A PhD is a Doctor of Philosophy (PhD) and it sits proudly at the top of the ladder as one of the highest academic awards that can be given to an individual – a unique academic qualification1. A doctorate requires a student to have successfully completed a defined programme of work in a particular field of study and requires intense intellectual effort (Park, 2007). The award of a doctorate generally consists of a research project, each student must present results from their research to the faculty in a lengthy formal document called a dissertation (thesis), and defend their work with an oral (viva) examination.
Quantitative and qualitative and theoretical or philosophical methodologies are both acceptable, generally a variety of methods and tools are required to uncover deep understanding, new techniques, principles, mechanisms and abstractions. The PhD has especially been an indicator of capability, applicability and scope, but it is solely grounded in research. The singular use of research tends to ensure that the project is narrow with applicability to a limited group of people with a similar interest. The majority of PhD work rarely becomes public, is often not completed, and could be said to have little value in terms of the research being ready for application to or the development of practice. I suggest it is not well designed to advance the competencies, transferable skills and attitudes and behaviour of the researcher.
Less than 1% of the population attain this level of academic achievement (Pearson and Ford, 1997). In addition, many students fail to complete doctorate level study. This is generally because students are unable to grasp the level of knowledge with regard to research methodologies and often fail to obtain the depth regarding research principles and processes. All too often the work contributes to the supervisor’s research or work (Bone et al., 2002). It may be fair to say, and it is certainly commonly alleged that the standard to be attained to achieve a PhD varies considerably both between and even within institutions.
The doctorate was originally designed for an academic career based on preparation for appointment as an academic (Bone et al., 2002). In today’s academic workforce, a PhD is not a necessary or sufficient condition for appointment, as teaching within higher education tends to be more theoretical rather than about research. This sole purpose of the doctorate has since been questioned, as it no longer fits the expectations of students and employers as it is not well matched to the needs of careers outside research, a job in academia and the industrial research laboratory.
Traditional PhD holders have generally not been seen as having ‘relevant’ employment skills. The PhD is not owned by the institutions that design the programs, recruit the students and confer the degree (Park, 2007). There are multiple stakeholders with an interest in its development. There appears to be a mismatch between what universities are producing and what employers are looking for in terms of doctoral graduates. There has also been a change in attitude towards the award of a PhD and its value in the wider context, other than just academia.
The complexity of a number of roles outside academia has grown and different types of doctorates have been developed to meet the demands required by the employment market (Table 1). Postgraduate degrees have been developed which are now more useful to the practice base of a profession, e.g. engineering, accountancy, law and education, and more recently in nursing (Ellis, 2005). There are mixed views about the need for specialised doctoral degrees in other professions like education (D.Ed) and engineering (D.Eng) (Park, 2007) and it is assumed that the introduction of a doctorate in nursing (D.Nurs) would be no different. Such programmes already exist in the USA (e.g. D.N.Sc.; DNS) but have yet to find widespread appeal and are rare in the UK. I argue that they should be welcomed by government’s determining health care policy and by nursing professionals as a means of reconstructing the relationship between theory and practice.
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 | Award | Characteristics | Limitations | |
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| Traditional PhD | Based largely on the supervised research project, examined on the basis of a thesis | The traditional PhD is too narrowly focussed and not matched to careers outside of research or academia | |
| PhD through publication | Is by the presentation of a volume of academic publications, with a viva voce examination. Published work has to demonstrate contribution to knowledge. The publications have to function, as a coherent whole in a particular field. Generally the research presented is practical and applied rather than purely theoretical | Many universities offer this route to a doctorate, often restricting the eligibility to those who have a direct connection with the university. The PhD through publication is limited to certain outputs in specified journals or books. The work generally has to be of a research nature, otherwise it will not be considered. However, the published work has been judged in the public domain and by peers | |
| The new route PhD | Originally known as the Enhanced PhD, Intended to meet the needs of particular overseas markets, e.g. US. Will include broader subject knowledge in addition to research expertise. Originated due to a dissatisfaction of the traditional, publications, taught and professional routes | Intended to meet the needs of particular overseas markets will potentially take longer and include significant amounts of taught material | |
| A taught PhD | Attempted to give students greater knowledge of research methodologies. Teaching often restricted to conventional didactic approaches | May be considered that taught PhDs are not comparable with the traditional PhD. The taught doctorate continues to require research and most have to meet specific learning outcomes and as such are subject to formal assessment. Questions remain about level with regard to various taught PhDs and how do they differ from a good Masters. | |
| Professional doctorate | A further development of the taught PhD. Meant to be relevant to professional practice. Generally includes taught elements. May include a Masters and some are credit rated (APL). The field of study is that of a professional discipline rather than academic enquiry and scholarship. Often uses imaginative and creative ways of supporting learning | It is recognised that conventional teaching may not best facilitate learning at the highest levels, and that other forms of directed and guided study are of considerable value.Designed for professionals working in a practice environment, continues to be based on a number of taught modules, which are examined and must be passed | |
| A practice-based doctorate | Generally ideas and theories emerge from practice. The output can include written pieces (publications, conference papers, reflexivity and development of self). Can include one or more other outputs, e.g. DVD, book, which can form part of the output to be examined. Developing leaders in fields whereby practice plays a major role | May be judged as inferior or lesser quality to that of other ways of achieving a doctorate as it contains more coursework and less research | |
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The time is right and nursing is ready for a practice-based and/or professional doctorate in nursing (Ellis and Lee, 2005). Nursing is currently in a time of great change (Domino, 2005). Given the multiple Government policies driving for change in the delivery of care in the National Health Service (NHS). Recent government policy proposes increasing the value of the nurses’ role in society (Hewison, 2003). The making a difference (DOH, 1999) and the NHS plan (DoH, 2001a) is a 10-year programme of investment and reform that aims to secure a NHS that is fit for the 21st Century. This report discusses the value of nursing and the necessity of strengthening nurse education and training, and improving the career structure. It emphasises more nursing led services, senior practitioners/consultant grades and more nurses with qualifications at masters (MSc) and doctorate level. Their main thrust is to empower appropriately qualified nurses to undertake a wider range of tasks.
The document ‘Liberating the talents’ (DoH, 2002) values nurse generalists and advanced and specialist skills. It advocates new and creative ways of working and greater freedom and more flexibility. The ‘Working together–learning together’ (DoH, 2001b) report advocates and values inter-professional education (IPE) as the nurses role in the future will require nurses to manage patient care in collaboration with other health care disciplines (Domino, 2005). There are increasing recommendations to expand accessibility, strengthen clinical ladders and widen participation. Finally, advanced nursing roles and specific skills such as nurse prescribing have become common. This has resulted in nurses taking on roles that have traditionally been associated with doctors (Bradley and Nolan, 2007). This provides a different image of nursing towards that of an independent professional practitioner.
In professional practice-based/professional doctorates the vehicle for research is a topical, applied issue or problem, based in a candidate’s workplace and/or professional practice rather than an academic research question. The research questions originate from practice and acknowledge the importance of practice in the development of new knowledge, which is ready on completion for implementation into practice. Whereas with the traditional PhD there is a time lapse between new knowledge generation and its implementation in practice as the researcher is generally at a distance from practice.
The outcome of the research is designed to provide valuable insights into and a contribution to knowledge in the field of the individuals’ professional practice (Johnson, 2005). It is the applied nature of the research that is the key element in practice-based doctoral programmes and what differentiates it from the PhD. A PhD is about research while a work-based professional doctorate is about research and personal and professional development (Johnson, 2005). Together with the research is an emphasis on reflexivity encouraging self-development, career advancement and/or to acquiring the high level skills needed to tackle work-based challenges.
In health care, there is a need for a doctorate to be achieved in a number of ways. The additional ways to obtain a doctorate are valuable as they advocate that an original contribution to knowledge does not have to be generated through empirical research or theory. Developing professional practice-based doctorate in nursing fills a gap in doctoral education. Yet many of the current professional doctorates are not solely related or specifically linked to nursing. Admittedly many are supposedly multi-professional, but nurses make up most of the students. A professional doctorate in nursing represents the coming of age of practice-based learning within a higher education curriculum (Bareham et al., 2000). The practice of research is informed by real problems in professional nursing practice, it is flexible and has wider benefits by giving nurses the preparation they need in research training, technology transfer, and the skills they require to become leaders in their field.
However, the professional doctorate in nursing has its limitations. Draper (2007) asserts that health services can simply not afford to commission the higher education sector to provide continuing professional development at this level, nor can potential students afford to foot the bill. This is also compounded by the lack of evidence of the benefits of professional doctorate education. Therefore, healthcare organisations prefer to use their limited funding to develop and run a range of in house training courses that are highly responsive to a fast-changing healthcare environment (Draper, 2007). Nevertheless, a new professional practice-based doctorate (DNurs) would include a broad range of issues and carefully thought-out curricula. This would encourage the use of a variety of research methodologies usually associated with naturalistic enquiry such as action research, narrative research/inquiry, case study, and participants/clients as researchers to support students while empowering the researcher to improve practice.
Many academics such as Mckenna (2005) and Kirkman et al. (2007) are resistant to the idea that the new routes to obtaining a PhD are comparable with the traditional PhD. The distinction between the differing patterns of PhD award is not well understood. However, this is an important point to bear in mind that although a practice base doctorate is different to the PhD it is equivalent to and not a lesser version of the PhD. Professional doctorates also challenge the received wisdom of how to examine doctoral level work (Stephenson et al., 2006). In this light professional doctorates in nursing do have their shortcomings and more of these may only surface as more programmes emerge. They also pose some interesting challenges within the realm of doctoral education in the UK and abroad.
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