The role of doctoral-educated nurses in the clinical setting: Findings from a scoping review.

Aims and objectives To map and summarise published studies on the career opportunities and roles of doctoral-educated (PhD and DNP) nurses in the clinical setting; to collate actions as proposed in the literature to promote career opportunities and roles for PhD and DNP nurses in the clinical setting. Background To improve healthcare outcomes and strengthen leadership in nursing practice, there is the need to place nurses with a doctorate in clinical settings. However, available evidence has never been summarised to map the state of the science in this field. Design A scoping review, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for scoping reviews statement (PRISMA-ScR). Methods An electronic database of literature was searched by accessing CINAHL Complete and Medline (on EBSCO Host) and SCOPUS to identify studies published between January 2009-December 2019. A thematic analysis was performed by identifying emerging patterns in the research questions. Results Ten studies were found with three types of clinical engagement: (a) a practice influencer/developer; (b) a clinical leader; and (c) a clinical teacher for students. Working in clinical areas, doctoral-educated nurses might influence several outcomes at the patient, research, staff and organisational levels. Conclusions Clinical roles for doctoral-educated nurses are still uncommon. However, in the last ten years, a debate has started to identify the possible careers in clinical settings, the needs and the challenges encountered while developing clinical academic roles, as well as the outcomes and actions that should be undertaken. Relevance to clinical practice Academic nursing bodies, working with professional bodies and healthcare institutions at different levels, are called on to develop career frameworks, allowing the opportunity for doctoral-educated nurses to be involved in clinical practice and to influence its quality and performance; this might in turn lead to an increase in the quality of research.