Doctor of Nursing Science

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The Doctor of Nursing Science (D.N.S. or D.N.Sc.) is an academic research degree awarded in a number of countries throughout the world as a terminal research degree in nursing. The title of this degree varies with the collegiate institution which grants it. Another form of this degree is a Doctor of Science in Nursing (D.S.N.) degree. This academic research degree is recognized by both the United States Department of Education and the National Science Foundation to be equivalent to the more commonly awarded Doctor of Philosophy Ph.D.^[1]

The University of Johannesburg in South Africa changed the nursing doctoral degree from a Doctor Curationis to a Doctor of Nursing Science <https://www.uj.ac.za/faculties/health/Nursing-Sciences />. According to the South African Qualification Authority (SAQA), the following is said about the University of Johannesburg's DNSc program <https://allqs.saqa.org.za/showQualification.php?id=111510 />:

PURPOSE AND RATIONALE OF THE QUALIFICATION This qualification includes the various specialisations in Nursing. Please refer to "Notes" for details on the specialisations.

Purpose: The Doctor of Nursing is a practice-focused professional qualification, designed around the development of high-level performance and innovation in a professional context and to prepare experts in specialised advanced midwifery practice. Learners are required to undertake a combination of coursework and advanced research, be it an original thesis or another form of research that is commensurate with the nature of the discipline. It will focus heavily on practice that is innovative and evidence-based, reflecting the application of credible research findings for sustained changes in health care.

This qualification will be an improvement of Maternal and Child Health (MCH) services through advanced Midwifery practice. The relationship with other health related disciplines by virtue of the practice-focused nature of the qualification will be enhanced. Inter and intra-professional recognition of midwifery by peers at an advanced level is one of the desired outcomes of the qualification. The modules will not only give the learners advance knowledge of Midwifery, but will add leadership, managerial and research skill, to enable the learner to function in a leadership role in practice.

Rationale: This qualification will provide learners with an opportunity to conduct independent original research through scientific discourse and independent investigation, thereby contributing to the development of these fields. The defining characteristic of a professional doctorate is that in addition to the demonstration of high-level research capability it requires the ability to integrate theory with practice through the application of theoretical knowledge to highly complex problems in a wide range of professional contexts. The outcome of this qualification is a comprehensive and systematic grasp of an in-depth body of knowledge in the areas of health policies, leadership and health care delivery with the emphasis on advanced Midwifery. As such advancing the development of specialist expert knowledge in this area thereby supporting evidence based professional practice, which is at the forefront in this area.

The qualification will be designed for qualified Midwives seeking leadership positions in health care. Graduates will have clinical practice-oriented leadership and specialised research skills that focus on evidence-based practice and on research utilisation for the improvement of clinical care delivery, patient outcomes and system management.

The learner intake will draw on Master learners who wish to enhance their knowledge and clinical practice in midwifery. There is a growing need for midwives both in the private and public sector as more prospective mothers are choosing the option of a midwife-assisted natural birth, this also being in line with the proposed National Health Insurance policy. There is a definite need to implement effective, sustainable and affordable improvement in the quality of Midwifery care in South Africa. New knowledge and leadership are necessary to eliminate avoidable maternal and new-born mortality and morbidity and to inform decision making in Midwifery. Consultation with key stakeholders will take place to explore and encourage the support by both public and private sectors for such a program and to discuss how to utilise the Doctoral Graduates in various practices. It will also be necessary to ensure commitment to give job opportunities for Doctoral Graduates with higher salaries and other incentives.

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING Recognition of Prior Learning (RPL): The Faculty of Health Sciences accepts Recognition of Prior Learning (RPL) as an integral part of education and academic practice. It is acknowledged that all learning has value. Through Recognition of Prior Learning, a learner may gain access, or advanced placement, or recognition of status, on condition that he/she continues his/her studies at the University of Johannesburg (UJ).

Entry Requirements: The minimum admission requirement is a Master's in Post-basic Midwifery or Nursing Science, Level 9. Or Related qualification at Level 9.

RECOGNISE PREVIOUS LEARNING? Yes

QUALIFICATION RULES The qualification consists of the following compulsory modules at Level 10 totalling 360 credits.

Compulsory Modules: Leadership Advocacy, 10 Credits. Health Informatics and Innovation Technology, 5 Credits. Applied Ethics for Advanced Practitioners, 10 Credits. Health Care Systems and Policies, 10 Credits. Advanced Pharmacology and Dispensing, 10 Credits. Advanced Anatomy and Physiology, 10 Credits. Financial Management in Health Care, 10 Credits. Evidence-based Practice, 10 Credits. Clinical Genetics, 15 Credits. Research and Statistics, 10Credits. Advanced Midwifery Clinical Practice 1, 20 Credits. Advanced Midwifery Clinical Practice 11, 40 Credits. Thesis proposal, 80 Credits. Writing of Thesis, 120 Credits.

EXIT LEVEL OUTCOMES 1. Critically analyse and influence health policy proposals, health policies, and related issues. 2. Demonstrate independent clinical leadership in the development and implementation of institutional, local, and state health care policy. 3. Use disciplinary and science-based theories to develop innovate, transformative healthcare delivery approaches. 4. Implement evidence-based practice at systems level to improve practice. 5. Engage with inter-disciplinary, collaborative teams to improve the patient experience of care and the health of populations and to reduce the per capita cost of health care.

ASSOCIATED ASSESSMENT CRITERIA Associated Assessment Criteria for Exit Level Outcomes 1: Evaluate health policy proposals, health policies and related issues, from the perspective of consumers, nursing and other health professions and other stakeholders in policy and public forums.

Associated Assessment Criteria for Exit Level Outcomes 2: Critically engage in policy making to shape health care financing, regulation and delivery, with specific reference to advanced midwifery practice. Actively participating on committees, boards or task teams on institutional, local, provincial, national and/or international levels. Critically discuss advocacy for the nursing and midwifery profession within the policy and health care communities.

Associated Assessment Criteria for Exit Level Outcomes 3: Analyse and describe critical elements necessary to the selection, use and evaluation of health care information systems and patient care technology. Demonstrate the conceptual ability and technical skills to develop and execute an evaluation plan involving data extraction from practice information systems and databases. Demonstrate leadership in the evaluation and resolution of ethical and legal issues, within health care systems relating to the use of information, information technology, communication networks and patient care technology. Evaluate consumer health information sources for accuracy, timeliness and appropriateness.

Associated Assessment Criteria for Exit Level Outcomes 4: Learners will: Evaluate, synthesise, critique, evaluate and defend relevant issues in evidence based health, health care, and practice. Evaluate and distinguish between different levels of evidence and kinds of evidence. Critically discuss the implications of evidence-based practice for the health care system. Efficiently locate, critically evaluate and effectively summarise evidence. Create a question around a select health issue/problem, discuss, evaluate and appraise evidence related to the issue, and propose and adapt an intervention related to the issue. Create an action plan related to a qualification or policy in the area of health (health policy, health care and health promotion). Discuss and solve issues related to the implementation of research findings within the practice (intervention implementation). Build and share ideas, resources and research and apply examples of evidence-based health across the knowledge to action process.

Associated Assessment Criteria for Exit Level Outcomes 5: Analyse care delivery approaches that current and future needs of patient populations based on scientific findings in nursing and other clinical sciences, as well as organisational political and economic sciences. Critically discuss accountability for the quality of health care and patient safety for populations with whom they work. Demonstrate advanced communication skills/processes to lead quality improvement and patient safety initiatives in health care systems. Apply the principles of business, finance, economics and health policy to develop and implement effective plans for practice-level and/or system-wide practice initiatives that will improve the quality of care delivery. Demonstrate sensitivity to diverse organisational cultures and populations including patients and providers. Evaluate effective strategies for managing the ethical dilemmas inherent in patient care.

Integrated Assessment: Assessment is an integral part of the teaching and learning process and is systematically and purposefully used to generate data for grading, ranking, selecting and predicting, but also to provide timely feedback on learner performance that should inform teaching methods and curriculum design. Assessments are directed by module and module outcomes as well as by the nature of the knowledge area or skills that are being assessed, e.g. written tests to assess cognitive processes/skills and/or knowledge of theory and Objective Structured Clinical Examination (OSCE) or simulations or Work Integrated Learning (WIL).

Formative Assessment: Formative assessment refers to assessment that takes place during the process of learning and teaching. The number of each assessment will depend on the individual module and credit thereof.

Summative Assessment: Summative assessments are conducted for the purpose of making a judgment about the level of competence of learners in relation to the outcomes of a unit/module and/or qualification. The results of such formal assessment (example tests, assignments, projects, presentations, creative production) are expressed as a mark reflecting a pass or a fail. The minimum number of summative opportunities required are contained in the Academic Regulations. The Family Health Services (FHS) has its own assessment policy, to which the Department of Nursing subscribes (refer to uploaded document). With reference to the research component this is in the form of feedback from the supervisor on an ongoing basis. See internal and external moderation/examination. With reference to the course work component the following applies: The Faculty Board (FB) is responsible for the determination and implementation of moderation processes and procedures that ensure that all learners, in all academic qualifications, are assessed in a consistent, accurate, and well-designed manner Research related guidelines and policies. With respect to the theses, external assessors are appointed to ensure adherence to quality standards.

Assessment and Monitoring of Work Integrated Learning: The qualification subscribes to the principles of Work Integrated Learning (WIL) which is compulsory for all learners enrolled in the qualification. WIL commences in the first year of the Doctoral qualification. Since WIL is considered integrated into the qualification, it is subject to all the applicable learning, teaching and assessment strategies in compliance with the University of Johannesburg (UJ) and Faculty policies. The WIL components will be done in accredited clinical training platforms (hospitals/clinics). Monitoring of learner learning and assessment is done jointly by the lecturers and clinicians at the training sites. Learners receive continuous feedback on their learning progress. WIL practices include theoretical (work-directed theoretical learning), problem based learning, clinical demonstrations, patient case taking skills, clinical practice and patient management. WIL will be assessed using the following assessment methods: Case presentations, tutorials, role play/simulated cases, video recording of clinical sessions with review thereafter, supervision and continuous evaluation of learners within the clinical environment, Objective Structured Clinical Examination (OSCE) with final clinical evaluation in the approved training platforms.

INTERNATIONAL COMPARABILITY American Association of Colleges of Nursing.

Qualification title Doctorate in Advanced Nursing Practice. This qualification compares favourably with the proposed South African Doctorate in Nursing. This is the outline of all Doctorates in Advanced Nursing Practice in the United States of America (USA).

Content: 1. Scientific Underpinnings for Practice. 2. Organisational and Systems Leadership. 3. Clinical Scholarship. 4. Information Systems. 5. Healthcare Policy. 6. Inter-professional Collaboration. 7. Clinical Prevention and Population Health. 8. Advanced Nursing Practice.

ARTICULATION OPTIONS This qualification allows possibilities for horizontal articulation.

Horizontal Articulation: Doctor of Philosophy, NQF Level 10. Doctor of Health Sciences, NQF Level 10.

MODERATION OPTIONS N/A

CRITERIA FOR THE REGISTRATION OF ASSESSORS N/A

NOTES This qualification includes the following specialisations: Doctor of Nursing Science in Critical Care Nursing Doctor of Nursing Science in Ethos and Professional Practice Doctor of Nursing Science in Midwifery and Neonatal Care Doctor of Nursing Science in Neonatal Intensive Care Nursing Doctor of Nursing Science in Nursing Administration Doctor of Nursing Science in Nursing Education Doctor of Nursing Science in Occupational Health Doctor of Nursing Science in Operating Room and Surgical Nursing Doctor of Nursing Science in Primary Health Care Doctor of Nursing Science in Psychiatric Nursing Doctor of Nursing Science in Trauma

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