Redefining the Journey: A Scoping Systematic Review of PhD and DNP Career Trajectories

BACKGROUND: Globally, doctorally-prepared nurses have pursued career paths centered on research and academic leadership. In the United States, alongside the PhD in nursing, there exists a distinct educational pathway, the Doctor of Nursing Practice (DNP), which emphasizes clinical practice. However, the actual career trajectories of individuals from both groups often diverge from these traditional expectations, prompting questions about how their roles are integrated within academic and clinical environments. AIMS: This systematic review aims to critically examine the career pathways of nurses with doctoral degrees, with a focus on the intersection of research and clinical practice. METHODS: Following the PRISMA guidelines, a systematic search of five databases (PROQUEST Nursing, Scopus, EBSCO, EMBASE, and PubMed) was conducted on October 14, 2024. We identified 6003 references, with 23 studies ultimately meeting inclusion criteria. Thematic analysis was used to synthesize findings. RESULTS: PhD and DNP nurses in the US exhibit overlapping yet nontraditional career paths, with PhDs taking on clinical leadership and DNPs entering academia. Globally, PhD nurses often hold hybrid roles in research, education, and limited clinical practice. Across contexts, both groups face role misalignment and identity challenges, including marginalization and limited institutional support. LINKING EVIDENCE TO ACTION: The findings highlight the blurring of traditional boundaries between PhD and DNP career paths, underscoring the need for flexible career models that combine academic and clinical practice as a viable option to address these challenges. TRIAL REGISTRATION: The review was registered in PROSPERO (Registration Number).