Clinical Hours for the DNP
Here at the DNP Answers blog we take your questions about the DNP and
answer them as best we can. This post is written by a special guest
blogger to DNP Answers, David O'Dell, NP, cofounder of Doctors of
Nursing Practice, LLC.
Q: I am interested in furthering my education and the DNP seems to be the logical choice, but some programs require an additional 500 clinical hours in addition to the clinical hours already completed for my MSN/FNP. I do not see the value of additional clinical hours where the preceptor is another MSN-prepared nurse practitioner. I have been a nurse practitioner for 6 years and don't see the value of following another nurse practitioner with the same training would be. I can understand if this were a sort of "residency" where we would be learning from a physician. Are there programs that give credit for years of service in lieu of additional clinical hours? (Anon.)
A: You ask an interesting question that in essence asks how a DNP student is going to be adequately challenged and evolve into something different than an MSN prepared clinician. The clinical hours required for the MSN degree can incorporate another MSN prepared preceptor learning the basics of practice, such as an FNP role. The DNP degree enhances these experiences and are not a repeat of the MSN program. At the doctoral level the student's self-direction efforts are critical. An MSN-prepared FNP with several years of experience would not be expected to repeat the same type of clinical experiences. How would that NP demonstrate doctoral preparation by repeating MSN level clinical work? More is expected for the DNP-prepared clinician.
The coursework for the DNP allows for an exposure to the sciences that broaden the practice of any clinician, to include research methodologies, biostatistics, epidemiology, philosophy of science and evidence-based practice courses. Other course work reflects the thrust of the individual DNP program. The AACN requires a minimum of an additional 500 clinical hours from the MSN to matriculate with a DNP degree. This is the expectation and any DNP program that does not emphasize practice would be suspect in the quality of what they have to offer. After all, this is a Doctor of Nursing PRACTICE degree, right?
Depending on the thrust of the practice and DNP program, the extra clinical hours could be considered a residency. This was the intent of the AACN. This residency could be clinical with physicians, or perhaps could be in a legislative position with a senator or legislator. Still other options for residency could be in administration on several levels. One DNP program's residency could be an alignment with engineers. The options for professional growth are tremendous - showing that the degree is not a rehash of the MSN-prepared NP.
The question of giving credit for years of service in lieu of additional clinical hours has been asked before. The DNP degree is a reflection of greater experiences to broaden and expand to a true terminal degree of nursing practice. Would it even be wise to consider past clinical experiences as adequate for doctorally prepared practice? I don't think so, and challenge all NPs to elevate practice to a higher level of sophistication. Some programs will indeed consider applying past clinical experiences to a 1,000-hour expectation of clinical experiences in an MSN to DNP program. This reflects a recognition of past experiences yet still challenges the student to elevate his or her skills to a level that can be recognized by all (including general society) that the DNP is truly a doctorate degree, and not merely a tweaked MSN degree.
Editor's note: Comment below to continue discussion on this topic, or send new questions to jford@advanceweb.com.