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survey, students may have interpreted it freely. However, the finding that only 32.5%
of the same students felt confident in writing research proposals, which is a necessary skill for research that are hypothesis driven and require scientific methodology, sug- gests that a large majority of these students may not be prepared for independent research (Fang and Bednash 2017).
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existing disciplinary boundaries and power relationships ‘… transdisciplinary entails not only transcendence of disciplinary boundaries, but to some extent the transcendence of the very idea of disciplines’ (p. 1270).
Walker et al. (2016) argue the ‘traditional’ PhD is more marked by Mode 1 knowledge-production than the professional doctorate, which conversely, derives its epistemological (as well as socio-political) capital from Mode 2 knowledge- production. Within Gibbons’ et al. (1994) taxonomy, Rolfe and Davies (2009) explain that the traditional Mode 1 PhD is usually situated within a single and discrete academic discipline, such that the boundaries of relevant knowledge and theory, along with the valid and accepted methods for generating and disseminat- ing that knowledge, are secure and largely uncontested (pp. 1267–1268).
Furthermore, Mode 1 knowledge production is ‘driven by an academic agenda, categorised by the associated disciplines … residing in the University, where they are guarded by an academic elite’. Besides, under this Mode 1 knowledge produc- tion ‘students are inducted into the disciplinary knowledge and practice of the University and to be successful they must align themselves to the theoretical and methodological frameworks which characterise these’ (Rolfe and Davies 2009, pp. 1267–1268). Therefore, based on the these explanations, it could be interpreted that the PhD is a product of and for the University rather than any other place; a point reinforced by Maxwell and Kupczyck-Romanczuk (2009) who acknowl- edged that the focus of professional doctorate work is the community of practice, as opposed to the community of academics. Another detail outlined by Rolfe and Davies that warrants noting‘. …at the outset the focus of Gibbons’ et al. distinction between Mode 1 and Mode 2 is on production rather than product. Knowledge is categorised and valued according to how it is produced rather than what it looks like, and it therefore makes no sense to refer to Mode 1 or Mode 2 knowledge per se’ (Rolfe and Davies 2009, p. 1267).
Mode 2 knowledge production is characterised by Gibbons et al. (1994) as:
‘a constant flow back and forth between the fundamental and the applied, between the theoretical and the practical. Typically, discovery occurs in contexts where knowledge is developed for and put to use, while results—which would have been traditionally characterised as applied—fuel further theoretical advances’
(p. 19). It is important to note according to Rolfe and Davies (2009) that Mode 2 represents an alternative to Mode 1 knowledge-production rather than a replace- ment and in this sense it complements the desire by universities to provide profes- sional doctorates whilst preserving the traditional PhD. Mode 2 knowledge production has five characteristic elements, recognising that:
1. Knowledge is not produced separately to the context in which it is used 2. The range of sites where knowledge is produced is diverse
3. Knowledge is transdisciplinary and resides within individual practitioners and teams
4. Knowledge is reflexive and embedded, coming from somewhere as opposed to existing by itself ready to be discovered
5. Novel forms of quality control are indicated (Nowotny et al. 2005).
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According to Lester (2004) second generation professional doctorates appear to be more accepting of Mode 2 knowledge-production ‘being more equally rooted in the contexts of the academy, the profession and the work place or practicum’
(p. 758). Under Mode 2, the link between theory and practice is more apparent as they become two sides of the same coin, and because research takes place in the workplace, knowledge-production and diffusion are interlinked (Rolfe and Davies 2009, p. 1268).
It has been identified that there is a marked paucity of published evidence of the impact of professional doctorates on patient care, or even of the impact of learning outcomes achievement on practitioners and students in nursing and across health- care disciplines (Ketefian and Redman 2015; Wilkies et al. 2013; Clearly et al.
2011; Watson et al. 2011; Reed 2006). This deficit applies not only in healthcare but in other professions (Kumar 2014). It is uncertain if this is exclusively the result of the noticeable lack of research, or if it reflects a lack of clarity in the design of professional doctorates that flows into difficulty in identification of researchable questions (Cashin et al. 2017). Therefore, an academic conversation needs to start about the future direction of doctoral education globally for advanced practice nursing. According to Thompson and Schwartz Barcott (2019) the knowl- edge broker role needs to be integrated into advanced practice curricular (i.e., doc- toral studies) to teach the necessary skills and provide experiential learning.
Knowledge brokering would enable the advanced practice nursing practitioner change the availability and access to information, improve health literacy and be responsive to underserved population needs, particularly in the context of social justice and empowerment (WHO 2004; O’Fallon et al. 2003). Being at the margin, advanced practice nursing practitioners can appreciate not only the system as a whole but also the needs of those located on the periphery and in that context work- ing within marginality the advanced practice nursing practitioner can support social justice (Delvin et al. 2018, p. 114).
A systematic literature review by Hawkes and Yerrabati (2018) draws on the evi- dence of 193 academic papers to map out the existing academic knowledge about professional doctorates and highlights the gaps that warrant research. The findings reveal that literature is largely dominated by papers based in three countries: the USA (44%), the UK (31%) and Australia (17%). Very little has been written outside these three countries, and these are the same three countries in which professional doctor- ates are most dominant (Hawkes and Yerrabati 2018). Further, this systematic review highlights the need for academic work in this area to move beyond individual case studies of practice on programmes towards developing principles of practice for pro- fessional doctorates as a whole (Hawkes and Yerrabati 2018). The authors report that the literature on doctorates in education has led to general consensus on two important aspects—curriculum and student experience—the literature on other types of profes- sional doctorates is limited (doctor in nursing = 13 papers out of 193) and there is therefore scope for research in these areas for other professional doctorates (Hawkes and Yerrabati 2018). Of note, the prime driver for the professional doctorate in educa- tion appeared to be industry related, or what Brennan refers to as “the production of useful knowledge to provide Australia with economic advantage” (Brennan 1995,
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p. 22). Conversely, such an imperative is all too apparent within health care with an ageing population, the mounting costs of technology and the concomitant rise in consumer expectations (Ellis 2007). Further, Hawkes and Yerrabati (2018) identify two significant gaps in knowledge, even on the doctorates in education programmes.
The first is literature on the wider impact of professional doctorates. While it is clear for those who work with professional doctoral students that there is a wider value, this is not well documented in the literature. The second is a significant gap in the taught aspects of the doctorate in education programme and little about the thesis stage and the role of the supervisor (Hawkes and Yerrabati 2018).
The emphasis on practice improvement drives the curricular content in DNP programs and requires that students possess a command of practice problems and the ability to access and assess evidence-based literature for solutions to practice problems (Brown and Crabtree 2013). The focus of the DNP practice was not viewed from the lens of discovery, but from a lens of translation of the “best” evi- dence into practice. The PhD was established to generate evidence, whereas the DNP role is to translate and disseminate evidence into practice. The continuous loop or life cycle of evidence translation not only impacts patient care at the point of delivery, but also is a stimulus for future research and discovery through measurable system-based improvement (Kirk Walker and Polancich 2015, p. 268).
Healthcare today and into the future is increasingly more complex and requires ever more highly skilled healthcare professionals to meet the challenges of provid- ing safe, and evidenced-based quality care. Doctoral research and education based in the workplace and designed to improve healthcare while skilling up nurses and other professionals in research methods has never been more relevant and appro- priate (Walker et al. 2016). The goal of doctor of nursing practice (DNP) programs should be to produce nurses that are uniquely prepared to bridge the gap between the discovery of new knowledge and the scholarship of translation, application, and integration of this new knowledge in practice (American Association of Colleges of Nursing [AACN], 2006). Knowledge generation is necessary—but not sufficient—to transform the role of nursing and lead change (Dreher et al. 2014).
Nursing knowledge eventually must reach the public domain, where people and families personally feel its benefits. The DNP is the profession’s best chance to increase the number of advanced practice nurses needed for health care transfor- mation (Dreher et al. 2014). Doubling the number of nurses with a doctorate and removing the scope of practice barriers, alone, will not be sufficient to transform advanced practice education or the health care system. According to Dreher et al.
(2014) there is an obligation to create not just curricula for advanced practice but learning environments in which nurse scientists and clinicians, working collabora- tively, are joined by experts from other professions and disciplines to offer learning opportunities and experiences that will serve our students well—not just in 2020, but in 2030 and 2040 and 2050 (p. 108). The discipline of nursing has much to gain from embracing, rather than retreating from, the challenges posed by second gen- eration professional doctorates, and these offer an alternative but no less academi- cally sound education in preparing nurses to play a full and active role at the theory-practice interface (Rolfe and Davies 2009).
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A scoping review of peer-reviewed literature in databases; CINAHL, Medline and PsycINFO from January 2000 until 2017 was undertaken by Cashin et al. (2017) pertinent to the development of professional doctorates in the discipline of nursing.
The purpose of the review was to inform thinking with regard to future design work for a post-masters (nurse practitioner endorsement) professional doctorate (Cashin et al. 2017). The authors postulate that the discussion now needs to progress from second- to third-generation professional doctorates in nursing and move beyond the comparison with the PhD, to a discussion of a learning product at doctoral level that has internal coherence, and where course philosophy, learning outcomes, teaching and learning activity and assessment are clearly articulated. The learning product would not be judged against the PhD but rather against university (and societal) standards of doctoral education (Cashin et al. 2017). The doctorate degree would concentrate on building practice capability rather than producing nurse scientist capability. Accordingly, clear articulation of the learning product may indeed enable identification of findings that could begin a body of research that ascertains the impact of the doctorate on learners and also on the systems in which they practice at an advanced level. Such research is much needed to gauge the transformative nature and social robustness of the professional doctorate and to establish its place in development of nursing practice scholarship (Cashin et al. 2017).