Beyond academic integration: Professional identity, relational support, and interprofessional learning in DNP persistence

Online Doctor of Nursing Practice (DNP) programs face persistent attrition, limiting the supply of doctoral-prepared nurse leaders capable of advancing evidence-based practice and leading healthcare transformation. This qualitative case study examined how professional identity formation, relational support, and interprofessional learning shape persistence in online DNP education. Following Yin's (2018) case study approach, 11 students and recent graduates from a single asynchronous online DNP program enrolling post-baccalaureate and post-master's nurses at a private healthcare university participated in semi-structured interviews. Data were analyzed using a hybrid inductive-deductive thematic approach. Three themes emerged: (1) evolving professional identity and purpose, as students gained role clarity and leadership confidence; (2) structural and relational supports, where flexibility paired with accessible faculty and staff promoted retention; and (3) interprofessional learning, which fostered professional growth and reduced isolation. Findings extend Tinto's Student Integration Model to professional doctoral education, reframing persistence as professional integration that encompasses identity formation, commitment to the profession, and leadership readiness. Intentional cultivation of these interdependent domains supports the development of doctoral-prepared nursing leaders. • Professional identity formation was central to online DNP persistence. • Persistence reflected professional integration, not academic integration alone. • Multi-level mentorship supported coursework and scholarly project phases. • Interprofessional learning built leadership identity and reduced isolation. • Identity, support, and IPE domains worked together to sustain persistence.