering high-quality patient care and disease prevention, this new innovation seeks to focus
on the leadership, research, and problem-solving skills of an advanced practice nurse.
To further understand the driving force behind the AACNs position on the potential
implementation on a required doctoral degree for current and future APNs, this annotated

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bibliography attempts to address both negative and positive viewpoints and also addresses the
educational curriculum on this controversial debate on the proposed doctoral level education
requirement to pursue a career in advanced practice nursing. The list of sources below provides
many different perspective on this long-lasting matter and is formulated from scholarly/academic
journals. This issue sparks an interest to future nurses, current advanced practicing nurses,
nursing education programs, and the overall doctoral education program in general because this
debatable subject has direct effects, whether positive or negative on those who are most involved
and do not pertain to those who do not wish to purse or have an interest in the nursing profession.
The professions of the contributing authors to the academic journals in this field ranges from
nurses who have gained credentials beyond the post-graduate level in nursing to researchers who
are experts in nursing informatics.
In this annotated bibliography, researchers, current and future advanced practice nursing
students, nurse education programs, and nurse educators will be made knowledgeable of the new
innovations that has the nursing community buzzing and the effects it has on the growing health
care industry.

Apold, S. (2008). The doctor of nursing practice: looking back, moving forward. Journal For
Nurse Practitioners, 4(2), 101-108.
In this scholarly journal article, Susan Apold, vice president of academic affairs and dean
of faculty at College of Mount Saint Vincent in Bronx, NY and also the immediate past
president of the American College of Nurse Practitioners seeks to discuss the long-lasting
conversation and conclusion on the adaptation of the doctor of nursing practice as the
required credential for the advanced nursing practice profession. This article unfolds the

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origin behind doctoral education, provides an explanation of the challenges and beneficial
aspects of a new doctoral degree for the advanced practice nursing education, and lastly,
suggest ways on moving forward in relation to the growing healthcare system. Opponents
of the potential DNP practice credential argue that if this new requirement is in-fact
implemented, it may prevent nursing faculty from having tenure which will enable them
from participating in policy issues, decision-making on the college/university level,
budget distributions, and other inquires that focuses on the overall growth, development,
and actually sustainability of nursing as a discipline in higher education (p. 105).
Contrary to the challenges this new development may face, there are also some
advantages to this process in which the author suggest that the DNP practice degree may
increase knowledge to improve the practice of nursing, leadership roles, and develop
improvements in patient-outcomes.
Susan Apold uses this article to portray its relevance to my research in its importance for
moving forward with this new required doctors in nursing practice (DNP) by suggesting
that the nursing profession must embrace and openly discuss the unanswered questions
that wonders through the minds of those involved such as myself, because it is imperative
for me to confront the pros and cons to the potential innovation seeing as I wish to pursue
a career as a nurse practitioner.
Boland, B., Treston, J., & O'Sullivan, A. (2010). Climb to new educational heights. Nurse
Practitioner, 35(4), 36-41.
In this scholarly article, the authors who all have the necessary post-masters level
credentials in nursing seek to explain the dynamics of the doctoral level of advanced
nursing practices and informs future nurses who wish to practice in this particular level

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on what to look for and what to be aware of when pursing the complexity of the doctoral
education program. The authors discusses the potential of this innovation and argue that
this proposal can significantly influence the evolution of advanced nursing practice and
have an impact on current and future nurse practitioners. In the article, the author
informs those that hope to pursue this potential innovation of the essentials of the
doctoral education in advanced nursing practice. Emphasize is placed on examples of
DNP programs in the U.S. and what the institutions main focus and objectives are in
those particular programs.
This article is important to my research because it demonstrates its relevancy to the
healthcare system and how imperative it is for future advanced nurses to examine all of
the possible effects of the proposed DNP degree to ensure that this would be the right fit
for their career.
Brar, K., Boschma, G., & McCuaig, F. (2010). The development of nurse practitioner preparation
beyond the master's level: what is the debate about?. International Journal Of Nursing
Education Scholarship, 7(1), 15P.
The authors in this scholarly journal article who are all experts in the nursing profession
explains the overview of the DNP in the U.S. makes a comparison to the way it has a
direct influence on the DNP program in Canada. In both countries, Brar et al. establishes
that the driving need for the DNP program correlates to the shortage of nurses educated at
the doctoral level and argues that the program can bridge gap in knowledge between the
masters degree level and the PhD program. If this gap is not filled, researchers believe
that this can hinder the quality development of patient care. The debate in this article

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focuses on using the doctoral program as an alternative to the PhD program in the states,
and whether or not Canada should follow behind. The authors compare and contrast
between the DNP and the PhD in nursing. The PhD in nursing focuses on the research
and education aspect of nursing whereas the DNP concentrate more on the clinical
practices or clinical teachings. A major similarity between the two, the authors argues,
are that both programs both utilize content from research methods.
This article is relevant to my research due to the clarity the authors provide on the
confusion between the DNP and the PhD nursing programs. The potential implementation
is not only being discussed in the U.S, but has also sparked controversy across the world
such has in Canada, which overall proves how prevalent this conversation is to those who
are directly or wish to become involved in the nursing profession.
Chase, S., & Pruitt, R. (2006). The practice doctorate: innovation or disruption?. Journal Of
Nursing Education, 45(5), 155-161.
The authors, Dr. Susan Chase who is an interim Assistant Dean for Doctoral Programs
and Associate Professor, Christine E. Lynn College of Nursing at Florida Atlantic
University and Dr. Rosanne Pruitt who is a Professor and Director at Clemson University
School of Nursing in Clemson, South Carolina, describes the preparation of advanced
nursing practice with a Doctor of Nursing Practice (DNP) degree as a disruptive
innovation. This scholarly article main objectives focuses entirely on the future
difficulties of this innovation in regards to future students, current practicing advanced
nurses, nursing colleges, and the overall education of a doctoral degree as a unit. The
American Association of College of Nursing (AACN) has proposed by the year 2015 that

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all advanced practicing nurses be required to obtain a DNP degree as a credential,

however, the researchers in this article has set their own recommendations and opinions
in which they have proposed that the AACN entirely eliminate the 2015 deadline for the
innovation of a doctoral prepared nursing practice.
This scholarly article is important to the potential innovation of a required DNP
credential for advanced nurses because it describes the negative aspects of this discussion
and its effects on new and current nurses, educators, nursing schools, and takes a stand on
how this innovation threatens the nursing doctoral degree as a whole.
Chism, L. (2009). Toward clarification of the doctor of nursing practice degree. Advanced
Emergency Nursing Journal, 31(4), 287-297.
The author of this academic journal, Lisa Chiasm who is a DNP, APRN,BC, at the
Karmanos Cancer Institute in Michigan sets out to inform those interesting in the field on
the competencies of the DNP in nursing. As in the article by Brar et al., Chiasm addresses
the confusion between the DNP and PhD programs and distinguishes between the two.
The author explains the role DNP graduates play in regard to emergency nursing settings
which includes research, leadership skills, and serving as an advocate.
The importance this article possess it relevant to my research because it outlines the roles
and responsibilities of a DNP professional in relation to nursing settings and to members
that are not directly involved in this profession. The clinical expertise developed from
this innovation allows for future and current advanced nurses to practice leadership skills
in any setting.

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Dracup, K., Cronenwett, L., Meleis, A., & Benner, P. (2005). Reflections on the doctorate of
nursing practice. Nursing Outlook, 53(4), 177-182.
Kathleen Dracup, a Professor and Dean at the School of Nursing, University of Californi,
Linda Cronenwett, a Professor and Dean at the School of Nursing, University of North
Carolina at Chapel Hil, Afaf I. Meleis, a Professor at Margaret Bond Simon Dean at the
School of Nursing, University of Pennsylvania, Patricia E. Benneris a Professor and
Thelma Shobe Endowed Chair in Ethics and Spirituality at the University of California
all seek to address what they believe are the potential consequences of adopting a practice
doctorate within the nursing profession in which they argue might be negative for the
nursing profession, for healthcare, and for society as a whole. The practice doctorate, in
their professional opinions threatens the number of nurses prepared at the PhD level and
changes the nature of university-based faculties of nursing.
This scholarly article is important because it provides a different perspective on the
negative effects this new innovation would have not only to those who have or wish to
obtain DNP degree but to the new and current nurses at the PhD level as well. This
proves that there are a plethora of people that can be affected by this proposal.
Draye, M., Acker, M., & Zimmer, P. (2006). The practice doctorate in nursing: approaches to
transform nurse practitioner education and practice. Nursing Outlook, 54(3), 123-129.
Mary Ann Draye, an Assistant Professor, Director of the Family Nurse Practitioner
Program, at the University of Washington School of Nursing, Michele Ackeris, a Senior
Lecturer, Director of the Pediatric Nurse Practitioner Program at the University of
Washington School of Nursing, Phyllis Arn Zimmer, a Lecturer, Family Nurse

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Practitioner Program at the University of Washington School of. All 3 authors of this
scholarly journal article touches on how turmoil in the healthcare system present renewed
challenges to the nursing profession as whole. The authors argue that these challenges
may be good for the healthcare system in which gives the opportunity to increase
nursings capacity to provide leadership toward improving the health status of the nation
through the innovation practice doctorate. The authors also provide suggestions on how
the AACN can go by implementing this innovation, for example, curricula need to be
carefully crafted, and that education and practice play hand-in-hand in identifying the
practice doctorate as the way to accomplish these goals.
The importance of this article is relevant to my research due to the fact that it discusses
the positive aspects of the proposal. The controversy that surrounds this discussion may
be a start in the right direction by serving as a means for researchers and expertise to
brainstorm ideas on the proper ways to implement this innovation if-in-fact the AACN
makes a decision to do so.
Fain, J., Asselin, M., & McCurry, M. (2008). The DNP... why now?. Nursing Management,
39(7), 34-37.
At the University of Massachusetts Dartmouth, College of Nursing, James A. Fainis dean
and professor, and Marilyn Asselin and Mary McCurryare assistant professors all have
the necessary credential and are expertise in this field argues that the staffing shortage for
healthcare professionals is well recognized and the need will continue to grow for
advanced practice nurses to obtain a DNP degree. The authors describes the roles and
responsibilities of DNP nurses, the main purpose as to why the program is implemented,

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and discusses the need for requirement of the DNP as the established credential. They
also explain the educational preparation behind the program.
The article is relevant to my research because it portrays the positivity and the need for
this potential requirement. The authors aids those in or wish to become a member of the
nursing profession in understanding why the DNP should be the requirement for
advanced nursing practice.
Fulton, J., & Lyon, B. (2005). The need for some sense making: doctor of nursing practice.
Online Journal Of Issues In Nursing, 10(3).
In this article based on the issues that surround the doctorate-level of nursing practice,
Fulton & Lyon who are Doctors in Nurse Practice (DNP) attempt to ascertain whether the
on-going proposal of implementing a practice doctorates would pose an arising concern
for the method of nurse practice. With an interest in the educational and economic effects
on students and employers, as well as its significance on the overall focus of the practice
doctorate, the authors summarizes and reflects on the problematic implementation of the
practice of doctorate in nursing and proposes a more thorough debate involving all parties
before progressing further with this degree.
This is especially important in my discussion of including a doctorate degree in the
advancing roles of nurse practitioners because this article contributes to the on-going
debate of implementing such degree and seeks to emphasize the negative effects it has on
the ever-changing phenomenon of the healthcare system educationally and economically.

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Hathaway, D., Jacob, S., Stegbauer, C., Thompson, C., & Graff, C. (2006). The practice
doctorate: perspectives of early adopters. Journal Of Nursing Education, 45(12), 487496.
Dr. Hathaway is a Dean, Dr. Jacob is Executive Associate Dean, Dr. Stegbauer is
Associate Dean, Dr. Thompson is Professor of Acute and Chronic Care, and Dr. Graff is
Assistant Professor of Primary and Public Health and Chief of Nursing at the Boling
Center for Developmental Disabilities, College of Nursing, University of Tennessee
Health Science Center, Memphis, Tennessee. The emergence of the Doctor of Nursing
Practice (DNP) degree is being described as a disruptive innovation as mentioned in
another source that is altering the landscape of nursing and health care and creating a
great deal of controversy within and beyond the profession of nursing. This article
proposes that the DNP is not start of a recent controversy and that innovation begun in
the late 1960s with the advent of nurse practitioner programs. As expected with disruptive
innovations, many challenges face those who are early adopters and who wish to forge
ahead during the phase of this innovation. As faculty and administrators of secondgeneration DNP programs, the authors are fully aware of the ongoing discussion and
issues related to the practice doctorate. This article shares the experiences of this group of
authors/early adopters and their insights into controversies surrounding the DNP
The article is significant to the controversial discussion of a DNP requirement because it
signifies that this debate is not relatively recent but has been a topic of interest first in the
1960s and now almost decades later is still sparking a great debate. This authors outlines

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their negative thoughts on the future of this innovation, and those who wish to become
involved should consider these effects.
Lenz, E. (2005). The Practice Doctorate in Nursing: an idea whose time has come. Online
Journal Of Issues In Nursing, 10(3)
In this article by E. Lenz, a clinical expertise in the nursing profession, demonstrates the
practice and educational trends that led to the resurgence of interest in the practice
doctorate in nursing. The characteristics of existing practice doctoral programs and
differences between practice and research-focused programs were explained as well as
the potential benefits of the degree for health care and for nursing education. The author
describes several of the issues that were taken into consideration in the development of
the AACN position on the practice doctorate which included the scope of the degree, the
recommendations in regard to the structure of the curricula and content areas and that is
to be taught behind the DNP program, and the controversial decision to recommend that
the DNP be required as the credential for advanced nursing practice. If the excitement,
interest and the number of institutions moving ahead to develop DNP programs are valid
implies, then the practice-focused doctorate in nursing is an idea in which he argues, is a
time that has arrived.
This article is significant to my research because it touches on the conditions that must be
discussed in order for the implementation to take place and also offers recommendations
for moving forward with this proposal. Since this idea has the entire nursing profession
debating back and forth on this idea then this seeks to prove that the time for the DNP
program to be in-fact put into perspective due to the interest it has sparked.

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Mundinger, M. (2005). Who's who in nursing: bringing clarity to the doctor of nursing practice.
Nursing Outlook, 53(4), 173-176.
Mary Mundinger, Dean and Centennial Professor of Health at Columbia University
School of Nursing, addresses the practice of advanced nurses across the country and how
the many factors such has the growing complexity and vitality of care, the aging of the
US population, and the shortage of primary care physicians all contribute to the need for
increased knowledge and practice competency. The author claims that a formal and
standardized educational process leading to a doctoral degree is essential for quality
assurance, to clarify and validate authority/responsibility, and to recognize and identify
these practitioners (p. 173). The Doctor of Nursing Practice (DNP) degree will put into
perspective of the knowledge and skills necessary for the scope of clinical nursing
This article is relevant to my search because it dignifies the importance and positive
effects the DNP poses over the future of advanced nurse practices and to the healthcare
system as a whole.
Mundinger, M., Cook, S., Lenz, E., Piacentini, K., Auerhahn, C., & Smith, J. (2000). Assuring
quality and access in advanced practice nursing: a challenge to nurse educators. Journal
Of Professional Nursing, 16(6), 322-329.
Mary O. Mundinger, DRPH, RN, FAAN, Sarah Sheets Cook, Med, RN, Elizabeth R.
Lenz, PhD, RN, FAAN, Karen Piacentini, MBA, Carolyn Auerhahn, EDD, RN, And
Jennifer Smith, MBA, RN who are all deans or associate deans at Columbia University in
New York seek to discuss how as primary care providers and a public seeking higher

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quality, cost-effective care, advanced practice nurses will be measured not only by their
comparative value in delivering conventional primary care, but also by the uniqueness of
their contributions to health outcomes (p. 322). These additional skills in which they
argue, pertain to nursing practice at all levels which include health education, disease
prevention, health promotion, community resource access, and partnerships with patients.
Government, private payors, and national and state regulators all authorize increasingly
independent practice by advanced practice nurses. The authors also discuss that these
add-on roles of advanced practice nurses primary care should match their title and
certication that is to be distinctive to that level of practice. They argue that a Doctor of
Nursing Practice (DNP) degree would signal to the public that nurses at their highest
practice competence are at the same level as other health professionals holding
This article is relevant to my research because it discusses that the scope of practice for
advanced practicing nurses should be distinctive only to advanced practicing nurses and
that it should not be correlated with any other healthcare profession that upholds to the
doctorate degree of education. The new potential innovation address many questions and
concerns that new and perspective nursing professionals should take into consideration if
this idea were to become permanent.
O'Sullivan, A., Carter, M., Marion, L., Pohl, J., & Werner, K. (2005). Moving forward together:
the practice doctorate in nursing. Online Journal Of Issues In Nursing, 10(3).
In this article, the authors who are all experts in this field and who have obtained an PhD
in nursing shifts the focus of deciding if establishing the practice of a doctorate degree

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would have an negative or positive outlook on the dynamics of nursing, but rather takes
an innovative approach that seeks to ensure the quality of nursing educational programs
as a whole. The authors put an emphasis on the changing educational system for nurses
that will accommodate the movement of an advanced and diverse healthcare system and
that will facilitate a more in-depth scope of practice for nurse practitioners. Nurse
practitioner primary objective focused on prevention of diseases and delivering quality
healthcare to a wide-range of people, but researchers are trying to slightly change this
aspect to include informatics, more knowledge, leadership, and a business outlook on the
demanding healthcare system as a unit. Integrating this newly implementation of a
doctorate degree and determining how to propel this phenomenon forward into
educational programs are what researchers are trying to establish as well.
This article is especially significant in my discussion of an implementation of a
doctorate degree into the practice of nurse practitioners because it shifts the focus of
figuring out an answer to the debate of whether or not this aspect holds a negative or
positive effect on the future of nurse practitioners, but researchers instead are far more
interested in determining ways to include the practice doctorate into the quality of
nursing educational programs as well as look for ways in which these programs can move
along with the continuously and growing dynamics of the health care system.
Sperhac, A., & Clinton, P. (2008). Doctorate of nursing practice: blueprint for excellence.
Journal Of Pediatric Healthcare, 22(3), 146-151.
Arlene M. Sperhac PhD, CPNP, FAAN and Patricia Clinton PhD, CPNP, FAANP
professors at Rush University and University of Iowa speaks on the DNP curriculum and

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what the main objectives which are content on leadership, management, and other topics
that are needed to address some of the issues in the health care system that are not
typically included in most master of science in nursing curricula, as well as additional
essential content and nurse practitioner competencies (p. 146). As pediatric nurse
practitioners and other advanced practice nurses go forward in their careers, the DNP
may have an impact on their role. In this article, the authors provide a background of the
DNP movement, changes in advanced practice nursing education, and the concerns of
currently practicing pediatric nurse practitioners prepared at the master's level.
The importance of this scholarly article outlines the educational curriculum that the DNP
program contains and how advanced practices nurse, specifically those specializing in
pediatrics may be directly impacted on the idea of the new innovation. Due to the fact
that I am highly considering specializing in pediatrics, I must assess my future standing
in relation to clinical expertise, leadership, and knowledge base before considering future
career goals.
Swanson, M. L., & Stanton, M. P. (2013). Chief Nursing Officers' Perceptions of the Doctorate
of Nursing Practice Degree. Nursing Forum, 48(1), 35-44.
Michelle L. Swanson, DNP, MSN, RN, ACM, Director of Hospitalist Services,
Community Health Systems, Franklin, TN; and Marietta P. Stanton, PhD, RN, C, NEABC, CMAC, CCM, CNL, a Nursing Professor, Capstone College of Nursing, University
of Alabama, Tuscaloosa, AL evaluates Chief Nursing Officers Perception of the DNP
degree. Swanson and Stanton utilized an online survey to obtain perception on the
appropriateness of the DNP program in relation to a research/business practice setting

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and its relevance to the daily nursing operation management and they find that they are
many perceptions on the DNP program innovation where those nurses who have tenure
responded more positively that the DNP program would provide them with the
knowledge content appropriate for nursing practice. Overall, according to the researchers,
Practicing CNOs in the acute care setting do perceive the DNP as an appropriate degree
option for nurse executive roles at aggregate, system, and organizational levels (p. 35).
This article is relevant to my research because researchers were able to take into
consideration the thoughts and ideas of those already practicing in the field. This is useful
to because it would allow me to formulate my own thoughts and opinions on my intake
on this potential required credential.
Wall, B., Novak, J., & Wilkerson, S. (2005). Doctor of Nursing Practice program development:
reengineering health care. Journal Of Nursing Education, 44(9), 396-403.
Dr. Wall, an Assistant Professor and Interim Director of Graduate Studies in Nursing and
Dr. Novak, a Professor and Associate Dean of the College of Pharmacy, Nursing, and
Health Sciences, and Head of the School of Nursing, and Dr. Wilkerson, Associate
Professor and Director of Doctoral Program Development, Purdue University School of
Nursing in West Lafayette, Indiana discuss in this article, the developmental process of a
Doctor of Nursing Practice (DNP) program that uses resources to create unique DNP
curriculum opportunities. Other schools, they suggest may benefit from this experience in
the development of their own DNP programs. The authors state, The program delivers
an innovative curriculum from post-baccalaureate to doctorate, emphasizing health care
engineering and interdisciplinary collaboration among faculty, hospitals, community

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leaders, and policymakers, policy residency, and cognate residencies in an area of

specialization (p. 396). The seven core competencies recommended by the American
Association of Colleges of Nursing are incorporated into the curriculum.
This article is relevant to my research because it demonstrates the educational aspect of
the potential idea and the associated curriculum that stands behind the DNP program.
Emphasis is placed on what the curriculas objectives are and that these are the main
focuses that other nursing institutions should put into perspective as they create DNP
programs for new and prospective advanced nurses to follow.
Webber, P. (2008). The Doctor of Nursing Practice degree and research: are we making an
epistemological mistake?. Journal Of Nursing Education, 47(10), 466-472.
Dr. Webber, a Professor in Nursing at Shenandoah University in Winchester, Virginia
discusses the literature about whether Doctor of Nursing Practice (DNP) curricula should
prepare students to be principle investigators of research or whether this skill should be
left to other doctorally prepared nurses such as a PhD. Currently, Dr. Webber argues that
nurse practitioners have to rely on medical research to support their practice due to a lack
of research and researchers which correlates to the shortage in DNP prepared nurses. She
also argues that Nurse practitioners run the risk of adopting practice values of medicine
rather than those unique to this specialty. Despite this risk, several national organizations
have recommended that DNP programs not prepare graduates to be principle
investigators (466). This decision in which the authors oppose, poses several levels of
concern, including failure to analyze the adequacy of our current approach to research,
and the effects of the downhill doctoral faculty shortage.

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This article outlines its significance to my research in that it explains why the proposed
DNP required credential is detrimental to the future of advanced nursing practice and
explains why new and current nurse practitioners should not be the driving force behind
medical research suggesting that researched-based practice should be left to those on a
PhD level. This proves that are there are many debates on this controversial topic and
many different expertise all pose different concerns and challenges.