The ethical integration of generative artificial intelligence in Doctor of Nursing Practice project planning: A formative approach.

In this column, leaders from ALSN discuss the issues presented by a lack of differentiation in functional nursing leadership competencies between Masters of Science in Nursing (MSN) and Doctorate of Nursing Practice (DNP) prepared graduates. An ad hoc committee of members of ALSN) was convened to conduct a comprehensive review of the existing literature and develop an initial set of nursing leadership competency and sub-competency statements that align with the AACN's Essentials 10 Domains of competency for nursing education.

Medication-related harm in older adults often reflects cumulative system vulnerabilities rather than isolated prescribing errors. Doctor of Nursing Practice (DNP) programs emphasize systems-based practice; however, strategies integrating specialty expertise with shared accountability remain limited. A cross-track unfolding case was implemented during a required 2-day DNP immersion at a large academic institution. Advanced practice and systems leadership learners engaged sequential phases of a longitudinal medication-related harm case across out-patient and acute contexts. Evaluation data included Likert-scale ratings and open-ended comments. Ninety-seven learners completed the evaluation. Ratings were high for organization (M = 6.03), engagement (M = 6.02), and understanding of the DNP role (M = 5.94). The unfolding case received a mean session rating of 3.75 (5-point scale). Open-ended comments reflected appreciation for cross-track integration. A cross-track unfolding case may offer a practical strategy for integrating clinical reasoning and systems accountability in DNP education.

In the United States, accredited nursing programs must align their Doctor of Nursing Practice (DNP) curricula with the American Association of Colleges of Nursing (AACN) Essentials, necessitating a shift to a competency-based curriculum and the adoption of structured approaches to curriculum redesign. Revising a DNP curriculum across 12 baccalaureate nursing to DNP specialty programs and two postmaster's DNP programs presents challenges in coordination, faculty engagement, and competency alignment. Faculty at a large public school of nursing applied a modified Delphi method, grounded in backward design, to revise the DNP curriculum. The process incorporated theoretical frameworks, methodology, and implementation strategies. Through iterative feedback and consensus building, faculty developed new courses and an innovative curriculum supporting advanced practice clinical and nonclinical programs. This approach resulted in a revised DNP curriculum aligned with the Essentials and offers insights for programs undertaking similar curriculum revisions.

Polypharmacy is a growing health care concern that is ameliorated through deprescribing, the process of safely removing inappropriate medications. Despite the proven benefits of deprescribing, formal deprescribing education in the health professions in the United States, including interprofessional deprescribing activities, is limited. A deprescribing interprofessional educational (IPE) simulation activity was conducted with 52 third- and fourth-year health professions students to improve their understanding of deprescribing and communication among the interprofessional health care team. The virtual simulation featured prebriefing, an unfolding case study, and debriefing. In total, 21 MD students, 20 PharmD (Doctor of Pharmacy) students, and 11 DNP (Doctor of Nursing Practice) and FNP (Family Nurse Practitioner) students participated in the IPE simulation activity. A retrospective pre/post survey was administered, with 49 students (94%) responding. Participants provided positive feedback about the simulation, indicating that they rated the activity highly, valued the unfolding case study used, and were able to consolidate their learning on deprescribing. IPE activities are a promising avenue for deprescribing education.

Doctor of nursing practice (DNP) programs face challenges related to variability and rigor of practice-focused scholarly work, particularly DNP projects. Inconsistent expectations and limited integration of evidence synthesis undermine competency development in evidence-based practice and knowledge translation. This article proposes embedding systematic review methodology as scaffolded signature assignments within a competency-based DNP curriculum. Guided by backward design and constructive alignment, assignments are intentionally aligned with doctoral competencies in evidence synthesis, critical appraisal, and research translation. Examples demonstrate how systematic review components can be operationalized as signature assignments across DNP project courses to support progressive competency attainment. Integrating systematic review methodology into signature assignments strengthens scholarly rigor, clarifies expectations for DNP scholarship, and enhances practice readiness by preparing graduates to address practice gaps and translate evidence into quality improvement and systems-level change.

Background: Doctor of Nursing Practice (DNP) projects frequently encounter challenges related to variability in design, limited sustainability, and misalignment with organizational priorities, reducing their long-term impact on practice transformation. There is a growing need for structured academic-practice models that embed DNP scholarship within existing quality improvement (QI) infrastructures to enhance rigor, continuity, and sustainability. Objective: To describe the development and implementation of the Sustained Student Integration Model (SSIM), a longitudinal framework designed to integrate DNP student projects into the ongoing QI infrastructure of a nurse practitioner (NP)-led interdisciplinary practice. Methods: The SSIM was developed using principles from Donabedian's Quality of Care Model, the Social Ecological Model, patient-centered care frameworks, and Interprofessional Education Collaborative competencies. The model embeds DNP projects longitudinally across successive student cohorts within an NP-led interdisciplinary practice, fostering continuity and scalability. Key components include structured mentorship, interdisciplinary collaboration among psychiatric and primary care NPs, pharmacists, and other professionals, and alignment with practice-level QI priorities. Results: To date, more than 20 DNP projects have been implemented within the SSIM framework across domains, including access and continuity of care, cardiometabolic health, digital health innovation, and specialty populations. Outcomes include sustained practice changes, peer-reviewed publications, and national scholarly presentations, demonstrating both educational and organizational impact. Conclusions: The SSIM provides a replicable, longitudinal approach to embedding DNP scholarship within clinical practice. By aligning student projects with organizational priorities and interdisciplinary QI infrastructure, the SSIM enhances sustainability, rigor, and translational impact. Implications for Nursing: The SSIM positions NP-led academic-practice partnerships as innovation hubs that prepare practice-ready nurse leaders while advancing equity-focused, interdisciplinary care delivery. This model offers a scalable solution to long-standing challenges in DNP education and contributes to the advancement of sustainable, system-level nursing practice transformation.

Background: In 1995, a rural health department initiated a Title X-funded family planning program serving three Midwestern counties. The program was discontinued in 2017 due to the lack of a nurse practitioner (NP), leading to limited access to family planning services and increased teen births and low-birth-weight infants. Objective: To describe the impact of a Doctor of Nursing Practice (DNP)-led initiative to restart family planning services in the underserved rural area. Methods: In 2022, a DNP-prepared NP led the project to reinstate the clinic. The project committee secured funding, designated clinic space, ordered supplies, contracted a provider, and developed staff assignments, billing methods, and community outreach strategies. Results: The clinic reopened in June 2023, offering comprehensive family planning services and education. By the third quarter of 2024, total utilization reached 308 patients. Over 85% of eligible patients initiated contraception. Sexually transmitted infection testing totaled 289 tests, and 31 identified positive cases were treated. Sixty-seven cervical cancer screenings were completed. Conclusions: The DNP-led initiative successfully reinstated family planning services that produced immediate measurable improvements in access to reproductive health care. The model demonstrates the significant population-level impact of DNP-led initiatives on rural health systems. Implications for Nursing: Utilizing DNP-prepared NPs in leadership roles can enhance health care delivery in underserved areas, improving public health outcomes and addressing disparities in underserved rural areas, demonstrating the value of advanced nursing practice in community health initiatives.

Did the DNP kill the PhD? The relationship between PhD and DNP program enrollment and potential consequences for nursing.

In this column, the author discusses the need for collaboration between PhD and Doctorate of Nursing Practice (DNP) prepared nurses in generating and implementing evidence-based practices, improving patient care and the work environment. PhD/DNP scholarly collaboration is most effective when there is clear role differentiation, mutual respect for complementary expertise, and shared goals tied to patient and system outcomes.

This article describes the development of the Doctor of Nursing Practice (DNP) Leaders in Practice Assessment (DNPLPA) Tool and assessment of the psychometric properties of this 33-item instrument. This study used a descriptive mixed-methods design to collect data. A national convenience sample of 208 practicing DNP nurses completed the 28-item online tool that focused on five specific outcome sections, each followed by five open-ended questions. Cronbach's alpha reliability coefficient for instrument dissemination was 0.969. Parallel analysis and scree plot results suggested that a four-factor solution was the most appropriate model. Confirmatory factor analysis also confirmed a four-factor model. The DNPLPA Tool addressed many of the key recommendations listed by the American Association of Colleges of Nursing and offers a reliable and valid instrument to collect leadership outcome data. From factor analysis results, a wording-specific revision is warranted in one of the outcome sections.

Background: Artificial intelligence (AI) is rapidly transforming nursing education and clinical practice. As AI becomes increasingly embedded in health care delivery, integrating AI competencies into Doctor of Nursing Practice (DNP) education is essential to prepare advanced practice registered nurses (APRNs) to utilize these tools effectively and ethically. Objective: This manuscript examines the integration of AI into DNP education, addressing policy implications, best practices, and strategies to prepare APRNs for leadership in AI-enhanced environments. Methods: A review of institutional innovations and faculty strategies demonstrates the application of AI in nursing education through adaptive learning platforms, virtual simulations, predictive analytics, and AI-driven clinical decision support systems. Case exemplars highlight implementation approaches and educational outcomes. Results: AI-enhanced tools have demonstrated several benefits, such as improved student engagement, individualized learning, and enhanced clinical reasoning. Case-based reflections revealed enhanced decision-making, mentorship, and student competency tracking. Limitations and potential risks of AI are also identified. Key guiding principles include evaluating existing competencies within the context of AI capabilities, defining emerging AI needs, supporting faculty development through AI training, and advancing policies for responsible and ethical AI use. Conclusions: The nursing profession is well recognized for its innovative approach to adopting new technologies. Embedding AI into DNP education requires intentional curricular reform, strong leadership support, and ethical oversight to ensure sustainable adoption. Nursing faculty must champion the strategic and responsible use of AI to prepare APRNs for evidence-based, technology-driven practice. DNP-prepared nurses, with their expertise in quality improvement and ethical practice, are uniquely positioned to shape the development and implementation of AI tools.

Feedback literacy is an essential skill set that supports practice improvement and professional growth in advanced practice nurses. Doctor of Nursing Practice (DNP) students who focus on developing competence in writing-mastery goals-versus attaining a grade-performance goals-may exhibit a greater capacity for feedback literacy. This study explored whether mastery-oriented DNP students exhibit more feedback literacy behaviors compared with performance-oriented students in a scholarly writing course. In an observational study, 20 DNP students completed the Achievement Goal Questionnaire-Revised (AGQ-R) and Feedback Literacy Behaviour Scale (FLBS). Data were analyzed using effect size calculations. Mastery-oriented students scored higher on all FLBS subscales, with medium to large effect sizes. Writing instructors who promote a mastery-oriented approach to learning to write can foster DNP students who are better able to give, receive, and use feedback to adopt self-reflective strategies and effect practice improvements.

Background: Graduate nursing students face unique challenges balancing the demands of school, work, and personal life, putting both their academic success and individual well-being at risk. Objectives: This study examined the impact of embedding Community Resiliency Model© training in a Doctor of Nursing Practice (DNP) program at a U.S. public university to determine the utility of and perceived need for resilience training in this population and measure student resilience, burnout, and posttraumatic growth. Methods: A quantitative, pre/post design was used to evaluate outcomes via surveys utilizing open-ended questions and three validated instruments before and following resilience training. Results: Among 98 students who participated, the training was described as good to excellent quality (95%) and most (85%) continued to use the skills learned. All students recommended that resilience training should be included in a DNP program. There were no statistically significant differences in measures of resilience, burnout, or posttraumatic growth. Conclusions: A holistic approach including building resilience is needed to appropriately support graduate nursing students. Implications for Nursing: Resilience training is essential to equip DNP students with the skills needed to navigate demands of personal and professional life while ensuring their own well-being and that of those they serve.

The 2021 AACN Essentials call for competency-based Doctor of Nursing Practice (DNP) education that prepares graduates for complex practice environments. This article describes a practice-first curriculum redesign to improve scholarly project feasibility, strengthen alignment with clinical priorities, and enhance evidence translation into practice. A multidisciplinary task force mapped 11 core DNP courses to Essentials domains and advanced-level competencies following a needs assessment. Objectives and learning activities were revised to emphasize measurable practice-based outcomes. Redundant coursework was removed, and content in implementation science, interprofessional practice, social determinants of health, and the care continuum was strengthened. The scholarly project was restructured into proposal, implementation, and dissemination phases, supported by a scholarly writing course and competency-based evaluation. Outcomes included a competency map, milestone-based rubrics, revised sequencing, and structured project checkpoints. Evaluation demonstrated clearer expectations and feasibility across practice settings. This redesign aligned DNP curricula with AACN Essentials nationwide.

As artificial intelligence (AI) becomes increasingly integrated into education, understanding student perceptions of AI-generated support is critical. This pilot study examined how Doctor of Nursing Practice (DNP) students evaluate statistical help from different sources. Seven DNP students submitted statistical questions related to their capstone projects and received blind responses from a custom-trained, large language model (LLM) chatbot; a graduate assistant; and a professor. Students rated each response on helpfulness, satisfaction, and likelihood of use (i.e., 1 = worst, 5 = best), and guessed which response came from the chatbot. The LLM chatbot received the highest average ratings for helpfulness and satisfaction. However, students consistently rated responses lower when they believed they were AI-generated. Students preferred the LLM chatbot's responses when blinded yet demonstrated a bias against AI when the source was suspected. This bias may influence AI adoption in academic support and warrants further study.

Questions continue to arise as to what exactly Doctor of Nursing Practice (DNP) practitioners are doing differently in practice. The DNP Leaders in Practice Assessment (DNPLPA) Tool was developed for this reason and was the instrument used in this study. Data from a mixed-methods online study of a national sample of 208 practicing DNP nurses are reported. Means are reported, and the Staff Outcomes-based questions had the highest mean, followed closely by the Patient/Population Outcomes questions. Themes were created from the qualitative data that reflected three main categories: Implementation, Dissemination, and Professional Expectations. Exemplars demonstrated the wide range of activities of DNPs in practice today. Data validate that DNP practitioners are making major impacts in practice, education, and service, and through scholarly activities. The DNPLPA Tool collected a wealth of data that adds depth and breadth to the nursing body of DNP practice today.

ABSTRACTCompleting both Doctor of Nursing Practice (DNP) and Doctor of Philosophy (PhD) in Nursing degrees offers benefits and challenges. Integrating these programs enhances nurses' skills as clinicians and scientists, necessary for nurse practitioners in academic and clinical settings. An increasing number of nurses combine DNP and PhD degrees. This descriptive review evaluates this transformative shift in nursing education and practice. It offers perspectives to understand this change and discusses the significance of the shift. The review highlights role changes and opportunities related to education, scholarship, and practice. Additionally, it addresses policy implications, theoretical considerations, and organizational changes necessary to support this transformation.

To critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship. The DNP is a practice-focused doctorate established in the United States, distinct from the research-oriented PhD. Similar professional doctorates in the United Kingdom and Australia share the goal of integrating clinical expertise with scholarly inquiry. Despite the rapid growth of DNP programs and the increasing recognition of applied scholarship, many universities continue to privilege traditional research metrics in academic tenure and promotion. This narrow focus on discovery-based outputs marginalises the contributions of DNP faculty in implementation science, systems leadership, and education. Discursive position paper. Analysis of policy reports, faculty promotion guidelines, AACN Essentials, and peer-reviewed literature on doctoral education, professional doctorates, and academic equity, 2000-2025. Current academic evaluation systems sustain hierarchical norms that undervalue practice-based scholarship. This misalignment restricts the career trajectories of DNP-prepared faculty and constrains nursing's leadership in applied innovation. Reframing scholarly legitimacy through Boyer's model of discovery, integration, application, and teaching enables recognition of diverse expertise without compromising academic rigour. Fully integrating professional doctorates into academic structures requires deliberate reforms in evaluation frameworks, mentorship programs, and institutional policies. Such changes would advance equity, reflect the realities of modern nursing, and align doctoral education with the evolving needs of healthcare systems. This paper contributes to the international discourse on the future of doctoral education by offering a practical model for inclusive faculty advancement. It also advocates adopting pluralistic definitions of scholarship to support diverse academic career paths in nursing. No patients, service users, caregivers, or members of the public were involved in the development of this discursive paper. The analysis synthesises existing scholarship, policy documents, and theoretical frameworks and does not draw on primary data requiring patient or public involvement.

Doctor of Nursing Practice (DNP) students often experience elevated psychological stress due to the rigorous academic, clinical, leadership, and scholarly project requirements of doctoral nursing education. These demands frequently occur alongside professional employment and personal responsibilities, creating pressures that can negatively affect well-being and academic performance. High levels of perceived stress among graduate nursing students have been linked to burnout, reduced engagement, cognitive fatigue, and delays in program completion. This systematic review examined the effects of structured wellness interventions on perceived stress and academic success among DNP students. Interventions such as mindfulness training, resilience programs, structured physical activity, peer support, and coaching were generally associated with reduced stress and improved academic engagement and self-efficacy.