Journey to the highest level of nursing practice: An educational paradigm case

NP educators are challenged to develop seamless curricula to prepare students for entry level NP practice. During the next decade, this educational goal will be complicated by multiple levels of learners within NP classrooms; namely, students pursuing post BSN- DNP degrees with initial NP preparation and those returning Post-MSN degree to attain the DNP degree. Nonetheless, one set of Nurse Practitioner Core Competencies have been promulgated by NONPF (2012). These core NP competencies build upon both the Master’s Essentials (AACN, 2011) and the DNP Essentials (AACN, 2006). Examining the nuances of difference between Master’s and DNP Essential documents (Crosswalk of Master’s Essentials with the Baccalaureate and DNP Essentials (AACN, Master’s Essentials Toolkit, n. d.) presents a bit of a conundrum for educators, who struggle to clarify differences in expected performance levels between e MSN and DNP prepared NP students. It becomes an academic exercise to differentiate expected student outcomes and to scaffold curricula. Instead of clear demarcations which NP educators are skilled in using to illustrate similarities and differences between RN level practice and APRN level practice, the path from MSN prepared to DNP prepared NP is not as readily illuminated. The educational journey to the highest level of nursing practice as a DNP prepared NP is fraught with many of what Benner (1996) has termed “graded qualitative distinctions.” Nonetheless, in educational practice, differences do come into focus for both learners and teachers as they complete the journey. As NP educators strive to develop their expertise as teachers, crafting paradigm cases of successful transition to DNP level practice can be a useful tool. In this paper the authors will deconstruct a paradigm case of 1 Post MSN-DNP student as she journeyed to the highest level of nursing practice. Important nuances of differentiated practice became salient within many of the NP Core Competencies (NONPF, 2012), including scientific foundations, leadership, quality and policy. Practical knowledge embedded within this paradigm case can inform the practice of NP educator s as they embrace the complexity of NP education during the transition from MSN to DNP degree as the preferred entry level for NP practice.