OK..... Amid Calls For More Highly Educated Nurses, New AACN Data Show Impressive Growth In Doctoral Nursing Programs

According to new survey data released by the American Association of Colleges of Nursing (AACN), enrollment in doctoral nursing programs increased by more than 20% this year, signaling strong interest among students in careers as nursing scientists, faculty, primary care providers, and specialists. Final results from AACN's 2009 annual survey confirm that enrollments in all types of baccalaureate and higher degree programs continue to trend upward. Though nursing schools have been able to expand student capacity, the latest data show that more than 54,000 qualified applications to professional nursing programs were turned away in 2009, including more than 9,500 applications to master's and doctoral degree programs.

"Expanding capacity in baccalaureate and graduate programs is critical to sustaining a healthy nursing workforce and providing patients with the best care possible," said AACN President Fay Raines. "Even though these across-the-board increases in enrollments are encouraging, we simply must find ways to advance policy and programs that will enable schools to accommodate all qualified applicants in professional nursing programs. Bringing more nurses into graduate programs is urgent given the calls for more expert nurses to deliver high quality, cost-effective care in a healthcare system undergoing reform."

AACN's latest survey findings update the preliminary data announced in December 2009 and determine enrollment trends by comparing data from the same schools reporting in both 2008 and 2009. Final survey data show that enrollments in entry-level baccalaureate programs in nursing rose by 3.6% in 2009, a slight increase above the earlier reported increase of 3.5%. For a graphic depicting enrollment changes in baccalaureate programs from 1994-2009, see here.

This increase in the baccalaureate student population is welcome news given the calls by AACN, the American Organization of Nurse Executives, the American Nurses Association, and other authorities to concentrate the education of new nurses in baccalaureate programs. In a recent landmark report by the Carnegie Foundation for the Advancement of Teaching, Dr. Patricia Benner and colleagues state that "profound changes in nursing practice call for equally profound changes in the education of nurses." The authors found that many of today's new nurses are "undereducated" to meet practice demands across settings and voice their strong support for high-quality baccalaureate degree programs as the appropriate pathway for RNs entering the profession.

Given the need for more nurses to serve as Advanced Practice Registered Nurses (APRNs), assume faculty roles, and embark on careers as research scientists, the growth in the number of students entering both practice-focused and research-focused doctoral programs last year is particularly gratifying to nursing's academic leaders.

In October 2004, AACN member schools voted to endorse the Position Statement on the Practice Doctorate in Nursing, which called for moving the level of preparation for advanced nursing practice from the master's to the doctoral degree by the goal date of 2015. In the six years since this position was taken, nursing schools have made great strides toward realizing this vision by planning and launching Doctor of Nursing Practice (DNP) programs, which are now available in 35 states. AACN's survey found that 28 new DNP programs were opened in 2009, bringing the total number of programs to 120. In addition, data collected through the annual survey and a supplemental survey completed by AACN in February 2010 found that an additional 161 DNP programs are in the planning stages. At present, 71.9% of schools with APRN programs (388 schools) are either offering or planning a DNP program.

"The stunning growth in the number of DNP programs is truly impressive, as we are only at the midway point in realizing the 2015 vision for advanced nursing education," said Dr. Raines. "A change of this magnitude is enormous, and we realize that schools in many states are facing great economic, resource, and regulatory challenges in their efforts to move to the DNP. AACN stands ready to focus its efforts on influencing policymakers, advocating for resources, and developing tools to support schools committed to making this transition."

The number of research-focused doctoral programs (e.g., PhD, DNSc, DNS) is also climbing with 120 programs currently enrolling students and another 8 programs in development. For a graph showing the increase in the number of doctoral nursing programs over the past four years, see here.

Other key findings from AACN's 2009 survey include the following:

Applications and Acceptance Rate: In the 2008-2009 academic year, 208,784 completed applications were received for entry-level baccalaureate nursing programs (an 9.6% increase from 2008) with 130,601 meeting admission criteria and 87,620 applications accepted. These data translate into an acceptance rate of 42.0%. For a graphic showing a six-year trend in applications received, see here.

Total Enrollment: The AACN survey found that total enrollment in all nursing programs leading to the baccalaureate degree is 214,533, an increase from 201,407 in 2008. Within this universe, 151,378 students are enrolled in entry-level baccalaureate nursing programs. In graduate programs, 77,146 students are enrolled in master's programs, 4,177 are enrolled in research-focused doctoral programs, and 5,165 are enrolled in practice-focused doctoral programs in nursing.

Survey Response: AACN's findings are based on responses from 683 nursing schools (87.7%) in the U.S. and its territories that grant baccalaureate and/or graduate degrees. AACN data reflect actual counts reported in Fall 2009 by nursing schools, not projections or estimates based on past reporting trends.

Student Diversity: At all levels, professional-level nursing programs reported increases in the number of students from minority backgrounds over the past year. While the percentage of students from underrepresented backgrounds remained high in entry-level baccalaureate nursing programs at 26.3%, the proportion of minority students in master's programs increased to 25.6%, in research-focused doctoral programs to 23.0%, and in practice-focused doctoral programs to 19.4%. For ten-year data on diversity in nursing education programs, see here.

Men in Nursing: Though men represent only 5.8% of the U.S. nursing workforce, the percentage of men in baccalaureate and master's nursing programs are 10.8% and 9.1%, respectively. In doctoral programs, 7.3% of students in research-focused programs and 8.1% of students in practice-focused programs are men.

Accelerated Programs: Accelerated nursing programs continue to be an important pathway into nursing for individuals with degrees in other fields who are looking to change careers. Last year, 12 new accelerated baccalaureate programs were launched, bringing the total to 230 programs. Currently, 11,960 students are enrolled in these programs, up from 11,018 in 2008, and the number of graduates has climbed to 7,444. In the 65 accelerated master's degree programs now available, 5,385 students are enrolled, and 1,562 students graduated last year. See here.

Degree Completion Programs: Given the call for nurses to continue their education, AACN was pleased to see growth in degree completion programs for RNs looking to earn a baccalaureate or master's degree. From 2008 to 2009, enrollment in RN-to-Baccalaureate programs increased by 12.8%, which marks the seventh year of enrollment increases. Currently, 634 RN-to-Baccalaureate and 161 RN-to-Master's Degree programs are available nationwide with many programs offered completely online. In addition, 14 new RN-to-Baccalaureate and 27 new RN-to-Master's programs are under development. See here.

Clinical Nurse Leader: The national movement to advance the Clinical Nurse Leader® (CNL) role gained momentum last year with 7 new CNL programs opening, which brings the total number of programs to 88. Currently, 1,808 students are enrolled in these generalist master's programs (up 9.6%) and 499 CNLs graduated last year (up 6.9%). For details on the CNL, see here.

Baccalaureate-to-Doctoral Programs: One innovative educational pathway that is bringing younger faculty and scientists into nursing is the Baccalaureate-to-Doctoral program. AACN's latest survey shows that 71 research-focused Baccalaureate-to- Doctoral programs are now available with an additional 12 programs under development. See here.

Doctoral Nursing Programs: The overall number of nursing students in doctoral programs increased by 20.8% from 2008 to 2009. Enrollments in research-focused doctoral programs (i.e., PhD, DNSc) increased by 5.1%, or 201 students, last year with the total student population reaching 4,177. The number of enrollees in DNP programs increased by half during that same timeframe with the student population growing from 3,415 to 5,165 students (51.2%). In terms of doctoral program graduates, 567 students graduated from research-focused programs in 2009, and 660 graduated from DNP programs.

Though interest in baccalaureate and graduate nursing programs is strong, thousands of qualified applicants are being turned away from four-year colleges and universities. In fact, AACN's survey found that 54,991 qualified applications were not accepted at schools of nursing last year due primarily to a shortage of faculty and resource constraints. Within this total, applications turned away include 42,981 from entry-level baccalaureate, 2,475 from RN-to-Baccalaureate, 8,491 from master's, and 1,044 from doctoral programs.

The top reasons reported by nursing schools for not accepting all qualified students into entry-level baccalaureate programs include a lack of faculty (61.4%), insufficient clinical teaching sites (60.8%), limited classroom space (47.5%), budget cuts (32.2%) and insufficient preceptors (31.0%). For a graphic showing the number of qualified applicants turned away from entry-level baccalaureate nursing programs over the past seven years, see here.

AACN's 29th Annual Survey of Institutions with Baccalaureate and Higher Degree Nursing Programs forms the basis for the nation's premier database on trends in nursing school enrollments and graduations, student and faculty demographics, and faculty and deans' salaries. Complete survey results are compiled in the report 2009-2010 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, which may be ordered online in late March here. Details about AACN's annual data reports on faculty and dean salaries will be available in April 2010.