The BSN-PhD/DNP education programmes in nursing: a scoping review protocol

Abstract

Introduction

To address evolving healthcare challenges, developing advanced clinical-academic nursing talent has become imperative. Bachelor of Science in Nursing - Doctor of Philosophy/Doctor of Nursing Practice (BSN-PhD/DNP) education programmes create structured pathways that connect the undergraduate and postgraduate training processes, enabling the systematic identification and development of clinical academic talent through a vertically integrated education programme. However, related literature is fragmented, and training processes remain unclear. This protocol is for a scoping review that aims to synthesise existing information about the training process (eg, admission, examinations and curriculum) and barriers and facilitators to implementing this education programme to enhance the development of a high-quality BSN-PhD/DNP education programme.

Methods and analysis

The scoping review will be conducted following the methodological guidelines provided by the JBI guidelines. The scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews checklist. Literature will be retrieved from PubMed, Web of Science, Cochrane Library, EMBASE, SCOPUS, ERIC, CINAHL, Proquest, EBSCO, CNKI, Wanfang and VIP on March 16, 2025. Additionally, grey literature, such as official websites of the top 50 or 100 nursing universities ranked by QS and Google searches, will be reviewed. Two researchers will extract data independently from the eligible literature. Discrepancies will be addressed through discussions with other researchers. The results will be displayed in both tables and written format.

Ethics and dissemination

This study does not require ethical approval. We will disseminate our results in peer-reviewed journals and present at conferences relevant to the field of nursing education.

Trial registration number

This scoping review protocol has been registered on Open Science Framework (https://osf.io/9xwnj).

STRENGTHS AND LIMITATIONS OF THIS STUDY.

• The search strategy incorporates 12 peer-reviewed electronic databases and online search engines to identify published and grey literature, encompassing academic research articles, commentaries, related reviews and reports.

• Our scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist and JBI methodology for scoping reviews.

• This scoping review is limited to include studies published in English or Chinese.

Introduction

The nursing education landscape is undergoing significant transformations in response to the increasing complexity of healthcare systems and evolving patient needs. These developments have necessitated higher competencies among nursing professionals, coupled with the urgent demand for cultivating highly competent practitioners and researchers.^{1 2} To address these challenges, establishing effective mechanisms for early identification and targeted development of exceptional nursing talents has become imperative.³

Currently, at the doctoral level, nursing education primarily offers two distinct pathways: the research-oriented Doctor of Philosophy (PhD) and the practice-focused Doctor of Nursing Practice (DNP).^{4 5} The American Association of Colleges of Nursing emphasised the need for a more comprehensive doctoral education system during its 2019 Doctoral Education Conference, particularly highlighting the value of Bachelor of Science in Nursing - Doctor of Philosophy/Doctor of Nursing Practice (BSN-PhD/DNP) programmes in establishing systematic learning pathways.⁶ Specifically designed for students holding or pursuing a Bachelor of Science in Nursing (BSN) degree, these integrated programmes establish a systematic and coherent educational pathway. These programmes integrate undergraduate and graduate studies through coordinated recruitment, curriculum design, assessment and other training phases, to cultivate future PhD or DNP professionals.^{7 8} By eliminating boundaries between training phases and ensuring a seamless clinical-academic continuum, these innovative integrated education programmes facilitate the early identification and specialised nurturing of top-tier nursing talent.^{9 10}

Models similar to the BSN-PhD/DNP framework have been well established in clinical medicine, engineering and other disciplines,¹¹,¹³ having successfully implemented and developed integrated training systems over the past several decades.¹²,¹⁴ These integrated training systems have proven effective in promoting systematic knowledge acquisition in clinical medicine, engineering and pharmacy, enhancing learning efficiency and developing students’ innovative and practical capabilities to meet evolving societal needs.¹²,¹⁴ Furthermore, these disciplines have made significant progress, with relevant reviews providing a systematic summary of admission standards, curriculum design and other key aspects.^{14 15}

However, BSN-PhD/DNP programmes are being explored initially in the nursing field. Previous studies demonstrated that BSN-PhD/DNP programmes in nursing exhibit structural superiority over traditional linear pathways through several key dimensions, which can be outlined as follows: ¹⁶,²⁰First, the programme achieves curricular efficiency by strategically eliminating redundant coursework across educational stages, thereby compressing total programme duration while maintaining equivalent academic rigour.^{16 17 20} Second, the programme provides students with opportunities to publish research findings earlier in their academic careers. This early publication enhances their academic credentials and strengthens their research skills, preparing them to contribute meaningfully to the field of nursing.^{18 19} Finally, the integrated design concurrently fosters professional identity formation, with about 21 participants reporting clearer career trajectories and enhanced understanding of healthcare system complexities.¹⁷

Despite the advancements in the field of nursing, the current literature remains fragmented, and the overall training processes of BSN-PhD/DNP programmes are still unclear. This review aims to synthesise the fragmented information and provide evidence-based insights to inform the development of high-quality BSN-PhD/DNP programmes in nursing.

Research questions

1. What are the features and categories of sources in the eligible literature on BSN-PhD/DNP education programmes in nursing?

2. What training processes are included in the BSN-PhD/DNP education programmes in nursing?

3. What are the major barriers and facilitators of implementing BSN-PhD/DNP education programmes in nursing?

4. What are the research gaps in the area of BSN-PhD/DNP education programmes in nursing?

Methods

This scoping review aims to synthesise global evidence on BSN-PhD/DNP programmes. Specifically, its objectives are to (a) map heterogeneous evidence globally, without restrictions on study design; (b) clarify the conceptual boundaries of this emerging educational model, such as curricula and admission pathways; and (c) provide foundational insights to inform the development of future education programmes in this field of study. To ensure methodological rigour, this scoping review will follow the PRISMA-ScR checklist²¹ and the guidance of the JBI Reviewer’s Manual.²² This scoping review’s protocol has been registered on Open Science Framework on 28 February 2025. The study is scheduled to commence on 4 May 2025 and will conclude on 4 September 2025.

Inclusion and exclusion criteria of literature

Population: All relevant personnel (ie, nursing executives, nurse managers, nursing academic faculty and nursing students) in any nursing settings (ie, clinical, college or academic institution) who are involved in the BSN-PhD/DNP education programmes are all eligible.

Concept: The research concerning BSN-PhD/DNP education programmes and degree attainment (with a focus on the integrated training from Bachelor of science in nursing to Doctor of Philosophy or Doctor of Nursing Practice) is eligible. We will not restrict the entire education or training processes but involve a specific part of it (eg, admission, examinations, curriculum or mentorship); it will also be included in our study.

Context: The literature should at least focus on BSN-PhD/DNP education programmes in the context of nursing education.

Literature type: Various types of literature will be included (eg, original studies, correspondence papers, letters to the editor, editorial pieces and review articles, provided that their full texts are accessible).

If the full texts cannot be obtained, we will contact the authors to obtain the original first. If still unable to obtain, the relevant literature will be excluded.

Information sources

We will search 12 databases (including nine English databases and three Chinese databases) to ensure the comprehensiveness of the literature. Literature published from the inception of the database to the date of the search will be retrieved from PubMed, Web of Science, Cochrane Library, EMBASE, SCOPUS, ERIC, CINAHL, Proquest, EBSCO and Chinese databases (CNKI, Wanfang and VIP) on 16 March 2025. In addition, to ensure the comprehensiveness of the search, grey literature (eg, official websites of universities ranked in the top 50 or 100 for nursing by QS and Google search engine) will also be reviewed.

Search strategy

In PubMed or other databases supporting MeSH, keywords will be entered to search for relevant MeSH terms (eg, nurses, education and nursing). Based on the research topic, all possible keywords, synonyms, abbreviations and spelling variants will be listed. Preliminary searches will be conducted to review titles, abstracts and author keywords of relevant articles, allowing for the extraction of additional potential free-text words (eg, nurs*, BSN-PhD/DNP). Finally, MeSH terms and free-text words will be combined using Boolean logic (AND, OR). The search strategy will be adjusted according to the unique features of each database to finalise the search expression. The search strategy outlined in table 1 will identify relevant literature on BSN-PhD/DNP programmes in nursing education within PubMed. Online supplemental tables S1 in the supplementary materials will present the search strategies for various databases.

Table 1. Search strategy in PubMed.

	Search
1	Nurses [Mesh] OR Nursing [Mesh] OR Students, Nursing [Mesh] OR nurs* (Title/Abstract) OR Nursing student* (Title/Abstract)
2	Education, Nursing, Baccalaureate [Mesh] OR “BS” (Title/Abstract)OR Bachelor of Science (Title/Abstract) OR “BSN” (Title/Abstract) OR Bachelor of Science in Nursing (Title/Abstract) OR bachelor’s degree (Title/Abstract)OR Undergraduate program* (Title/Abstract)
3	Education, Nursing, Graduate [Mesh] OR doctoral program* (Title/Abstract) OR doctoral degree (Title/Abstract) OR “PhD” (Title/Abstract) OR “Doctor of philosophy” (Title/Abstract) OR “DNP” (Title/Abstract) OR Doctor of Nursing Practice (Title/Abstract) OR “BS to PhD” (Title/Abstract) OR “BS-PhD” (Title/Abstract) OR “BS-DNP” (Title/Abstract)OR “BS to DNP” (Title/Abstract) OR “BSN to PhD” (Title/Abstract) OR “BSN-PhD” (Title/Abstract) OR “BSN to DNP” (Title/Abstract) OR “BSN-DNP” (Title/Abstract) OR “BS-DNP” (Title/Abstract) OR “BS to DNP” (Title/Abstract) OR BSN-to-PhD Pathway (Title/Abstract) OR BSN-PhD pipeline (Title/Abstract) OR early entry PhD program* (Title/Abstract)
4	#1 AND #2 AND #3

Literature selection

Two researchers will independently select relevant studies using Covidence. Discrepancies will be resolved through discussion with a third researcher, and if needed, the original authors will be contacted. A pilot screening will be conducted for both the title/abstract and full-text stages. During the pilot screening, the two reviewers will assess a set of 20 articles in each round, identify discrepancies and engage in discussions to refine the selection criteria. This process will continue until a 75% or greater agreement is achieved during the pilot screening. The results of the screening will be presented in the PRISMA 2020 flow diagram (see figure 1).²³

Figure 1. The results of the screening will be presented in the PRISMA 2020 flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Data extraction

Data extraction will involve the extraction of both qualitative and quantitative data. There will be two researchers independently extracted from the eligible literature included in our study, with detailed information primarily shown in the supplementary materials (online supplemental tables S13-S16). If there are discrepancies during the data extraction process, they will be resolved through discussion with a third researcher. Supplementary material (online supplemental table S13) will show the characteristics of original research from the eligible papers (eg, author/year/country, study goal/design/setting, main conclusions and findings). Supplementary material (online supplemental table S14) will show the characteristics of the included text and opinion literature (eg, type of literature, focus area, study context/setting, texts and reviewers’ conclusions). Supplementary material (online supplemental table S15) will show the information of BSN-PhD/DNP education programmes in nursing: author, year, country, type of the programme, duration, training processes (ie, admissions, guidance from mentors, curriculum, practice and assessment), major barriers/facilitators and key outcomes.

Critical appraisal of individual sources of evidence

Research on BSN-PhD/DNP education programmes within the nursing field is limited. The primary objective of this study will be to synthesise and present the current landscape of BSN-PhD/DNP education programmes in nursing, providing an overview of a comprehensive training programmes based on the findings. Consistent with established scoping review methodology, the review will focus on mapping and describing the characteristics, components and educational trajectories of these programmes as reported in the existing literature, rather than offering specific, synthesised and clinically meaningful conclusions.^{24 25} Therefore, the quality of the included literature will not be evaluated.

Synthesis and presentation of the results

The synthesis and presentation of the results will focus on summarising the key characteristics and findings of the BSN-PhD/DNP education programmes identified in the eligible literature. The extracted data will include both qualitative and quantitative information, with detailed summaries provided in the supplementary materials (online supplemental tables S13-S15). For the qualitative information, a content analysis will be employed to integrate the findings.²⁶ To ensure trustworthiness, credibility will be enhanced through the use of authentic illustrative quotes and a clear, detailed description of the analysis process; transferability will be achieved by providing a sufficient description of the research context, participant characteristics, data collection and analysis process; and dependability and confirmability will be ensured through detailed documentation of analytical decisions and the use of appendices or tables to demonstrate explicit linkages between the data and results (categories). This approach will allow for a comprehensive understanding of the themes and perspectives related to these programmes. For the quantitative data, descriptive statements will be used to present key data and trends.