The Need for Advanced Clinical Education for Nurse Practitioners Continues Despite Expansion of Doctor of Nursing Practice Programs

We read with great interest Mundinger and Carter’s exposition of how, in their view, Doctor of Nursing Practice (DNP) education has lost its way and what consequences might result. Mundinger and Carter note that DNP programs are overwhelming focused on nonclinical practice. We share the concern of Mundinger and Carter about the future of nurse practitioner (NP) education within the context of expanding DNP programs. In this commentary, we raise concerns about NP transition to practice and the limited, but concerning, evidence that new NPs struggle in their transition to practice. We note that this concern is magnified as NPs continue to move into specialty roles. Health systems have responded to this concern by developing residency and fellowship programs. Fifteen years after the AACN position statement on the clinical doctorate was issued, the goal of DNP education remains an unfinished project. An important question remains: Can, will, and how should DNP programs deliver?

The entry-level occupational therapy clinical doctorate: The next education wave of change in Canada?

Background. Currently, Canada and the United States are the only two countries that mandate entry to the occupational therapy profession at the master’s level. There was a recommendation considered by the American Occupational Therapy Association that by 2025 all education programs would move to the clinical doctorate level. In August 2015, the Accreditation Council for Occupational Therapy Education made the formal decision that for now, the entry-level qualification for occupational therapists in the United States will remain at both the master’s and clinical doctorate levels. Purpose. This article presents an overview of the types of doctorates available, the pros and cons of moving to the clinical doctorate, and some potential questions that will need to be considered. Key issues. Is the next step in the educational progression of occupational therapy in Canada the entry-level clinical doctorate? What are the potential implications for the profession, our clients, and funders? Implications. Further discourse and investigation of this issue is needed.