Doctoral education, advanced practice and research: An analysis by nurse leaders from countries within the six WHO regions

Mi Ja Kim, Hugh McKenna, Patricia Davidson, Helena Leino-Kilpi, Andrea Baumann, Hester Klopper, Naeema Al-Gasseer, Wipada Kunaviktikul, Suresh K. Sharma, Carla Ventura, Taewha Lee

Research output: Contribution to journalArticlepeer-review


Doctoral education, advanced practice and research are key elements that have shaped the advancement of nursing. Their impact is augmented when they are integrated and synergistic. To date, no publications have examined these elements holistically or through an international lens. Like a three-legged stool they are inter-reliant and interdependent. Research is integral to doctoral education and influential in informing best practice. This significance and originality of this discussion paper stem from an analysis of these three topics, their history, current status and associated challenges. It is undertaken by renowned leaders in 11 countries within the six World Health Organisation (WHO) regions: South Africa, Egypt, Finland, United Kingdom, Brazil, Canada, United States, India, Thailand, Australia, and the Republic of Korea. The first two authors used a purposive approach to identify nine recognized nurse leaders in each of the six WHO regions. These individuals have presented and published papers on one or more of the three topics. They have led, or currently lead, large strategic organisations in their countries or elsewhere. All these accomplished scholars agreed to collect relevant data and contribute to the analysis as co-authors. Doctoral education has played a pivotal role in advancing nurse scholarship. Many Doctor of Philosophy (PhD) prepared nurses become faculty who go on to educate and guide future nurse researchers. They generate the evidence base for nursing practice, which contributes to improved health outcomes. In this paper, the development of nursing doctoral programmes is examined. Furthermore, PhDs and professional doctorates, including the Doctor of Nursing Practice, are discussed, and trends, challenges and recommendations are presented. The increasing number of advanced practice nurses worldwide contributes to better health outcomes. Nonetheless, this paper shows that the role remains absent or underdeveloped in many countries. Moreover, role ambiguity and role confusion are commonplace and heterogeneity in definitions and titles, and regulatory and legislatorial inconsistencies limit the role's acceptance and adoption. Globally, nursing research studies continue to increase in number and quality, and nurse researchers are becoming partners and leaders in interdisciplinary investigations. Nonetheless, this paper highlights poor investment in nursing research and a lack of reliable data on the number and amount of funding obtained by nurse researchers. The recommendations offered in this paper aim to address the challenges identified. They have significant implications for policy makers, government legislators and nurse leaders.

Original languageEnglish
Article number100094
JournalInternational Journal of Nursing Studies Advances
Publication statusPublished - 2022 Dec

Bibliographical note

Funding Information:
ANPs are not regulated or legislated for in Brazil. A discussion about the role has been initiated at different levels, especially by the Federal Council of Nurses. This has also been supported by the Pan American Health Organisation (PAHO) and the PAHO/WHO Collaborating Centre for Nursing Research Development at the University of São Paulo at Ribeirão Preto College of Nursing. In this context, one of the aims of the professional masters and doctoral programmes is to focus on enhancing good practices by the ANP ( Parada et al., 2020 ).

Funding Information:
The following individuals have assisted in data collection and analysis and editing. Dr. Cherzad Ghazi, Dean of Faculty of Nursing at Badar University, Egypt. Hyeon Kyeong Lee, PhD, RN, FAAN, Professor, College of Nursing, Yonsei University, Republic of Korea ( Seung Eun Lee, PhD, RN, Assistant Professor, College of Nursing, Yonsei University, Republic of Korea ( SangA Lee, MSN, RN, PhD candidate, University of Massachusetts at Boston, US. ( Dr Donna Brown, Senior Lecturer, Ulster University. Mary Crea-Arsenio, MSc, PhD(c), Senior Research Analyst, Global Health Office, Faculty of Health Sciences, McMaster University ( Anna Suutarla, Head of International Affairs, Finnish Nurses Association (

Funding Information:
The National Research Foundation (NRF) funds a broad spectrum of disciplines in South Africa. Clinical health science research is funded by the Medical Research Council. Nurse researchers can apply to both these organisations, but the competition is intense and has led to limited research funding for nurses. Consequently, in 2013 the NRF identified nursing science as a ‘vulnerable science’ and agreed to support an intervention programme (2013–2017) to develop it in South Africa. The SANTRUST/PLUME structured support programme was designed to support nursing schools and nurse researchers to develop research programmes. In its four-year timeframe, 55 PhD students and 26 lead researchers were supported.

Funding Information:
Historically, Egypt has been the regional leader in undertaking health research. The National Research Centre was established in 1956 and the Academy of Scientific Research and Technology in 1971. However, these offer very limited support for nursing research. Currently, research funding comes from the Ministry of Finance and universities have called for innovative research ideas to access these grants. There are also research competition grants from bodies such as United States Agency for International Development, the Ford Foundation and United Nations Agencies such as WHO. Like other disciplines, nursing must compete in a crowded market for limited research grants, often with limited success.

Publisher Copyright:
© 2022

All Science Journal Classification (ASJC) codes

  • Nursing(all)


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