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RE-VISIONING THE DOCTORAL RESEARCH DEGREE IN NURSING IN THE UNITED KINGDOM

Christopher R Burton, DPhil PGCertHE, BN, RGN Joy Duxbury PhD, BSc, RMN, RN, RNT Beverley French, PhD, RNT, RGN, RNMH Rob Monks PhD, BSc, PGCE, RGN Bernie Carter PhD, PGCE, PGCE, BSc, RSCN, SRN ABSTRACT

In the light of concerns about the wider social and economic value of the PhD training programme,

this article discusses the challenges being directed primarily at the traditional doctoral programme

of study. While the PhD is primarily concerned with the student making an original contribution to

knowledge, the value added component of the doctoral research degree needs to respond to the

needs of a wider market of purchasers, and to meet practice and policy requirements for research

leadership. The United Kingdom Research Councils (UK GRAD 2001) suggest a range of seven skill

domains over and above research design and management that should be offered to students. The

seven domains are research skills and techniques, participation in the research environment,

research management, personal effectiveness, communication, networking and team working, and

career management. This article develops and extends these skill domains for the current

healthcare context and considers how these should guide the development and evaluation of the

value-added components of doctoral research degree programmes in nursing. The challenges that

these issues present to academic departments are also discussed. Our conclusion is that PhD

research training needs re-visioning and broadening so that the students’ experience includes these

value added components.

Key words: doctoral research programme; nursing; health care; skills training; leadership.

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BACKGROUND

The defining feature of a doctoral research degree (PhD) programme is that the student makes an

original contribution to knowledge. This is achieved through an approved research project,

supervised by experts in the subject discipline and methodological approach. As nursing has

developed worldwide as an academic discipline, so increasing attention has been paid to doctoral

programmes in nursing (Galvin & Carr, 2003 p304; Kirkman, Thompson, Watson & Stewart, 2007;

Upvall & Ptachcinski, 2007). McKenna (2005) notes that detailed global statistics relating to the

number of nurses who are doctorally prepared are not readily accessible and Ketefian (2008)

highlights the dearth of doctoral programmes and doctorally prepared nurses in developing

countries. The United Kingdom Clinical Research Collaboration (UKCRC) (2007) report quotes, 900

nurses were registered on UK PhD programmes within nursing/midwifery in 2005. Of these only 8%

were aged 29 years or under, with the majority (over 60%) aged 40 or over. Of those midwives and

nurses working in UK University Hospitals, fewer than 1 in 10 have a research degree.

Concerns about the wider social and economic utility of traditional research training programmes

for the UK and elsewhere in the world (Boud & Tennant, 2006; Neumann, 2005) have generally

renewed interest in the value-added component of research degrees (The Higher Education Funding

Council for England (HEFCE) 2000). Knowledge is increasingly being defined economically rather

than epistemologically (Usher, 2002) and nursing knowledge is being similarly defined. The fact

that a successful student has added to a body of knowledge would no longer seem to be enough to

justify the social investment in research degree funding (Usher 2002, Tennant 2004). This should be

of particular concern to academic departments of nursing grappling with the sustainability of

student admissions, and seeking to ensure student retention and completion. Increasingly,

academic departments will need to respond to the needs, values and sometimes conflicting goals of

a wider market of purchasers, such as individual students, employers, regional and national

commissioners of education and training, as well as more traditional governmental and charitable

funders of research degree fellowships. In addition to reflecting national initiatives to improve

research capability, the different requirements of purchasers will need to inform the design and

structure of research degree programmes. Another pressure highlighted by Kirkman et al. (2007)

and Hinshaw and Leino-Kilipi (2005) is the expected ‘greying of the professoriate’ which will further

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limit supervisory capacity in many countries over the next decade (Long, 2007). In this position

paper we focus primarily on the traditional route to a PhD in nursing in the UK but acknowledge

that our discussion is shaped and informed by the debates resulting from the alternative PhD

routes. Our discussion is contextualised within the international literature as the challenges faced

in the UK are mirrored elsewhere in the world.

THE DOCTORAL RESEARCH DEGREE

As an academic credential marking advanced study and training in research, the pre-eminent

position of the traditional research degree is clearly under scrutiny (Ellis, 2005; Usher, 2002).

McAlpine and Norton (2006 p4) note that “epistemological questions are being raised about the

nature of the doctorate, which has traditionally included lengthy study, original research and thesis

preparation”. Pressure to change is also compounded by a range of factors including declining

numbers of applicants, economic uncertainty and limited confidence in the career benefits of

existing doctorates (Johnston & Murray 2004). McAlpine and Norton’s (2006) model of nested

contexts (department-disciplinary context; institutional context; societal-supra societal context)

which influence retention and completion illustrate how many interlocking issues are influencial.

Nyquist and Wulff (2003) argue that current graduate education does not adequately match the

needs and demands of broader society and fails to provide systematic and appropriate supervision,

resulting in high attrition rates amongst doctoral students. Furthermore, the overall quality and

coherence of the learning experience of doctoral students has come under significant attack,

having been described as a national concern (Johnston & Murray 2004). The establishment of

nursing PhD consortia (see for example, Long, 2007) or a virtual research community (see for

example, Effken, Boyle & Isenberg, 2008) are measures which have been taken in the USA to

address some of these challenges.

However, questions remain as to the purpose of academia in the knowledge economy, and a clear

picture of the aspirations of commissioners or students themselves is lacking at a strategic level

(see also McKenna, 2005). There are pressures to link higher education to the workplace (Nixon et

al. 2006) albeit that most focus is on undergraduate and taught postgraduate courses and the

requirement to develop a portfolio of skills (Craswell, 2007). Given these pressures, the need to

accommodate new ways of structuring doctoral degrees underpinned by new ways of producing

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knowledge is inevitable. There are early indications that traditional structures and management

processes need to change (Malfroy & Yates 2003).

Until recently, there appears to have been a lack of systematic and theoretical thinking about such

issues in the generic PhD and specific nursing PhD literature (McAlpine & Norton, 2006). However,

Kim et al. (2006) have addressed the need for global quality criteria, standards, and indicators for

doctoral nursing programs and Kjellgren et al. (2005) have suggested a strategic approach to the

evaluation of doctoral nursing programmes. Despite the lack of empirical research on professional

doctorates noted by Ellis and Lee (2005), the emergence of the practice doctorates has resulted in

a spate of articles comparing practice (and other new) doctorates to traditional PhDs (Ellis & Lee,

2005; Galvin & Carr, 2003; Kirkman et al., 2007; Upvall & Ptachcinski, 2007). The traditional model

of PhD supervision has been the primary framework available to supervisors on which to base their

approach. Whilst the traditional model offers a ‘safe’ (although rarely tested) approach,

application is often problematic in ‘professional routes’ at doctoral level. As Park (2005, 2007)

clearly highlights, the primacy of the traditional route to a PhD is under threat from “new variant”

doctoral degrees such as the PhD by Publication and Professional Doctorates. However, there is

clearly a debate surrounding the ‘academic’ qualities of practice and practice-based PhDs (Winter

et al. 2000; Ellis, 2005; Fulton & Lyon, 2005; McKenna, 2005). In this context fundamental

questions have been raised about the purpose and place of the PhD in higher education (Tinkler &

Jackson 2002). As a result professional groups such as nurses have criticised this approach, and

suggested that the PhD of the future should cater for and prepare candidates for different careers

(see for example, Magyary, Whitney & Brown, 2006). The social, academic and cultural isolation

traditionally associated with the British PhD in particular is seen to be problematic (Johnston &

Murray 2004), and at odds with the prevailing practice model of nursing which is multidisciplinary.

The Research Councils (UK GRAD 2001), who are the major national funders of research degree

fellowships in the UK, published a joint statement on skills training requirements for research

students. Although these councils rarely fund nursing research degree programmes, the statement

does provide an indication of the seven domains of transferable, value-added skills that students

should be supported to enhance during their studies. These domains are:

• Research skills and techniques

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• Participation in the research environment

• Research management

• Personal effectiveness

• Communication

• Networking and team working, and

• Career management.

Examination of the different skills within these domains suggests that research degree providers are

keen to ensure that, alongside the development of exemplary skills in many aspects of research

design and conduct, students must develop a greater degree of independence to embed their

knowledge and skills in the workplace. This requires a greater sense of personal leadership,

including awareness of the relevant policy and political climates, and enhanced communication and

networking skills. The challenge for nursing departments is to review these skill domains within the

context of the actual and potential career trajectories of research degree graduates.

The workplace context which nursing graduates will be entering after completion of a research

degree is becoming more complex and varied, and extends beyond the traditional move into higher

education. Increasing opportunities for practitioners to engage in research within the clinical

environment are emerging as the non-medical consultant role (Department of Health 1999) and

other advanced practice roles are embedded in health service organisations. The non-medical

consultant role has, for example, an expectation that role incumbents will participate in research.

Early role evaluation has however demonstrated considerable variation in the interpretation of this

engagement at a local level (Guest et al. 2004), with various levels of engagement in and

integration of research (Woodward, Webb & Prowse 2005). This clearly highlights it as an important

area for role development. It must be acknowledged that currently a research degree programme

may be a feasible career development route for only a limited number of aspiring nursing

consultants. Ensuring that a programme is relevant to their other role domains (expert practice,

clinical leadership and education) will increase the proportion who do choose to use this route for

their career development. Ensuring relevance and professional specificity will provide a greater

selection of career development opportunities for these practitioners. Such programmes could

include taught and professional doctorates (Galvin & Carr, 2003; Jolley, 2007; Yam, 2005), which

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would need to address research in a sufficiently rigorous manner whilst ensuring that they do not

revert “de facto to the norms of the conventional PhD” (Boud & Tennant, 2006 p302). This is

crucial in ensuring that there is sufficient investment in future nursing research leaders, whether

they work in a University or practice environment.

Promoting a greater synergy between research and practice within career frameworks for nurses in

advanced and consultant roles is reflected in emerging policy for research capability and capacity

building (UKCRC 2006). The UKCRC (2007) report on clinical academic career pathways for nursing

visualises a greater flexibility of employment opportunities within research networks or clinical

research centres, and dedicated opportunities for research training. The development of new

career opportunities for researchers outside of academic departments of nursing will have

important implications for research training, which is often underpinned by the prevailing culture

of academe. Those academic departments of nursing who have a track-record in clinical nursing

research will have first-hand experience of the demands of clinical research, such as funding,

project management, governance and ‘survival’. It is likely however that all departments will need

to review the fitness for purpose of research degree graduates in clinical research networks and

facilities. It is also inevitable that academic nurses working within Universities will need to consider

their fitness to supervise this new type of graduate. Just as opportunities need to be opened up for

clinical nurses to sustain and enhance their post-doctoral research skills with secondments to

academic departments, so will academic nurses want to benefit from secondment to practice.

HEALTH POLICY

Recent UK health reforms indicate that the policy agenda for health care includes a clear intention

to diversify the range of health care providers (Department of Health 2006). Within the National

Health Service there is diversification in the structure and management of existing service

provision. The emergence of practice-based commissioning and patient choice as drivers of change

(Department of Health 2003) will see much greater involvement of the independent, voluntary and

not-for-profit sectors in health care provision. These providers are largely under-developed in terms

of commitment to the professional development of nursing, although they provide plenty of

opportunities for social enterprise (Department of Health 2007). Importantly, there is a drive to

increase the number and range of examples of entrepreneurial activity by nurses in both statutory

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and non-statutory providers (Traynor Davis & Drenann 2006). Whether entrepreneurial practice can

be developed or is innate in individuals is an issue for debate. Educational providers do however

have an important role to play in releasing practitioners from the confines of existing paradigms

and professional models, and supporting creativity and innovation.

Starting with The Patients’ Charter (Department of Health 1991), health policy has steadily

reflected a requirement for public services to be patient as opposed to professional-centred,

promoting patient involvement in service design, delivery and evaluation. This has culminated in

the more recent initiatives such as the Expert Patient Programme (Department of Health 2001)

which recognises the unique knowledge and expertise that patients living with health problems can

bring to peer support services. Whilst increasing patient power and autonomy may not always be

comfortable in practice, this fits comfortably with the espoused theories of nursing which are

generally holistic and empowering of patients. For some researchers in nursing, this challenges the

traditional strategies for generating research ideas and questions which have focused on the

refinement of theory, and emerge from a mainly academic discourse in the scientific literature. A

strong and meaningful engagement with patients is now the norm for health research (Farrell,

2004; Kelson, 2005; Nilsen, Myrhaug, Johansen, Oliver & Oxman, 2006), and the demonstration of

this is now a usual pre-requirement for research funding.

CONCEPTUAL FRAMEWORK

Synthesis of the Research Councils’ joint statement on skills training, frameworks for advanced

practice and roles, and the health policy mentioned above would suggest that there are a number

of key concepts that should guide the evaluation and development of the value-added components

of research degree programmes in nursing.

Research skills, techniques and management

By implication, research degree programmes enable students to develop expert skills in specific

aspects of research methodology and methods, and in the management of research projects. The

nature of clinical problems that drive research in health care however requires that researchers

have a well-rounded experience of a variety of approaches and methods. There may therefore be

benefit in ensuring that research degree graduates have breadth and depth in both topic and

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methodological expertise. This may be facilitated either by general research methods training, but

also through exposure to the research of other students and academic staff. This is particularly

challenging for students in academic departments of nursing who often have to balance the

demands of their research and clinical roles, and consequently have reduced opportunity to

participate in the wider academic community available to full-time research students. The

acquisition of a skills base which keeps abreast of change within health care is challenging,

particularly when balanced against the slower pace of time traditionally associated with fostering

the deep critical thinking and reflexivity required to contribute to original conceptual and/or

theoretical knowledge.

Participation in the health care research environment

The clinical research environment is very different to the research environments of higher

education, and consequently requires a different set of skills. For example, researchers in nursing

will often have to balance clinical, research and other role components, and consequently

experience different relationships with the University sector. In addition, other relevant and more

established relationships, for example the clinical lectureship, tend not to be available to nurses.

Funding streams for research are different, governance regulations are comprehensive, and there

are a wide range of research ‘stakeholders’ such as pharmaceutical companies, government and

patients, who require very different returns from research. In addition, research partners will often

be multi-disciplinary, and may hold different or even opposing views about the utility of different

research questions, approaches and methods. The challenge for academic departments of nursing is

to support PhD students to develop the skills and strategies that will help them to survive and

thrive in this environment, whilst maintaining integrity and the personal investment which is crucial

to successful PhD completion.

Personal effectiveness, leadership and career management

It is clear therefore that graduates require a sense of, and some capability in, aspects of personal

leadership. Strategic thinking that is reflective of actual and potential shifts in policy, and that

informs the establishment of medium and long-term personal research objectives is required.

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Existing academic models of career management adopt an insular stance, suggesting time aside to

think creatively about the development of research plans, the development of a topic niche, and

publicising research outcomes through academic journals (Berman 1999). Whilst these are

important elements of career management, they are primarily geared towards a career in an

academic setting and a context which is distorted by the targets of the all encompassing targets

(performativity) of UK governmental research evaluation such as the previous Research Assessment

Exercise and the prospective Research Excellence Framework

(http://www.hefce.ac.uk/Research/ref/). Many nurse researchers will also need time aside to

think, but strong relationships with practice and policy through which research questions and ideas

emerge collaboratively are likely to be more relevant and may be more likely to attract funding.

Whilst topic specialisation has obvious benefits for the development and peer recognition of

expertise, the success of the strategy to some extent depends on the availability of research

funding. In health, this availability is influenced by developments in policy which can often be rapid

and be reflective of political rhetoric.

Communication (writing and presentation)

Publication in well regarded scientific journals remains the pinnacle for many staff in academic

departments of nursing, largely as a result of strategies for external peer review of research

credibility - even though measures such as impact factors are being vociferously challenged (Brown

2007, Williams 2007). As more varied career opportunities become available, so researchers will

increasingly have other demands on their dissemination activities, such as the production of

practice policy and guidance, to meet the needs of a variety of audiences. The drive for more

robust dissemination strategies will continue. These will include other researchers, practitioners,

service commissioners and managers, and patients themselves.

Networking across professional boundaries and organisations

Increasing the inter-disciplinarity of academic research is advocated as a means of ensuring that

research better responds to the needs of the UK economy, and increases international economic

competitiveness (HEFCE 2000). This echoes to some degree the benefits derived from inter-

disciplinary health services in improving clinical effectiveness and the patient experience. Inter-

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disciplinarity in academic research however requires the collaboration of a much wider mix of

academic disciplines, drawing on the differences in theoretical perspectives and methodologies to

design new solutions to problems and develop new technologies. For nursing graduates inter-

disciplinarity should likewise mean more than multi-professional research, and programmes should

be able to equip them with the skills and confidence to develop alliances with researchers and

practitioners from a range of academic disciplines such as sociology, psychology, economics and the

arts. This is particularly important when the post-qualification environment for graduates is

undergoing profound change. Being able to operate effectively alongside researchers from other

disciplines requires reciprocal understanding of each others’ values bases. A mixed economy of

health care for example requires those developing services through research to have a much

greater awareness of business planning methodology and economics. Such changes also require

require “supervisors who are open to trans-disciplinary work and cooperation”(Boud & Tennant,

2006 p304).

Creativity and innovation

Research degree programmes have generally been viewed as exercises in enculturation, usually

from both a professional and research perspective (Becher 1989). This ensures that the research

undertaken within a PhD is firmly grounded in both theory and design, enabling the student to be

seen to systematically generate ‘new knowledge’. Whilst this is obviously advantageous in

demonstrating the credibility of the student’s thesis, there is the potential for this to stifle

creativity and innovation. Consolidating and promoting entrepreneurship within health care is likely

to be a distinct advantage for graduates in the new health care environment. Enhancing the inter-

disciplinarity of research may help research students and supervisors develop new approaches and

ideas, however the demands of progression and completion may mitigate against their

implementation. The significant challenge therefore for research degree programmes is to ensure

that creativity is nurtured both within and outside the prevailing paradigm. Nurturing creativity

may well provide the necessary support to graduates working within the performance-oriented

culture that is the contemporary NHS whereby keeping ahead, being entrepreneurial and market-

oriented are key to maintaining a professional identity (Dent & Whitehead 2002).

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Patient involvement

Increasing public involvement in the organisation and delivery of health care has been cited as the

key aim of UK health policies which diversify health care provision, increasing the role of the

private, voluntary and not-for-profit sectors (Department of Health 2006). These policies may be

uncomfortable for some, challenging what could be viewed as the core values of nursing within the

UK, steeped in a publicly-funded service model. It is essential however that the positive aspects of

these values, such as meaningful patient engagement in establishing and delivering a research

agenda, rather than simply their rhetoric, are maintained and embedded in research and

development. In practice, graduates of research degree programmes in nursing should be supported

to develop the skills and knowledge to ensure that the patient experience remains at the centre of

their research endeavour. This may best be achieved through exposure to a research environment

which values the contribution that patients can bring to research (The National Working Group on

Evidence-Based Health Care, 2008; Thornton, Edwards & Elwyn, 2003).

RESEARCH PROGRAMME DEVELOPMENT

The challenge for academic departments of nursing is to ensure that research degree programmes

provide sufficient opportunities for students to hone their knowledge and skills. To date, some

progress with this has been made, particularly with respect skills and techniques. Increasingly,

Universities require students to undertake programmes of related studies (see for example, the

University of Exeter http://www.admin.ex.ac.uk/gradschool/skills/index.shtml ; Cardiff University

https://rssdp.cf.ac.uk/) , usually starting on enrolment on their programmes. Typically these have

related to ensuring as wide an exposure as possible to information literacy and communication skills

(see for example, Craswell, 2007) and to different research methods, compensating for the high

degree of specialism developed in methods associated with the thesis subject.

Evidently there are many opportunities for students to develop their knowledge and skills in

research management through the management of their research study, even where programmes of

related studies are limited. More recently opportunities to develop a breadth of research literacy

have been fostered. Often in nursing, research students will have to negotiate funding and access

for their research, navigate the complexities of research governance, balance the challenges of

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real-world clinical research with the demands of University regulations and progression

requirements, and negotiate a successful model of supervision within the academic department.

Success within these activities is likely to skill-up students providing them with greater confidence

to ‘fly solo’ in a post doctoral research position.

Opportunities for students to share learning from their own experiences of their research, as well

as sharing strategies for coping with the rigours of the research degree pathway, are important.

Some academic departments provide resources to facilitate this peer-learning either through

shared resources such as a ‘research student base’, or more formal action learning sets. The

success of these initiatives depends however on the ability of part-time students to access them.

Where this is possible, this peer learning can provide opportunities for students to explore the

demands of the health care research environment as it relates to different research topic areas.

CONCLUSION

For maximum benefit to students, strategies to address networking, inter-disciplinarity,

entrepreneurship, personal leadership and a strong patient focus must be embedded in the culture

that research students experience throughout their research degree programme. The values

demonstrated through supervision, and exposure of students to the range of research ongoing

within an academic department, should ensure that the values become integrated within the

students’ own world view, reflecting the importance that needs to be attached to them. Given the

fact that the development agenda for research degree programmes in nursing described earlier is

relatively immature (for example, health policy has yet to be embedded in commissioning and

delivery), it may be that there is a need for exposure to be more explicit.

Our view is that the frameworks for research supervision for all types of PhD should be widened as

this would consequently expand the context of research students’ experience. This does not mean

that the membership of research supervisory teams should be necessarily broadened, although

there may be strong benefits from having teams represent academia, clinical practice and other

disciplines in some cases. A pre-requisite to these benefits would be the availability of sufficient

research expertise in clinical practice, which is often lacking (UKCRC 2006). Rather, a more flexible

visioning of the programme of related studies is required, that provides students with opportunities

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to develop value-added skills as they progress through their research. These opportunities should

include exposure to the full range of stakeholders that will have a role in shaping the range of work

environments that students may enter on completion of their research degree. These include

service commissioners, senior managers from statutory and non-statutory services, policy leaders,

patient representatives and the like as well as visionary academic research leaders with subject

specific and methodological expertise. This requires a flexible rather than a modular approach, and

may include the provision of master-classes with carefully selected external speakers, expert

facilitated action learning sets, shadowing of key stakeholders, and access to bespoke personal

development programmes.

Whilst there are necessarily resource implications associated with this, a key advantage of these

strategies is that, by implication, they engender greater involvement of stakeholders in the

research degree programme itself. This has obvious benefits for schools of nursing in promoting

greater awareness of the benefits of research degree programmes and their post graduates, and

gaining intelligence to guide the ongoing development of programmes. Needless to say it would also

sustain and enhance networks and dialogue between supervisors and external stakeholders. Perhaps

more importantly, it would make visible to students the joint academic-professional commitment

to their individual personal and professional development. This is particularly important where

students’ research degrees are mostly either employer or self-funding. Whilst a cultural shift within

both academe and practice settings is necessary to accommodate this revisioning, the potential

value-added gains to all parties (student, supervisors, clinical stakeholders) would seem to far

outweigh any initial discomfort that may be experienced.

REFERENCES

Becher, T., 1989. Academic Tribes and Territories: Intellectual Enquiry and the Culture of

Disciplines. Open University Press, Milton Keynes.

Berman, F., 1999. Building a Research Career. Career Mentoring Workshops, University of

California, San Diego. Available at

http://www.cra.org/Activities/craw/projects/mentoring/mentorWrkshp/career_building.pdf

(last accessed 1st April 2008).

Boud,D., & Tennant,M. (2006). Putting doctoral education to work: challenges to academic

practice. Higher Education Research & Development, 25(3), 293-306.

14

Brown, H., 2007. How impact factors changed medical publishing-and science. British Medical

Journal 334, 561-564.

Craswell,G. (2007). Deconstructing the skills training debate in doctoral education. Higher

Education Research & Development, 26(4), 377-391.

Dent, M., Whitehead, S. 2002. Managing Professional Identities: Knowledge, Performativity and the

‘New’ Professional. Routledge, London.

Department of Health. 1991. The NHS Patient’s Charter. Department of Health, London.

Department of Health. 1999. Nurse, Midwife and Health Visitor Consultants: Establishing Posts and

Making Appointments (HSC 1999/217). The Stationery Office, London.

Department of Health. 2001. The Expert Patient: A new approach to chronic disease management

in the 21st Century. The Stationery Office, London.

Department of Health. 2003. Building on the Best: choice, responsiveness and equity in the NHS.

Department of Health, London.

Department of Health. 2006. Our Health, Our Care, Our Say: a new direction for community

services. Department of Health, London.

Department of Health. 2007. Welcoming Social Enterprise into Health and Social Care. Department

of Health, London.

Effken,J.A., Boyle,J.S., & Isenberg,M.A. (2008). Creating a Virtual Research Community: The

University of Arizona PhD Program. Journal of Professional Nursing, 24(4), 246-253.

Ellis,L.B. (2005). Professional doctorates for nurses: mapping provision and perceptions. Journal Of

Advanced Nursing, 50(4), 440-448.

Ellis,L.B., & Lee,D.N. (2005). The changing landscape of doctoral education: Introducing the

professional doctorate for nurses. Nurse Education Today, 25(3), 222-229.

Farrell,C. (2004). Patient and Public Involvement in Health: The Evidence for Policy

Implementation. London: Department of Health.

Fulton,J.S., & Lyon,B.L. (2005). The Need for Some Sense Making: Doctor of Nursing Practice.

Online Journal of Issues in Nursing, 10(3 (Manuscript 3)).

Galvin,K., & Carr,E. (2003). The emergence of professional doctorates in nursing in the UK: Where

are we now? Nursing Times Research, 8(4), 293-307.

Guest, D.E., Peccei, R., Rosenthal, P., Redfern, S., Wilson-Barnett, J., Dewe, P., Coster, S., Evans,

15

A., Sudbury, A. 2004. An Evaluation of the Impact of Nurse, Midwife and Health Visitor

Consultants. King’s College London, London.

The Higher Education Funding Council for England (2000) A New Route to the PhD. Available at

www.newroutephd.ac.uk (last accessed 1st April 2008).

Hinshaw,A.S., & Leino-Kilipi,H. (2005). Future directions in knowledge development and doctoral

education in nursing. In S. Ketefian, & H.P. McKenna (Eds.), Doctoral Education in Nursing:

International Perspectives (pp.27-55). London: Routledge.

Johnston, B., Murray, R., 2004. New routes to the PhD: cause for concern? Higher Education

Quarterly 58 (1), 31-42.

Jolley,J. (2007). Choose your doctorate. Journal of Clinical Nursing, 16(2), 225-233Kelson, M.

(2005). The NICE Patient Involvement Unit. Evidence-Based Healthcare & Public Health, 9, 304–

307.

Ketefian,S. (2008). Doctoral education in the context of international development strategies.

Kim,M.J., McKenna,H.P., & Ketefian,S. (2006). Global quality criteria, standards, and indicators for

doctoral programs in nursing; literature review and guideline development. International

Journal of Nursing Studies, 43(4), 477-489.

Kirkman,S., Thompson,D.R., Watson,R., & Stewart,S. (2007). Are all doctorates equal or are some

"more equal than others"? An examination of which ones should be offered by schools of nursing.

Nurse Education in Practice, 7(2), 61-66.

Kjellgren,K.I., Welin,C., & Danielson,E. (2005). Evaluation of doctoral nursing programs - A review

and a strategy for follow up. Nurse Education Today, 25(4), 316-325.

Long,K.A. (2007). Nursing PhD Consortia: A Model for Maximizing Scarce Resources. Journal of

Professional Nursing, 23(5), 262-266.

Magyary,D., Whitney,J.D., & Brown,M.A. (2006). Advancing practice inquiry: Research foundations

of the practice doctorate in nursing. Nursing Outlook, 54(3), 139-151.

Malfroy, J., Yates, J. 2003. Knowledge in action: doctoral programmes forging new identities.

Journal of Higher Education Policy and Management 25 (2), 119-129.

McAlpine,L., & Norton,J. (2006). Reframing our approach to doctoral programs: an integrative

framework for action and research. Higher Education Research & Development, 25(1), 3-17.

McKenna,H. (2005). Doctoral Education: some treasonable thoughts. International Journal of

Nursing Studies, 42(3), 245-246.

16

Neumann,R. (2005). Doctoral Differences: Professional doctorates and PhDs compared. Journal of

Higher Education Policy & Management, 27(2), 173-188.

Nilsen,E.S., Myrhaug,H.T., Johansen,M., Oliver,S., & Oxman,A.D. (2006). Methods of consumer

involvement in developing healthcare policy and research, clinical practice guidelines and

patient information material.: Cochrane Database of Systematic Reviews.

Nixon, I., Smith, K., Stafford, R., Camm, S. 2006. Work-Based Learning: illuminating the higher

education landscape (The Higher Education Academy Final Report). The Higher Education

Academy, York.

Nyquist, J., Wulff, D.H. 2003. Re-envisioning Project Resources. Available at

http://www.grad.washington.edu/envsion/project_resources/national_recommend.html (last

accessed 19th April 2007)

Park, C., 2005. New variant PhD: the changing nature of the doctorate in the UK. Journal of Higher

Education Policy and Management 27, 189-207.

Park, C., 2007. Redefining the Doctorate. Discussion Document. The Higher Education Academy.

York. Available at

http://www.heacademy.ac.uk/assets/York/documents/ourwork/research/redefining_the_docto

rate.pdf (last accessed 1st April 2008)

Tennant, M. 2004. Doctoring the knowledge worker. Studies in Continuing Education 26, 431-441.

The National Working Group on Evidence-Based Health Care (2008). The Role of the

Patient/Consumer in Establishing a Dynamic Clinical Research Continuum: Models of

Patient/Consumer Inclusion. (pp.1-9).

Thornton,H., Edwards,A., & Elwyn,G. (2003). Evolving the multiple roles of 'patients' in health-care

research: reflections after involvement in a trial of shared decision-making. Health

Expectations, 6(3), 189.

Tinkler, P., Jackson, C., 2002. In the dark? Preparing for the PhD viva. Quality Assurance in

Education 10, 86-97.

Traynor, M., Davis, K., Drennan, V. 2006. The Contribution of Nurse, Midwife and Health Visitor

Entrepreneurs to Patient Choice: A scoping exercise A report to the National Co-ordinating

Centre for NHS Service Delivery and Organisation. Revised version October 2006. Available at

http://www.sdo.lshtm.ac.uk/files/project/90-final-report.pdf (last accessed 1st April 2008)

UK Clinical Research Collaboration (2007) Developing the best research professionals. Qualified

graduate nurses: recommendations for preparing and supporting clinical academic nurses of the

17

future. Report of the UKCRC Subcommittee for Nurses in Clinical Research (Workforce).

Available at http://www.ukcrc.org/PDF/Nurses_report_August_07_Web.pdf (last accessed 1st

April 2008).

UK GRAD Programme (2001) Joint Skills Statement of Skills Training Requirements. Available at

http://www.grad.ac.uk/downloads/documents/general/Joint%20Skills%20Statement.pdf (last accessed

1st April 2008)

Upvall,M.J., & Ptachcinski,R.J. (2007). The journey to the DNP program and beyond: what can we

learn from pharmacy? Journal of Professional Nursing, 23(5), 316-321.

Usher, R., 2002. A diversity of doctorates: fitness for the knowledge economy? Higher Education

Research & Development 21, 143-153.

Williams, G., 2007. Should we ditch impact factors? British Medical Journal 334, 568.

Woodward, V.A., Webb, C., Prowse, M. 2005. Nurse consultants: their characteristics and

achievements. Journal of Clinical Nursing 14, 845-854.

Winter, R., Griffiths, M., Green, K., 2000. The ‘academic’ qualities of practice: what are the

criteria for a practice-based PhD? Studies in Higher Education 25, 25.

Yam,B.M.C. (2005). Professional doctorate and professional nursing practice. Nurse Education

Today, 25(7), 564-572.