Direct Flight
Nurses inclined toward research or academia can help their careers take off with fast-track BSN-to-PhD programs

By Glen Fest and John M. Leighty
August 26, 2004

Postgraduate and doctoral studies in science-based professions can be a time-consuming affair of eight or more years. For nurses looking to become researchers or university professors, that would be a godsend.

Nurses answering the call to academia or research usually spend up to two decades meeting educational and clinical experience requirements of the traditional bachelor’s/master’s/doctoral track in nursing.

“By the time they get their PhD, they are 40 to 50 years old,” said Donna Lynn Rew, RNC, EdD, HNC, FAAN, a professor at the University of Texas at Austin School of Nursing. “In our discipline 85 it’s remarkable we’re the only one where people wait so long to get a PhD.”

As an antidote, many universities have, in recent years, adopted new paths of study for their PhD students. Accelerated — or “fast-track” — BSN-to-PhD programs are designed to send nurses more quickly into nonclinical fields in nursing research and nursing faculty, where shortages are as critical as the scarcity of bedside nurses.

Many schools have introduced the option within the past three to seven years. According to the American Association of Colleges of Nursing, 29 universities now offer accelerated BSN-to-PhD programs.

“We need to bring in the best and brightest of BSN students and allow them to continue their education,” said Jean Bartels, RN, PhD, professor and chair of the School of Nursing at Georgia Southern University, and president of AACN.

Early birds

Getting the doctorate at an earlier age provides two key advantages for students: an earlier start on tenure, and a chance to build a deeper research background.

“The main idea is to get younger people into research at an earlier age because it takes time to develop a significant intervention study that furthers the cause of nursing,” said Laurel Eisenhauer, RN, PhD, dean of the graduate program at Boston College William F. Connell School of Nursing. “Depending on the nature of the study, it can take years to build a track record or to develop the measurement mechanism needed for a major research project.”

Marjorie Isenberg, RN, DNSc, FAAN, dean of the University of Arizona College of Nursing, notes that biological scientists might enjoy a 40-year career after getting a doctorate by their mid-20s. For a doctoral research nurse, a career “might be only 20 years.”

Without having to first obtain a master’s degree, BSN-prepared doctoral nursing students concentrate on areas of research and theory coursework and bypass clinical preparation courses. University of Texas officials started their program after developing the curriculum allowing BSN-to-PhD students to take only nine to 12 hours of master’s-level coursework, Rew said, while skipping most clinical courses that are designed for advanced nurse practitioner candidates.

Under traditional tracks, several educators said, PhD candidates are slowed by mixing in four to five years of clinical experience, and taking dozens of credit hours of medical curriculum that is duplicative of their work experience or nongermane to research or education.

They also face external pressure to gain practice experience before entering graduate studies.

“They hear every day out there in the clinical area, ‘You can’t possibly teach or research if you haven’t developed your clinical skills,’” Rew said. “But you don’t need to know how to [insert] an IV to do research.”

Rew said many nursing students also don’t think to consider research or academia until they are exposed to the career pathways.

Bartels said promising baccalaureate students should be encouraged to pursue advanced degrees without major breaks for clinical work, which has been the norm in the past. “There’s really strong clinical experience embedded throughout the program,” she said.

Catching on

Accelerated BSN-to-PhD is not new. Nursing students at the University of North Carolina at Chapel Hill have had the option since 1989 — but none took it until 1998, according to Diane Holditch-Davis, RN, PhD, a professor in the School of Nursing and director of the school’s doctoral and postdoctoral programs.

Boston College enrolled its first student last year, after having first offered the option seven years ago.

“We didn’t have any interest initially with this option,” Holditch-Davis. “The assumption is [now] that the master’s program is no longer preparing a global advanced practice nurse — they are providing an advanced clinician.”

Many master’s programs have focused strictly on producing advanced practice nurses, and have sidestepped such areas as research methods, statistics, and nursing theory, said Holditch-Davis. UNC-Chapel Hill students take those courses, as well as two practice courses — which could be administrative rather than clinical.

Although it accelerates a student’s progress through the program, it doesn’t mean nursing students are skipping the master’s level, said Isenberg in Arizona. “Quite honestly, it’s a misnomer to call it ‘fast-track,’” she said. “It’s still using the core [master’s] curriculum.”

Eisenhauer said that [her?] school’s fast-track route to a nursing doctorate was designed so a student could get through the master’s component in two years. About 12 credits overlap with the PhD requirements, she said, giving students a boost toward finishing a doctorate within four years.

There are practical incentives for both students and schools in increasing enrollment in accelerated BSN-doctoral programs.

Schools lacking the capacity to enroll more doctoral students can shorten the waiting list by graduating students faster. Such programs also provide a better option to fill a looming gap in nursing faculty, which is aggravating the nursing shortage by forcing nursing schools to turn away thousands of qualified applicants, said AACN’s Bartels. The average faculty age of 53 means that in about a decade, 200 to 300 professors will be retiring annually. In the meantime, even with nursing schools reporting increases in enrollment, the number of doctoral graduates is down 9.9%, according to a recent AACN survey.

Students enjoy a wider array of federal loan and scholarship programs through the Nursing Reinvestment Act, and also may want to avoid the hassle of going through another application process. At UNC-Chapel Hill, Holditch-Davis said, a master’s is considered a terminal degree, so there is no direct master’s-to-doctoral program.

Most importantly, students can fully complete their education before lifestyle issues take priority, said Nancy Artinian, RN, PhD, director of doctoral and postdoctoral programs at Wayne State University School of Nursing in Detroit.

“The longer graduate studies are delayed, the more likely family and financial responsibilities will take priority,” she said. “We need to start training nurses toward the doctorate at an earlier age so we can lengthen their productivity and career.”

To comment on this story, send e-mail to editorca@nurseweek.com.