美国护理临床博士学位教育的发展及启示

Doctor of nursing practice education for advanced practice registered nurse in the United States

美国高级实践护士通过4种临床岗位(开业护士、临床护理专家、护理麻醉师和产科护理师)为大众提供初级医疗和保健服务,其教育要求也从硕士学位演变成护理临床博士学位。该文对护理临床博士学位的起源、发展以及课程设置进行介绍。护理临床博士从2004年正式设置,在大量科研成果的支持下和护理学科内部、整体医疗大环境的催化下得以曲线性高速发展。其课程设置遵从美国护理院校联合的《高级护理实践临床博士教育精要》课程指南及3步走的统一管理模式,为高级实践护士职责和胜任力提供了保障。高级实践护士从业的独立性得以不断改善和提高,良好的就业前景不容忽视。希望美国护理临床博士的发展历程以及高级实践护士的发展演变史会给国内的护理教育者和上层教育政策制定者和管理者带来一定的思考。

In the U.S.,advanced practice registered nurses （APRNs） provide primary care through 4 clinical roles： nurse practitioner,clinical nurse specialist,nurse anesthetist,and nurse midwife. The educational requirement for APRNs had shifted from a Master＇s degree to the Doctor of Nursing Practice（DNP） degree. The purpose of this ar- ticle is to provide an overview of the development and evolvement of the DNP. The American Association of Col- leges of Nursing published a position statement in 2004 designating DNP as the required degree for APRNs,and ＂The Essentials of Doctoral Education for Advanced Nursing Practice＂ and the APRN Consensus Model in 2006 to guide curriculum development for DNP programs. Since then,the DNP programs have grown exponentially,largely benefiting from scientific evidence indicating the effectiveness and quality of care provided by APRNs and strong supports from medicine. APRNs has been forecasted as the fastest growing segment of health care and far exceed- ing other health care jobs. While the Chinese culture and health care system are unique,the APRNs and DNP provide valuable insights to Chinese policymakers and educators for innovative ways to meet the health care needs of the public.