1. The Effect of Program Components and Life Demands on Dissertation Completion in DNP ABDs Ellen B. Daroszewski PhD, APRN School of Nursing California Baptist University 45 th Annual WIN Communicating Nursing Research Conference 2012 April 20 th Portland, OR

2. The Future of Nursing (IOM, 2010) Recommendation 5 Double the number of nurses with a doctorate by 2020

3. The Registered Nurse Population The 2008 National Sample Survey of Registered Nurses (USDHHS HRSA, 2010) All RNs 3,063,162 Nursing 0.4% Non Nursing 0.5% Doctorates Total 28,369 (0.9%) Nursing 0.4% NonNursing 0.5%

4. The Registered Nurse Population with Double the Number of Doctorates All RNs 3,063,162 RNs with Doctorates 1.8% 56,738 All RNs 3,063,162 Doctorates Total 56,738 (1.8%)

5. Number of Nursing Doctoral Programs and Students 2010 (AACN, 2011) DNP  182 programs  8,973 students (2011) PhD (in nursing)  126 programs  4,907 students (2011) Total RN Doctoral Students 2011 13,880 (nursing) + 6,940 (½ estimate non nursing) 20,820 13,880 28,369+ current RNs with a doctorate

6. Potential Increase in Doctorally Prepared RNs by 2020 (estimated 5 years to graduation) Nursing  13,880 students X 5 = 69,400 Non nursing  6,940 students X 5 = 34,700 New RNs with Doctorates by 2020 104,100 !!! From 0.9% to 3.8% Nearly Quadruple So what’s the problem?

7. Problem: PhD Completion Rates The Council of Graduate Schools (CGS) PhD Completion Project 7 year grant-funded project  29 major US and Canadian research universities  15 partner universities Findings  “The vast majority of students who enter doctoral programs have the academic ability to complete their PhD.”  On average only 57% of all PhD students complete their degree within 7 years 6 institutional and program characteristics which affect PhD completion  Student selection  Student mentoring  Student financial support  The environment of the program  The research modes of the discipline  Dissertation processes and procedures http://www.phdcompletion.org/ 57% PhD Completion Rate

8. CGS PhD Completion Project Main factors that contributed to completion Mentoring/advising Family support Financial support PhD Completion and Attrition: Findings from Exit Surveys of PhD Completers (2009)

9. Problem: Nursing PhD Completion Rates 52 Programs PhDs.org, 2011 Mean = 51.8%

10. Problem: Nursing PhD Completion Rates Megginson (2011) examining nursing PhD program outcomes noted a deficit between the number of students admitted and the number who graduate  Average admission of 6 to 10 students per year  Average completion rate of 1 to 5 graduates per year over the past 5 years  40% completion rate Megginson, L. (2011). Exploration of nursing doctoral admission and performance outcomes. Journal of Nursing Education, 50(9), 502-512.

11. Problem: Nursing Doctoral Completion Rates 20-50% of nursing doctoral students finish their degree (Cohen, 2011)  Dissertation completion is the major obstacle to doctorate completion Takes a LONG time  Women and minorities take the longest  Students who works on their dissertation for more than 2 years likely to never finish Cohen found completion MOST affected by  Program problems  Conflicts  Delays  Life demands  Parental responsibilities  Work Cohen, S. M. (2011). Doctoral persistence and doctoral program completion among nurses. Nursing Forum, 46(2), 64-70.

12. Doctoral Nursing Program Components “Easy” part  Courses  Research/lab/clinical experiences  Qualifying or other exams “Hard” part  Final “project”  Most significant work of the program  Dissertation  PhD - original research  DNP – practice-based project with many forms

13. All-But-Dissertation (ABD) DNP Student Survey Study aim To describe the helpfulness of program supports and affect of lifestyle factors on dissertation completion Completed: 3/56 (5%) students 53 ABDs: 3 cohorts 2 mo – 2.5 yrs

14. ABD Survey Methods Two part 25 item self-report  15 internal program support (PS)  10 external life factors (LF)  Written comments for each part Distributed using Qualtrecs software  53 ABDs received the survey  37 (70%) completed the survey 70% response rate

15. Internal Program Supports Course paper for Ch. 1 Course paper for Ch 2 Course paper for Ch. 4 Lit review papers Dissertation seminars Dissertation Blackboard resources Dissertation guidelines Dissertation proposal “tips” sheet General faculty feedback Chair feedback Academic member feedback Community member feedback Student colleague support/feedback Other college/university support Other sources of support Rankings +2 Very helpful +1 Somewhat helpful -2 Not helpful 0 Did not use Coursework Special dissertation help Feedback

16. External Life Factors Motivation to complete Time management Personal computer equipment Personal level of skill in using technology Employer/Employment Family/family obligations Friends/colleagues Finances Health Other life factors Rankings +2 Very helpful +1 Somewhat helpful -2 Negatively affected my dissertation progress 0 Did not affect my dissertation progress

17. Results: Internal Program Support Total scores: mean=42.8, SD=9.2, range =29, 24-53 (74 to -74 possible) RankingScoreInternal Program Supports 153Dissertation guidelines 153Dissertation proposal tips 153Course paper (Ch. 1) 451Lit review throughout program 550Dissertation seminars 648Chair feedback 648Dissertation Website 844Course paper (Ch. 4) 940Faculty feedback 940Other student feedback 940Course paper (Ch. 2) 1234Other support 1333Committee feedback (Academic member) 1431Committee feedback (Community member) 1524Other college & university support Very Helpful mean = 50.86 SD = 2.27 Somewhat Helpful mean = 41 SD = 2 Not Helpful mean = 30.5 SD = 4.51 Groups F = 61.96 p =.000 “Closer” to process more helpful

18. Results: Internal Program Support Comments “would like to have a better plan up front in the program” “changed topics and populations at a final hour so most help was through the practice of the process and instructor feedback” “this was the point where I bailed out on the previous topic, population, etc. and resorted to building on previous learning” “Hard to get e-mails back (from Chair), have to send several over several months and then hear back – felt like she was more engaged in the beginning, not so much anymore.” Most comments reported the supports were helpful

19. Results: External Life Factors Total scores: mean=28 SD=21.6, range=60, -5-55 (74 to -74 possible) RankingScoreExternal Life Factors 156Computer 255Skill in using technology 353Motivation to complete 435Friends/colleagues 533Time management 617Employer/Employment 714Health 812Family/family obligations 910Finances 10-5Other life factors Very Helpful mean = 54.67 SD= 1.53 Somewhat Helpful mean = 34 SD = 1.41 Negative Affect mean = 9.6 SD= 8.56 Groups F = 45.5 p =.000 Employment Hours/Week 13% < 40 __________ 86% > 40 36% > 50 18% > 60

20. Results: External Life Factors Comments “work demands are huge; work provides my basic needs; financial aid was still required …” “I am feeling overwhelmed with a new position at work and it seems I don’t have time at home to put into writing a dissertation because I am doing work for my job.” “Spouse's health caused delay.” “…life does get in the way, family, obligations and finances all come before the dissertation.” “I truly believe I would be finished with my dissertation if health issues did not get in the way.” “I am having difficulty getting started after a 6 month break for personal reasons.” Most comments reported that various life factors interfered with the dissertation process

21. Discussion ABD survey results supported the literature Doctoral program internal supports help ABDs Life demands were found to be least helpful and have the most negative affect on dissertation completion  Family & financial support important for completion Mentoring is important  Dissertation Advisor/Chair

22. Recommendations “Everyone” has to get better at supporting doctoral completion  Programs have to build in steps and support for students  Close to the dissertation process  Students have to learn to manage their life demands Respect and support for the difficulty of the dissertation process  Advisors/Chairs

23. Questions …? Dissertation or Die