Question: What Is a DNP Degree?

Answer: A DNP is a Doctor of Nursing Practice degree. It represents the highest level of educational attainment in the practice of nursing. DNP programs prepare Registered Nurses (RNs) for leadership roles in clinical nursing, nursing administration, nurse training and education, and other areas of professional nursing. Students in a DNP program engage with the latest developments in healthcare research and policy, learn organizational management and leadership skills, and receive instruction in patient care technologies and healthcare information systems. In addition, some DNP programs prepare students for certification in an Advance Practice Registered Nurse (APRN) specialization.

The DNP Degree

The Doctor of Nursing Practice (DNP) degree is one of two terminal degrees awarded in nursing, and the only practice-based doctoral degree available in the nursing field. Unlike a PhD in nursing, which is considered to be a more purely academic and researched based nursing doctorate, DNP programs are designed for practicing nurses who work in clinical, administrative, and educational areas of the profession.

DNP programs may offer clinical and didactic training for certification and licensure in APRN specializations, which include Nurse Practitioner (NP), Clinical Nurse Specialist (CNL), Certified Nurse-Midwife (CNM), and Certified Registered Nurse Anesthetist (CNRA). There are also DNP programs with tracks in executive leadership, nursing education, and healthcare informatics. However, the core DNP curriculum is designed to provide RNs with general practice-based knowledge and skills for advancement into the upper levels of the nursing profession.

The DNP Curriculum

DNP programs have three primary curricular components: general practice coursework; specialized practice coursework; and clinical practicums or internships. The core DNP curriculum can be completed in two years of full-time enrollment by RNs who start with a Master of Science in Nursing (MSN) degree. It covers topics in the evidence-based practice of nursing, clinical diagnostics, healthcare economics, healthcare policy and ethics, research methodologies, and organizational leadership, as well as subjects within an area of specialization.

The American Association of Colleges of Nursing (AACN) and its Commission on Collegiate Nursing Education (CCNE), which accredits nursing degree programs, provide a blueprint for DNP training in The Essentials of Doctoral Education for Advance Practice Nursing. Those essentials include:

• Scientific underpinnings for practice
• Organizational and systems leadership for quality improvement and systems thinking
• Clinical scholarship and analytical methods for evidence-based practice
• Information systems/technology and patient care technology for the improvement and transformation of healthcare
• Health policy for advocacy in healthcare
• Interprofessional collaboration for improving patient and population health outcomes
• Clinical prevention and population health for improving the nation’s health
• Advance practice nursing

The AACN identifies two general categories for DNP programs: those that specialize in advanced practice nursing with a focus on clinical care of individuals; and programs that focus on nursing practice at an aggregate, systems, or organizational level. It is further recommended by the AACN that DNP programs with an APRN focus include courses in each of the following clinical areas:

• Advanced health/physical assessment
• Advanced physiology/pathophysiology
• Advanced pharmacology

Finally, the AACN recommends that graduates from DNP programs accumulate at least 1,000 hours of post-baccalaureate clinical experience prior to conferral of a doctoral degree. Most DNP program allow students to carry half of those clinical hours (500 hours) into the program from prior graduate-level degree programs such as a MSN program or a post-master’s certificate program.

DNP Core Courses

Course names and description vary by program, and specific curricular components may be determined by the program’s area of specialization. However, some of the typical general core courses in a DNP curriculum may include:

• Quantitative Methods for Evaluating Healthcare Practices
• Data-Driven Healthcare Improvements
• Applied Finance & Budget Planning in Nursing
• Integrative Application of Evidence-Based Practice
• Epidemiology
• Informatics for Scholarly Practice
• Communication & Collaboration in Healthcare Teams
• Theories of Leadership & Organizational Management

DNP programs with an advanced practice specialization might include additional coursework in the following clinical areas:

• Diagnostic Health Assessment
• Pharmacology for Advanced Nursing Practice
• Primary Care Management Across the Lifespan
• Differential Diagnosis Theory
• Diagnosis & Management of Psychiatric Conditions in Primary Care
• Project & Practice Management

DNP Specializations

There are several specializations available at the doctoral level in nursing, some of which may qualify graduates for professional certification in that field. The main non-APRN DNP specializations are:

• Educational Leadership/Nurse Educator
• Executive Leadership/Nursing Administrator
• Nursing Informatics
• Advanced Clinical Practice (typically requires APRN licensure for admission)

APRN specializations in DNP programs include, but are not limited to:

• Adult-Gerontology Acute Care Nurse Practitioner
• Adult-Gerontology Primary Care Nurse Practitioner
• Clinical Nurse Specialist
• Neonatal Nurse Practitioner
• Certified Registered Nurse Anesthetist
• Nurse Midwifery
• Family Nurse Practitioner
• Pediatric Acute Care Nurse Practitioner
• Pediatric Primary Care Nurse Practitioner
• Psychiatric-Mental Health Nurse Practitioner
• Women’s Health Nurse Practitioner

DNP Program Formats, Admissions, and Pathways

DNP programs are offered in traditional campus-based formats, as well as online and in hybrid formats that combine distance learning and on-campus classroom instruction. Clinical internships and practicums must be completed in person at a site approved by the program, and in some APRN specializations (nurse anesthetist, for example) the clinical training typically takes place on the nursing school’s campus or at an alternate location. There are also a variety of enrollment options for DNP programs. Many programs offer full-time enrollment for students who are able to take three or more courses per semester, as well as part-time options for students who have work or other commitments outside of school.

Admission criteria vary by program, but a universal requirement is a valid and unencumbered state-issued RN license. Applicants are typically required to submit undergraduate and graduate degree transcripts, an updated CV, a personal goals statement, and letters of recommendation. Some schools require GRE scores and may have a minimum GPA requirement.

Finally, there are a number of different pathways by which RNs may earn a DNP degree. These pathways are contingent upon an applicant’s level of educational attainment. Individual DNP programs may or may not offer the following pathways:

MSN-to-DNP in Advanced Clinical Practice or Leadership: The shortest and most common route to earning a DNP is for RNs who have completed an MSN program. Many DNP programs will accept applicants who hold an MSN in any nursing specialization, while other programs require applicants to be licensed APRNs. There are also DNP programs that require applicants to have earned an MSN in the same specialty as the DNP program, or a post-master’s certificate in that specialty. For example, applicants to a DNP program with a Family Nurse Practitioner (FNP) specialization may be required to have completed an MSN or a post-master’s certificate program with an FNP curriculum.

MSN-to-DNP with NP Certification: These programs are designed for NPs who want to earn a DNP degree while completing the training for certification and licensure in an area of NP specialization. Some programs accept students who have completed any type of MSN program, while others require students to already be licensed as an APRN (these programs for practicing APRNs who want to add a second specialty area while also pursuing a DNP).

BSN-to-DNP: Programs that accept applicants who hold a Bachelor of Science in Nursing (BSN) but who have not completed an MSN program take longer to complete than MSN-to-DNP programs because students must complete master’s-level coursework before beginning their doctoral work. However, they provide RNs with a direct route to earning a DNP.

ADN-to-DNP: A select number of nursing schools are set up to accommodate students who received training to become an NP in an associate’s degree in nursing (ADN) program. Students in these programs must complete BSN and MSN requirements before embarking on their doctoral studies.

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