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Described as the capstone project, practice inquiry, or scholarly endeavor focused on practice, the final project of the Doctor of Nursing Practice (DNP) student provides the foundation for future scholarship, reflects the student's command of knowledge and expertise, and is an academic product that reflects the student's immersion experience (American Association of Colleges of Nursing [AACN], 2006 ). These demonstrations of knowledge and skill acquisition vary greatly among DNP programs. Indeed, Udlis and Mancuso (2012 ) suggested that commonly applied terms for the process of skill acquisition are practicum/residency , immersion experience , capstone seminar , or systems change initiative (p. 271). Expectations for the final product range from a close resemblance to a knowledge-generating, five-chapter PhD dissertation to a portfolio of the impact of a practice initiative. The considerable variance in definition of the capstone project has generated questions about the consistency of scholarly rigor and quality (Burke et al., 2005 ; Florczak, 2010 ). For consistency and clarity, the term project will be used throughout this article in reference to the capstone or final project of the DNP student.
When compared with the PhD, where expectations are consistent across programs regarding the components of a research thesis, the diversity encountered with the range of DNP projects creates confusion. A better understanding is needed of the meaning of the practice doctorate and the threshold that must be crossed to demonstrate the requisite command of clinical knowledge and other professional skills inherent in implementing sustainable changes in the health care system, such as leadership ability, economic analysis, change, and management expertise.
In the 2004 position statement on the practice doctorate in nursing, the American Association of Colleges of Nursing (AACN) discussed the differences between the PhD and the DNP, suggesting that the DNP programs have less emphasis on theory, research methodology, and different "dissertation" requirements, ranging from no final project to a capstone focused on practice. Later, AACN further differentiated the practice from the research doctorate stating, "Rather than a knowledge-generating research effort, the student in a practice-focused program generally carries out a practice application-oriented 'final DNP project,' which is an integral part of the integrative practice experience" (2006, p. 3). With the focus on clinical practice, some have questioned whether a...