• The Doctorate degree: Do I need it?

    In 2004, the American Association of Colleges of Nursing (AACN) announced a bold recommendation that the Doctor of Nursing Practice (DNP) be established as the gateway for entry to practice degree for all advanced practice nurses.  Several years later in 2007 the Board of Directors for the American Association of Nurse Anesthetists affirmed the AACN proposal by recommending that all nurse anesthesia programs be at the Doctorate level by 2025.

    Why a doctorate degree and why now?

    In response to the initiatives by both the AACN and the AANA board of directors, the Council on Accreditation of Nurse Anesthesia programs established a mandate that all nurse anesthesia education programs offer a doctorate degree to every person graduating in 2025 or later.  Over the past decade, most nurse anesthesia education programs have upgraded to the doctorate level with the remaining programs in the final stages for conversion to the new degree.  Because nearly all programs require 36 months for completion, new students starting their education in 2023 must be enrolled in a program that offers a doctorate degree upon completion in 2025.  Clearly the clock is ticking as the final programs scramble to meet doctorate level accreditation standards.

    Currently certified and actively practicing CRNAs will be able to continue to deliver anesthesia care using their existing credentials.  However, many experienced anesthesia providers desire an education level comparable to new graduates entering the profession.  Therefore, a push is underway among veteran providers to upgrade their credentials by participating in a degree completion program to earn a doctorate degree.

    Be a student as long as you still have something to learn, and that means all of your life.  ~Henry Doherty

    Does the Doctorate degree make me a better anesthesia provider?

    Clinical competence remains the foundation for the safe and effective of anesthesia care regardless of the type of practice.  History has proven that master’s level programs have done an exceptional job preparing students to assume a role as an independent anesthesia provider.

    The doctorate degree does not necessarily make the new graduate more skilled at delivering clinical anesthesia, however, the degree does make the person a more knowledgeable and versatile healthcare worker.  The doctorate degree expands the curriculum to include an understanding of leadership, healthcare policy, systems management, and the application of evidence-based healthcare.  Writing in the AANA Journal, Hawkins and Nezat list the following as additional subjects learned while earning a doctorate degree.

    •  Scientific foundation for practice
    • Organizational leadership and systems management
    • Clinical scholarship for evidence-based practice
    • Information systems and technology
    • Healthcare policy
    • Interprofessional collaboration and networking
    • Healthcare policy
    • Advancing nursing practice

    Which doctorate degree is best for me?

    The type of terminal degree that is best for you depends upon where you are currently working and your professional goals.  Advanced practice nurses, including CRNAs, have a variety of options when earning a doctorate degree.  Although completion of any of the terminal degrees will put Dr. on your nametag, they are not master keys that open every door.  For example, the DNP is the preferred degree for those who want to teach in a school of nursing, the PhD is more appropriate for those with an interest in scientific research.  Writing in nurse.org, author Mariam Yazdi recommends considering the following when deciding upon which is the best degree for you.

    • Where do I want to work?
    • What are the credentials of others applying for the position that I want?
    • Will a PhD make me more competitive than a clinical doctorate degree?

    Earning a doctorate degree builds upon clinical excellence and positions the learner to be an expert in evidence-based medicine and healthcare policy development.  Consider the following when applying for admission to the program.

    • PhD, Doctor of Philosophy   The PhD is the most common type of doctorate degree and is awarded by the majority of academic fields.  The degree is earned by producing sophisticated work that significantly adds to the body of knowledge for the profession.  In healthcare, the PhD commonly requires completing, presenting, and defending original research.
    • EdD Doctor of education    An EdD is an advanced degree designed specifically to prepare the candidate to assume a role in educational leadership.   In contrast, a PhD in education prepares the candidate to conduct research related to the education process.  The EdD is most applicable for University teaching outside the schools of medicine and nursing.
    • DNP Doctor of nurse practice     The DNP is designed to produce leaders in clinical nursing and nursing education.  Graduates with this degree learn to influence healthcare outcomes through effective leadership and organizational policy implementation.  The DNP was identified by the AACN as the preferred degree for nursing school faculty.
    • DNAP Doctor of Nurse Anesthesia practice     The DNAP is a doctorate degree specifically designed for practicing nurse anesthetists.  The degree has a focus on utilization of research to develop evidence-based practice, leadership for the implementation of change, and business management related to nurse anesthesia.
    • DMPNA Doctor of management practice for Nurse anesthesia     This very specialized degree builds upon a master’s degree in healthcare management and expands it to a doctorate level practice management degree with a focus on the business of nurse anesthesia and healthcare administration.

    What is my next step?

    For those who are content with the status quo, fear not, you will continue to recertify for practice based on your current credentials.  For those who seek to complete a terminal degree, the process starts with self-assessment and a critical look at personal goals and capabilities.  Once done, the second step is to select the type of degree that best positions you to achieve your career goals.  Finally, find and apply to a University that offers the degree you desire.   To help you with your search, the AANA Council on Accreditation offers a list of accredited programs.  The key to finding a program that welcomes practicing CRNAs is to look through the list and search for the word “completion”.  Online doctorate programs are common and allow the working CRNA to remain on the job and pursue the degree during personal time.

    Whether your goal is to keep up with the newbies, expand your knowledge, or position yourself for a leadership position, the doctorate degree is readily available to those willing to put forth the effort to earn it.  Are you smart enough?  If you can pass your certification exam and safely practice anesthesia, you have the intelligence to earn a doctorate degree.  All that is required is time, money, intellectual curiosity, and the tenacity to see the endeavor through to completion.  Go for it.

    Tom S. Davis, DNAP, CRNA, MAE, is the former Chief of the Division of Nurse Anesthesia at The Johns Hopkins in Baltimore, and former Chief CRNA at (Baylor) Scott and White, Main OR in Temple, TX. Col. Davis, USAF (Ret.), is well-known throughout the Nurse Anesthesia community for his leadership in clinical anesthesia, including developing the first distance education model while on the graduate faculty at Kansas University Medical Center.   Recognized for his expertise in team-building across department lines, Tom is a sought-after speaker, educator, author, and leadership trainer. Follow @procrnatom on Twitter.

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