The Doctor of Nursing (DN) program at the Lawrence Bloomberg Faculty of Nursing was the first program of its kind in Canada, designed to provide doctoral education to nurses who wanted to enhance their leadership capacity and drive system level change across health care and education.
The program also fills a critical gap in nursing education. One of the hallmarks of this new professional doctorate program, which first launched in 2021, is that it prepares graduates to rapidly implement their projects. It also allows students to continue working while pursuing their degree – a significant draw for nurses.
Different from the traditional Doctor of Philosophy (PhD), and the Doctor of Nursing Practice (DNP) degree offered in the United States, the DN program at U of T also provides students with the opportunity to participate in two internships that coincide with their research projects and help them build their implementation science and knowledge translation skills through experiential learning.
“I’m so incredibly proud of our first cohort of graduates from our Doctor of Nursing program. They are exemplary in their research scholarship and leadership skills, and have demonstrated the capacity of nurses to make an enduring impact on health, policy, and education across multiple sectors,” says Robyn Stremler, dean of the Lawrence Bloomberg Faculty of Nursing.
The five graduates who make up the inaugural cohort, Julia Fineczko, Breanna Lloy, Nikki Marks, Andrew McLellan and Vanessa Wright, have come from across Canada and as far away as Tanzania, to accelerate change in a variety of sectors, from community health and long-term care, to nursing education and transitional programs for nurse practitioners.
“With the DN program we have recognized a critical need for doctoral education among nurse leaders in health systems and education,” says Samantha Mayo, associate professor and Director of Doctoral Programs at Bloomberg Nursing. “These leaders have active roles in shaping the health care environment and are keenly aware of the pressing issues related to education and practice that are impacting the nursing workforce and quality of care. As such, they are uniquely positioned to be effective leaders in change and transition,” says Mayo.”
Meet the Doctor of Nursing graduates
Julia Fineczko completed one of her internships with the Registered Nurses’ Association of Ontario (RNAO) where she learned more about the association and its Long-term Care (LTC) Best Practice Program, including how it supported the sector and the role of the Director of Nursing Care within long-term care homes. Fineczko who has worked in LTC for six years and most recently as a Director of Nursing saw the challenges the position faces, including a lack of funding, the need for long on-call hours, and having to step into the front-line of care when homes are short staffed.
Her doctoral project explored support strategies available for this position, to help create effective leadership practices and improve how long-term care operates. She is now stepping into the role of Associate Director, Long-term Care Best Practice Program at the RNAO where she will build on her thesis findings.
“As a result of my internship and the DN program, I was able to further understand how associations like the RNAO support the long-term care sector, its leaders, and residents, with the implementation of best practices that enhance both the work environment and quality of care,” says Fineczko.
Breanna Lloy, a Nurse Practitioner (NP) from Nova Scotia knew the Doctor of Nursing Program was the right fit for her because she wanted a doctoral degree that would help her put research into action and expand her leadership skills.
Her doctoral project was personally motivated. It was focused on understanding how to better support nurse practitioners after they graduate and transition into their new roles, a time that can often leave them feeling isolated and burned out. Her project demonstrated a greater need for mentorship to connect NPs with one another and foster retention for this much-needed nursing role. Lloy is now the Professional Practice Leader with Nova Scotia Health working on redesigning a transition model for new NPs entering the organization.
“Nurses are life-long learners, and this program is an excellent opportunity to take research and apply it in the real-world, level up your leadership skills and influence change,” says Lloy.
Nikki Marks, is a nurse practitioner who currently works in acute care, and also follows lung transplant patients as they transition to rehab and home. Her doctoral work examined mobile health apps, and how they could support lung transplant recipients and their caregivers in performing self-care after their transplant surgery. It is a starting point she says, for developing technology that can support people with serious and persistent illnesses to manage their self-care.
She was drawn to the Doctor of Nursing program because of its promise to enhance leadership and knowledge translation capabilities, something she believes many nurse practitioners are well positioned for, given their deep clinical expertise and proximity to patients and caregivers.
“I think the DN program fills a gap in nursing leadership and education. I know I have gained so much from this program, and I encourage anyone who wants to take their nursing career to the next level to consider this degree,” says Marks.
Andrew McLellan, is a nurse practitioner who has worked as a nursing educator in several countries in Africa most recently at the Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. After observing challenges in the clinical learning environment that complicated the implementation of competency-based curricula – such as large student cohorts and difficulty tracking student progress, he created a participatory action research project that optimized clinical nursing education.
“The seeds of this doctoral study were planted long before my arrival in Tanzania,” McLellan reflects. “I had recognized the need for a participatory methodology, understanding that contextually driven and sustainable change could not be achieved through top-down approaches alone.”
McLellan is now working with the World Health Organization (WHO) Academy to develop a global course for policymakers on reorienting health systems towards a primary health care approach.
Vanessa Wright is a nurse practitioner with a background in community and population health – primarily with newcomers. Her doctoral work was motivated by the unique collaborative efforts that took place between community health and social organizations – like hospitals, food banks, and faith groups – during COVID19 to provide vaccines to high-risk communities.
“I wanted to capture the learnings from COVID19’s collaborative infrastructure, particularly the role of urban hospitals in community-based equity work, to understand how we can inform future integrated care approaches between health and the social care sector,” says Wright.
Wright plans to continue to engage with and study community health and collaborative practice in her career, focusing on how nursing can address system inefficiencies and advance health equity. “This program is a pioneer in having nurses examine the gap between research and operations and push out of our silos. As nurses we need to be action-oriented to see real change,” says Wright.