The Roy Adaptation Model as Theoretical Underpinning for DNP Education

Abstract

The Doctor of Nursing Practice (DNP) degree is a practice focused doctorate, with nursing theory providing guidance for integrative practice experiences and the DNP project. The Roy Adaptation Model (RAM) meets the DNP Essentials (AACN, 2006) as a process, a patterning of human-environmental integration, directing actions for making positive change of health in individuals and groups. Evaluative outcomes are measurable in all four adaptive domains (Roy, 2009). The RAM facilitates transforming the care context and culture of practice to holistic, person-centered care. Numerous types of DNP scholarship have been linked with the RAM; philosophical, scientific, and cultural assumptions of the RAM inform the DNP perspective. Middle range theory specifically links scholarship to practice supporting evidence-based practice initiatives. The RAM middle range theory template assists the practice experienced but nascent scholar to identify stimuli, coping processes, and adaptive modes defining the problem, activities, and outcomes in adaptive terms. Systems outcomes may include transformation of the system of care through collaboration. Practice change can be effected at multiple levels – individual health, group function, and healthcare delivery. DNP theory examples of the RAM will be given from acute care, primary care, community health, nurse anesthesia, and health systems (Hunt & Lord, 2019; Kass, 2018; Mann, 2018; Myers, 2017; Silva, 2018). Sample propositions for middle range theory support changing the culture. Adaptation is a core concept for nursing practice and interprofessional collaboration. Adaptation in one setting can serve as a model for other systems, creating adaptive change in healthcare broadly through practice generalizability. Utilization of the RAM for practice change supports patient-centered adaptation and cultural adaptation to produce sustainable evidence-based outcomes. Continued theoretical work is needed to identify settings and problems that can be transformed through theory. The scholarship of practice must be grounded in nursing theory such as the RAM. The participant will: 1. Relate the Roy Adaptation Model (RAM) to DNP Essentials (AACN, 2006) 2. Use middle range theory in designing curriculum for the practice-focused doctorate 3. Describe examples of RAM scholarship in DNP projects Topics: The DNP: Applying the Roy Adaptation Model (RAM) in the practice-focused doctorate The RAM as theoretical underpinning in the AACN DNP Essentials Middle-range theory uniting practice and scholarship Exemplars of theory-based DNP projects using the RAM