1. Clarke, Sean P. PhD, RN, FAAN

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There's been a lot of excitement about DNP programs over the last decade, which offer practice-oriented, heavily course-based doctoral education featuring a final capstone project rather than a dissertation. For many years, nurses working in clinical practice or management were put off by stories about rocky student paths in PhD programs, especially difficult courses seemingly unrelated to their careers and frustrating experiences planning and writing up their research. Until the DNP, there was no other option for those seeking a terminal degree to advance in their careers.

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Although statistics show huge growth in the number of DNP programs and student enrollments, PhD programs in nursing continue to serve students from a variety of backgrounds who have a range of professional goals. We review factors to consider if you're thinking about enrolling in a PhD program and how to make sure that you "get what you came for" if you do start one.


Still an option

A research doctorate is, as the name would suggest, advanced training in generating new knowledge in a scholarly discipline. All university schools of nursing offering a PhD program require students to complete a dissertation-an original contribution to knowledge that shows an ability to frame a research question emerging from a careful review of relevant literature, develop a defensible research plan, carry out the plan, and present the project's results in an acceptable format that accurately shows how the study extends previous work in the field. Many, but not all, schools take things a step further and emphasize that they aspire to graduate leaders who'll generate the next generation of nursing research; that is, they aim to produce full-time researchers. Most, but not all, have faculty with lengthy track records of publications and funding involved in teaching PhD courses and supervising dissertation work. However, programs differ in the backgrounds of the faculty teaching and supervising PhD students and the extent to which faculty members are research active (currently involved in conducting and publishing externally funded research).


The PhD is the logical doctoral program choice for the nurse who wants to become a faculty member or aspires to be a researcher. But even if you don't have plans to lead your own program of funded research after finishing a doctorate, there are still reasons to consider a PhD. Having a PhD is widely understood inside and outside of nursing to mean that you've built an impressive scholarly toolkit for analyzing problems and answering questions in your specialty. It also shows that you've met a high bar by following through on a serious academic project. Many PhD graduates look back on their courses and dissertation work as being very demanding but immensely rewarding. Nurses who have completed PhDs after working in clinical nursing and/or management have also found that building different mental muscles than the ones used every day on the job was stimulating and renewed their sense of challenge and reward in their nursing careers.


Needless to say, before applying to a PhD program, but especially before enrolling in one, there's much homework to be done. You need to consider your goals in pursuing the degree and what you're willing to commit, and possibly sacrifice, to reach those goals. There are many things that a bright individual with a promising career in nursing can do-seeking a research doctorate is only one. And if you aren't primarily interested in developing a set of research skills (at least for the time you're enrolled in the degree), both the courses and dissertation experience can be boring and perhaps even painful.


After clarifying your goals, the next big question is: Will the particular program or programs that you're considering meet your needs and interests? If you're a working clinician, manager, or continuing-education specialist, you need to find out about the possibilities of progressing as a part-time student for some or all of your time in the program unless you can afford to stop working (or greatly curtail your work hours). PhD programs typically offer full-time students several years of financial support with reduced or waived tuition, as well as a small wage or stipend for students who don't work or work minimally while enrolled. Many PhD programs are selective and only accept students with high grades, test scores, and publications and/or only offer stipends to their best candidates. But you may or may not be able to afford to study full-time and accept this arrangement even if you're offered it. If you have dependents or are at a point in your life where it's critical to earn and save money, full-time study and part-time work may not be possible.


The question of part-time versus full-time PhD study isn't just about money. Although you as a student have some control over many of the constraints and promoters of progressing successfully through a PhD program, the most important factor by far is carving out consistent study, research, and writing time among your other work and personal commitments. Keep in mind that some PhD programs will only admit students who commit to full-time status. Others won't require any formal commitment, but expect you to adhere to timelines and meet deadlines without much flexibility. Still others have been designed specifically to accommodate working professionals. Before signing up, you would be wise to find out the program's rules, as well as the success record of students with work backgrounds and life circumstances similar to yours.


PhD programs in any field are special in that they involve close work with a single advising professor or, sometimes, two cosupervisors. So the next critical question is: Are there PhD program faculty members at the schools in which you're interested who share your research and clinical interests? Preferably, you should identify at least two potential research supervisors from any program you consider and speak with them candidly about what you're looking for in a doctoral program and from their supervision. You should also understand what these professors are looking for in their doctoral trainees. Do they have ideas about the kinds of projects they can or will supervise? Are they interested in having you work on research projects with them above and beyond your own dissertation? You're looking for a match between your expectations and theirs. Most PhD programs ask on their applications that you indicate the advisor or advisors you plan to working with and will reject an applicant with solid grades and other credentials if they're unable to find a supervisor for that student.


If you do decide to enroll

Keep in mind that PhD courses tend to be very different from those in bachelor's and master's programs in nursing. They tend to require a great deal of reading and writing, and may involve highly complicated or technical material that takes multiple readings to digest. You'll take high-level courses in research methods outside the nursing school or department and may enroll in advanced courses in subjects related to your research topic but outside of nursing to get ready to design and conduct your own dissertation study. You can expect to spend many more hours outside of the classroom (or outside of your contact hours in an online program) completing course requirements than you have previously in your education.


Although the courses in a PhD program are usually rigorous, the true challenge for most students lies in getting through the dissertation. This occurs in stages: first completing and defending a proposal for a significant research project and then writing up the project and defending your actual dissertation document. The middle part, gathering your data and analyzing it, is also essential but doesn't usually involve a formal checkpoint in the process like defending the proposal and then the final dissertation. A PhD dissertation in nursing or a related field usually has five or more chapters and runs several hundred pages, but it can take different forms. An increasingly popular approach is for the dissertation to be a series of published journal articles with chapters at the beginning and end explaining the larger study and connecting the articles to broader ideas. Regardless of format, the dissertation requires many drafts and extensive input, which usually takes several years, but it can be managed in steps.


Know that most people who drop out of PhD programs quit before they defend a proposal, meaning that they ran into trouble settling on a topic or question, or building and writing up a literature review and research method. The positive side of this is that normally, even if your data collection takes unexpected turns, it's likely that if you defend a dissertation proposal, you'll actually finish the project, write your dissertation, and complete the degree. Your dissertation advisor is your guide or mentor through it all, which is why it's so important to choose a program that gives you a high likelihood of getting the support you'll need. Choosing a dissertation topic and maintaining a productive relationship with your advisor and the other researchers/faculty members who form your dissertation committee are important steps in the process. Fortunately, many people have written about these issues; it's worth reading books, blog postings, and advice guides, and talking with PhD graduates before starting down the path of a PhD.


The dissertation process has a reputation of being tough for good reason and the time it takes to move through it is often difficult to predict. Unlike courses that finish at the end of a semester as long as you've sat for exams and handed in assignments of reasonable quality, the dissertation isn't finished until your advisor and committee say it is. There's often flexibility in topics and exact research approaches, but not about the dissertation being of exceptionally high quality and representing a critical mass of work. Know that most PhD programs will be most concerned about maintaining high standards; student convenience and preferences tend not to be given as much weight as you may have experienced earlier in your education. A demanding degree that involves a research journey that can be unpredictable isn't for everyone, but a PhD may still be the right choice for you.


A last word...

Nurse leaders in many arenas have successfully completed PhDs. Different schools of nursing have developed their own versions of the PhD, which means that there's much diversity in doctoral education-not just between PhD and DNP programs, but within both types of programs.


The bottom line is that whereas some PhD programs are just for hardcore researchers, other PhD programs are still a viable option for many nurses in practice and leadership who are willing to take on the challenge. Don't assume that a program isn't interested in having you on board just because you're unable or unwilling to commit to an extended career in leading research. If you're committed to learning research skills and using them in your future work, and can show an admissions committee and potential supervisors that you're up to taking advanced courses and following through on a demanding research experience, you may be a good candidate for a PhD. If life circumstances, the nature of the program, the availability of supporting faculty within the program, and your personal goals line up, a PhD may be your best choice for the next step in your professional nursing career.