Answer: The Master of Science in Nursing (MSN) and the Doctor of Nursing Practice (DNP) are two different levels of graduate nursing degrees. Both degrees prepare registered nurses (RNs) to take on advanced roles in clinical nursing, administration, research, or nursing education. However, DNP programs contain additional training in competencies such as systems leadership, heath care policy, interprofessional collaboration, evidence-based practice, and health information systems. And while the MSN has traditionally been the entry-level education requirement for advanced practice registered nurses (APRNs), there has been a move in recent years to raise that requirement to the doctoral level, and eventually make APRN certification require a DNP.
RNs who wish to take on an advanced nursing role, or practice in an APRN specialty such as family nurse practitioner, psychiatric mental health nurse practitioner, or nurse midwifery, need to earn either an MSN or DNP degree. There are several pathways for each degree type including, but not limited to, Bachelor of Science in Nursing (BSN) to MSN programs, RN to MSN programs, BSN to DNP programs, and MSN to DNP programs. As the DNP is a doctoral degree, and a terminal degree in the field of nursing, earning a DNP typically takes longer than earning an MSN. The curriculum in a DNP program includes coursework and training meant to build on the knowledge and skills learned in a master’s program, and prepare students for the highest level of practice in their specialization.
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In 2004, the American Association of Colleges of Nursing (AACN) and its member schools voted to endorse the AACN Position Statement on the Practice Doctorate in Nursing. This called for changing the educational requirement to become an APRN from an MSN to a DNP by the year 2015. However, as of 2017, this transition has not occurred, and a DNP is not required for APRN licensure in any of the 50 states. If and when the requirements are officially changed, it is understood that current APRNs practicing with an MSN will be grandfathered in, and not required to earn a DNP in order to maintain their certification or licensure.
It should be noted that the American Association of Nurse Anesthetists has endorsed a doctorate as the minimum requirement for Certified Registered Nurse Anesthetists (CRNAs) by the year 2025, and the National Association of Clinical Nurse Specialists endorses the DNP as an entry level requirement for all Clinical Nurse Specialists (CNSs) by 2030. At the moment, however, it is up to students whether they want to pursue an MSN or DNP for licensure as an APRN.
As MSN programs are typically shorter than DNP programs, one advantage of earning an MSN compared to a DNP is that students can become certified and licensed to practice in their desired specialty in a shorter amount of time. This allows students to gain experience as an APRN before pursuing a DNP later through an MSN to DNP program. For more information on both MSN and DNP programs, see below.
The Master of Science in Nursing (MSN)
There are several different paths students can take to earn an MSN, depending on their current level of education. BSN to MSN programs, often referred to as traditional MSN programs, are for RNs who hold a BSN, and generally take two years of full-time study to complete, or two to four years on a part-time basis. For RNs with an ADN or Diploma in Nursing, there are RN to MSN programs that can typically be completed in around three years of full-time study, or three to four years for part-time students. There are also options for RNs with a non-nursing bachelor’s degree, or those who already possess an MSN or other master’s degree, and wish to obtain a post-Master’s certificate in a different specialization.
MSN programs are offered in both direct and indirect care specializations. Students interested in taking on a role in organizational leadership or nursing policy might choose to pursue their MSN in an indirect care concentration such as nursing administration, health care systems, nursing informatics, or public health nursing. For those who want to work in clinical nursing, and gain certification in an APRN specialty in addition to earning their MSN, programs are available in all of the main APRN specializations, including:
- Adult-Gerontology Acute Care Nurse Practitioner
- Adult-Gerontology Primary Care Nurse Practitioner
- Certified Nurse Midwife
- Certified Registered Nurse Anesthetist
- Clinical Nurse Specialist
- Family Nurse Practitioner
- Neonatal Nurse Practitioner
- Pediatric Acute Care Nurse Practitioner
- Pediatric Primary Care Nurse Practitioner
- Psychiatric-Mental Health Nurse Practitioner
- Women’s Health Nurse Practitioner
The curriculum in an MSN program will vary based on the specific path students take to earn their degree, as well as the particular specialization they pursue. For the most part, programs contain a combination of MSN core courses, such as Advanced Physiology, Advanced Pharmacology, and Advanced Health Assessment, and specialized training courses specific to the program concentration. MSN students must also complete a set number of clinical practicum hours to ensure they have received the proper hands-on training to practice professionally, and qualify to sit for the certification examination in their specialty. At the MSN level, clinical requirements may range from 600 to 1000 hours, depending on a student’s chosen specialty, the university, and the program path.
The Doctor of Nursing Practice (DNP)
The DNP is one of two terminal degrees in the field of nursing, the other being the Doctor of Philosophy in Nursing (PhD). While the PhD is more research focused, and aimed at prospective nurse scholars or scientists, the DNP is a practice doctorate, meaning it is intended for nurses who want to work in health care settings. Much like MSN programs, there are several paths students can take to earn a DNP based on their current level of educational attainment. BSN to DNP programs are designed for RNs who have earned a BSN, and would like to pursue a DNP without first completing a separate MSN program. The majority of BSN to DNP programs include an APRN specialty as part of the curriculum. Some of these programs award both an MSN and a DNP, while others simply culminate in the doctorate. BSN to DNP students can expect to complete their program in three to four years of full-time study, or four to six years of part-time study.
RNs who already possess an MSN can enter one of several different MSN to DNP pathways, depending on the focus of their master’s program. In most cases, a full-time MSN to DNP program will take one to two years to complete, while a part-time program usually takes two to three years. Finally, there are RN to DNP programs, which typically require an ADN for enrollment, or, in some cases, both an ADN and a non-nursing bachelor’s degree. These programs are relatively rare compared to other DNP paths, and generally take four years of full-time study to complete, or as much as six years on a part-time basis.
Traditional MSN to DNP programs generally come in one of two concentrations: clinical practice or leadership. While these two tracks may lead to different professional outcomes, they typically contain very similar curriculums, and often only differ by one or two courses. For RNs with an MSN who want to pursue an APRN certification along with their DNP, there are programs that include additional coursework and training in an advanced nursing specialty. These programs are available in all of the major APRN specialties listed in the MSN section above, and will include the same master’s-level specialization courses found in an MSN program in the specialty.
What sets DNP programs apart from MSN programs in terms of curriculum is the DNP specific coursework students must complete as part of their doctoral program. According to the AACN’s Essentials of Doctoral Education for Advanced Nursing Practice, all DNP programs must contain courses designed to prepare students in the following eight core competencies:
- Scientific underpinnings for practice
- Organizational and systems leadership for quality improvement and systems thinking
- Clinical scholarship and analytical methods for evidence-based practice
- Information systems/technology and patient care technology for the improvement and transformation of health care
- Health care policy for advocacy in health care
- Interprofessional collaboration for improving patient and population health outcomes
- Clinical prevention and population health for improving the nation’s health
- Advanced nursing practice
In addition to the required course credits, all DNP students will need to complete at least 1000 post-BSN clinical practice hours in order to qualify for their doctorate. MSN to DNP students may be able to apply up to 500 clinical hours from their previous graduate program to this total, assuming they completed 500 or more hours as an MSN student. The final component to any DNP program is an original scholarly work, commonly referred to as the DNP project. This project is developed over multiple semesters in conjunction with several practicum courses, and is intended to showcase the student’s ability to apply concepts learned through the DNP curriculum toward real issues affecting nursing practice or a specific patient population.