Reply to Janet S. D'Arcangelo by H. Michael Dreher on "Reflections on the DNP and an Alternate..."

Response to letter by Janet S. D'ArcangeloReflectionsthe DNP and an Alternate Practice Doctorate Model: The Drexel DrNP

We appreciate Dr. D'Arcangelo's comments and would like to respond to several points. First, we have always considered the '˜public will be confused' argument to be the least valid of the concerns surrounding the nursing practice doctorate. As the National League for Nursing Accrediting Commission (NLNAC) has recently written (press release 12/1/05) in their most progressive position statementthe doctor of nursing practice, "Other health care professionals such as dentists (DDS and DMD), psychologists (PhD and PsyD), and physicians (MD and DO) are able to define their roles, qualifications, and expertise to their patients and the public with more than one type of degree. We have confidence that doctorally prepared advanced practice nurses will be able to do so as well" (p. 1). Second, we are not suggesting we are inventing a new '˜clinical dissertation.' The PsyD degree did this first in 1968 at the University of Illinois at Urbana-Champaign and then in 1970 at Hahnemann University in Philadelphia (Hahnemann was renamed twice in the 1990s and then fully merged with Drexel in 2002) when they broke away from the PhD in Psychology and thus developed their alternative approach to practical, applied, clinical scholarship. We have simply adapted this dissertation model for our discipline with this new clinical research DrNP degree. Last, as several of the Drexel DrNP faculty (Dreher et al, 2005) have recently written in a Letter-to-the-Editor to Nursing Outlook, while we are generally in agreement with those who oppose the DNP, we are also skeptical that the PhD is the best degree model for the practicing APN clinician. There is an enormous cadre of prospective doctoral nursing students who do not necessarily want to become nurse scientists, who do not want to spend an average 8.3 years to get a doctorate by attending PhD study part-time, but most importantly, who certainly do not want to forgo employment and weaken their clinical skills by committing to full-time PhD study for 3-4 years. We think the number of APNs who will ultimately seek full-time PhD study and the nurse scientist role will always be relatively small. Our most recently admitted DrNP student (actually our first transfer student) said in his interview, "The PhD is a young person's game." We mostly agree, but counter by also saying that any alternative practice doctorate thus designed must be both rigorous and contribute to nursing science knowledge development. So like the many other health professions who have developed hybrid research/practice doctorate models as an alternative to their own PhD, we are only saying nursing also needs a practice doctorate with a similar credible '˜clinical dissertation' component.

H. Michael Dreher, DNSc., RN
Director of Doctoral Nursing Programs & Interim Director of MSN & RN/BSN Programs
Drexel University
Philadelphia, Pennsylvania


National League for Nursing Accrediting Commission. (December, 2005). NLNAC statementclinical practice doctorates. Retrieved December 24, 2005 from the NLNAC website:

Dreher, H. M., Smith Glasgow, M. E., Fisher, K., Lachman, V., Suplee, P., Falkenstein, K., & Wilson, L. (Nov/Dec, 2005). 'Letter-to-the-Editor" published in Nursing Outlook. Available: