One of the biggest challenges is identifying an appropriate topic or project idea. Coming up with a novel and innovative quality improvement, program evaluation, or other evidence-based practice project that is meaningful and can be realistically completed within the program timelines can be difficult. Students have to find a topic that is significant enough to meet the capstone requirements, but also feasible given any limitations at their clinical site or organization. This requires thinking creatively about how to address an issue that matters, while also working within real-world constraints.

Once a topic is identified, the proposal and IRB application process can also pose challenges. Developing a clear, well-written proposal that thoroughly justifies the need for and significance of the project takes effort. The proposal must demonstrate a strong understanding of the topic and include a comprehensive literature review and detailed methodology. Gaining approval from an Institutional Review Board for projects involving human subjects can take additional time and require revisions. This means students need to start the proposal and IRB process early to allow sufficient time for potential delays or needed changes.

Often a major hurdle is implementation of the actual project. DNP students have to balance the demands of the capstone with other responsibilities like coursework, clinical hours, and work or family obligations. Recruiting participants, collecting and analyzing data, implementing interventions or programs, etc. within the planned timeframe while juggling other priorities can be difficult. Unexpected issues also frequently arise that impact timelines, such as difficulties engaging stakeholders, challenges enrolling enough participants, adjusting methods midstream, and ongoing covid related disruptions. Flexibility and contingency planning is important.

Communication and navigating organizational bureaucracy can pose additional barriers. Collaborating with stakeholders like practitioners, administrators, and staff at various levels of an organization is necessary for many capstone projects but requires diplomacy, persistence, and relationship building. Gaining access to needed resources, data, and full cooperation from busy individuals and departments isn’t always straightforward. Political realities and resistance to change may arise that students have to work tirelessly to overcome. Strong communication, creating buy-in, and addressing concerns is paramount for success.

Data management and analysis skills also present hurdles for some students, especially those from non-research intensive backgrounds. Working with large datasets, performing more advanced quantitative or qualitative analytic techniques, using statistical software programs, and ensuring data integrity can prove intimidating or difficult to learn independently within tight time constraints. Accessing consultation support from statistical experts, learning specialists, and faculty methodologists is important but not always readily available. Rigor and quality must not be sacrificed despite these analytic challenges.

Drafting the lengthy capstone manuscript and presentation of findings to meet university format standards is a labor intensive task that many find quite stressful. Effectively synthesizing everything into a polished, well-structured written document or oral defense takes significant effort and attention to detail. Incorporating feedback from multiple committee reviews in a timely manner while still meeting deadlines demands strong project management, writing, and time management abilities close to graduation.

While the capstone experience aims to allow DNP students to demonstrate enhanced competencies in advanced clinical, leadership, advocacy, and scholarship roles, it also inevitably presents numerous obstacles. From topic selection to implementation to evaluation and reporting of results, developing, conducting and documenting the project within program timeframes despite other responsibilities and hindrances requires the highest levels of independence, resilience, and problem-solving from students. With diligent planning, open communication, support access, and flexibility, they can certainly overcome these considerable challenges of the DNP capstone.