Nursing Education, PhD and DNP Education, Strengths-Based Paradigm



  1. Lusk, Marcie Dianne
  2. Marzilli, Colleen


Abstract: Doctorally prepared nurses are well equipped to provide solutions to complex issues in today's rapidly changing health care environment. Collaborative relationships between doctor of nursing practice (DNP)- and doctor of philosophy (PhD)-prepared nurses facilitate timely translation of research into practice, enhanced educational opportunities, and development of interventions to improve health outcomes; however, challenges have been identified that hinder collaboration. This article highlights a three-pronged innovative and structured approach to identify individual student strengths, facilitate collaboration among DNP and PhD students, and set the foundation for implementation of a strengths-based curriculum during the doctoral educational experience.


Article Content

The landmark Institute of Medicine (2011) Future of Nursing report pointed out that competencies needed to practice nursing have greatly expanded in response to the complex health care environment. The report called for doubling the number of doctorally prepared nurses by 2020. Collaborative relationships between nurses prepared with the doctor of nursing practice degree (DNP) and doctor of philosophy (PhD) facilitate timely translation of research into practice, enhanced educational opportunities, and the development of interventions to improve health outcomes (Murphy, Staffileno, & Carlson, 2015). However, challenges have been identified that hinder collaboration among DNP- and PhD-prepared faculty and students (Staffileno, Murphy, & Carlson, 2017), especially role confusion.


This article highlights an innovative three-pronged approach used to identify individual student strengths, facilitate collaboration among DNP and PhD students, and set the foundation for implementation of a strengths-based curriculum during the doctoral educational experience. The aim is to highlight how this collaborative approach can empower doctorally prepared nurses while moving to a paradigm of strength. Focusing on strengths and collaboration provides an environment that facilitates the full practice of doctorally prepared nurses to transform the health care system while removing the role confusion and ambiguity that are barriers to PhD and DNP collaboration. We report on a novel tool that places the learner and the learner's strengths at the forefront of the learning process while creating meaningful relationships in an interprofessional manner.


Historically, nursing was focused on a subservient and supportive role in health care. Nursing care is part of the room charge in a hospital bill; nurses cannot charge for their services as a separate billable item or monetize their ability to positively impact and transform the health care system. As nurses advance from their BSN role to the MSN and, finally, the doctoral role, it becomes important to consider the inherent value and strengths the doctorally prepared nurse adds to the health care system. Because of this, it is important to innovate the doctoral curriculum so that PhD and DNP students work together, recognizing their individual strengths and the strengths of their colleagues.



It has long been believed that empowering individuals should be foundational within education and management; however, a deficit paradigm continues to permeate even diverse fields, such as education and health care (Lee, 2014). This paradigm focuses on finding problems and then correcting what is wrong or broken, often at the expense of understanding and developing what is right and working. This creates a culture where individuals self-identify what they are doing incorrectly and minimize what they do well. Strengths-based education involves a process of assessing, teaching, and constructing intentional learning activities to help students identify their inherent talents and develop those talents into strengths through the process of academic, personal, and leadership development. The basic principles are derived from research across disciplines and industries and include measurement of talents; individualization, which requires an individualized approach of instructional methods; networking with peers who affirm strengths (Lopez, Pedrotti, & Synder, 2015); and deliberate application of strengths into practice outside the classroom environment (Rath, 2007). Furthermore, this approach helps overcome the barrier to PhD and DNP collaboration by providing opportunities to jointly explore roles.


The innovation elevates students' strengths so they can practice to their fullest potential within their chosen degree. The first prong, the initial encounter, involves a focus on strengths. For the second prong, individualization, students' strengths are displayed on nametags to highlight what they do well. For the third prong, students come together to identify the differences and similarities between degrees while framing their learning in a strengths-based paradigm. Starting before their first semester in the program, students read the StrengthsFinders 2.0 book (Rath, 2007) and complete the StrengthsFinders 2.0 Assessment, an online survey exploring 34 themes that provides information about one's strengths as an individual. Students enter their top five talents into the survey, and faculty enter the information into a master list for all students. Faculty then create nametags that highlight the student's strengths and help frame the value the student brings to the health care system. Then, in the first semester of the programs, students come together for joint sessions during orientation, creating meaningful social interaction and opportunities for networking. From the information obtained through the online survey, faculty are able to create purposeful groups of PhD and DNP students to capture their different strengths and leverage their abilities, helping to tear down the silos that have historically limited how PhD and DNP education happens. This collaborative approach models the importance of collaboration in practice and creates opportunities for students to educate their colleagues on their respective domains. Students are proud of their individualization and enjoy being reminded of their own strengths. They are encouraged to network strategically and collaborate in the formation of partnerships and relationships that maximize strengths and lead to improved outcomes, creating a valuable structure for exploring PhD and DNP domains and roles.



Innovative approaches and experiences are required to actualize strengths. Thus, the strengths-based approach must be an ongoing effort throughout the educational journey, not simply an initial awareness of talents. Alignment of the student's personal goals with the assigned goals of doctoral education, whether PhD or DNP, creates opportunities for feedback. Doctoral programs are a time of self-discovery and advancing the mastery of one's chosen field and are rich in experiences and complex in structure. Using StrengthsFinders research as a foundational element in the doctoral program adds breadth to the curriculum and educational experience.


This approach advances the doctoral education process, creates an environment for the best possible patient outcomes, and helps frame the PhD and DNP student experience. Students are helped to know what they offer to their colleagues and gain a better understanding of their own roles. With the three-pronged approach to a strengths-based paradigm, students are able to focus on their role and their strengths and appreciate their ability to contribute to the team.


While evaluating the three-pronged approach, it is important to keep in mind that the PhD program has been accepting students and utilizing a strengths-based model since 2007 (Wieck, Alfred, Haas, & Yarbrough, 2014), whereas the first DNP cohort was admitted in Summer 2016. As the combined orientation is relatively new and a work in progress, faculty continually evaluate the effects of the strengths-based paradigm on learning and student outcomes. Preliminary anecdotal evidence suggests that the combined orientation creates a foundation for the development of activities for success while improving health within the community. This creates an empowered culture that provides students a unique opportunity to truly appreciate individual and team strengths, roles, and opportunities to collaborate, bringing together the academic and practice specialties to work synergistically to improve health outcomes. The approach recognizes that PhD and DNP students are not meant to complete health care research and practice interventions in isolation. This approach will continue to be evaluated, and data-driven decisions based on program evaluation and the strengths-based, combined PhD and DNP orientation will continue as the programs develop further. Evaluation data include assessment of leadership skills, guided reflection, attrition rates, and role-specific outcomes. Student satisfaction is continually monitored throughout the program.


The opportunity to use the strengths-based paradigm in teaching doctoral students is an innovative and timely tool for PhD and DNP faculty and doctoral education. This paradigm answers the call from the Institute of Medicine (2011) for collaboration while acknowledging that nurses should be full partners in practice and in reshaping the health care system while clarifying role responsibilities. Working with PhD and DNP students in their summer doctoral orientation provides a venue where both programs come together to truly embrace this collaborative and innovative approach. Further collaborative efforts will incorporate the strengths-based paradigm and PhD and DNP combined learning opportunities throughout the curriculum. Ultimately, the goal is for students to be self-actualized in their awareness of their own strengths and their complementary roles so they can work to the fullest extent of their education and abilities to improve outcome measures and transform the US health care system.




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Lopez S. J., Pedrotti J. T., & Synder C. R. (2015). Positive psychology: The scientific and practical explorations of human strengths (3rd ed.). Thousand Oaks, CA: Sage. [Context Link]


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