Conceptualization and Operationalization of Certification in the US and Canadian Nursing Literature

Strategies to Increase Nursing Certification: A Progressive Care Certification for Nurses-Pathway for Success

Nursing specialty certification is essential for delivering competent patient care based on evidence and improving outcomes. Certification enhances nurses' professional growth, promotes satisfaction, and creates stability in an organization. Nurses value certification, but certain barriers hinder them from taking the certification examination. This article describes strategies incorporated by a nursing professional development specialist to increase nurses' participation in the Progressive Care Certification for Nurses review course, certification success, and retention in the organization.

Consensus Standard for Evidence Integration into EMS Education and High-Stakes Testing

BACKGROUND

Incorporating emerging knowledge into Emergency Medical Service (EMS) competency assessments is critical to reflect current evidence-based out-of-hospital care. However, a standardized approach is needed to incorporate new evidence into EMS competency assessments because of the rapid pace of knowledge generation.

OBJECTIVE

The objective was to develop a framework to evaluate and integrate new source material into EMS competency assessments.

METHODS

The National Registry of Emergency Medical Technicians (National Registry) and the Prehospital Guidelines Consortium (PGC) convened a panel of experts. A Delphi method, consisting of virtual meetings and electronic surveys, was used to develop a Table of Evidence matrix that defines sources of EMS evidence. In Round One, participants listed all potential sources of evidence available to inform EMS education. In Round Two, participants categorized these sources into: (a) levels of evidence quality; and (b) type of source material. In Round Three, the panel revised a proposed Table of Evidence. Finally, in Round Four, participants provided recommendations on how each source should be incorporated into competency assessments depending on type and quality. Descriptive statistics were calculated with qualitative analyses conducted by two independent reviewers and a third arbitrator.

RESULTS

In Round One, 24 sources of evidence were identified. In Round Two, these were classified into high- (n = 4), medium- (n = 15), and low-quality (n = 5) of evidence, followed by categorization by purpose into providing recommendations (n = 10), primary research (n = 7), and educational content (n = 7). In Round Three, the Table of Evidence was revised based on participant feedback. In Round Four, the panel developed a tiered system of evidence integration from immediate incorporation of high-quality sources to more stringent requirements for lower-quality sources.

CONCLUSION

The Table of Evidence provides a framework for the rapid and standardized incorporation of new source material into EMS competency assessments. Future goals are to evaluate the application of the Table of Evidence framework in initial and continued competency assessments.

Credentialing and certification: Overview, science, and impact on policy, regulation, and practice

AIM

To engage the global nursing community in sharing knowledge, experiences, and lessons learned about credentialing of individual nurses to improve nursing practice, patient safety, and quality of care.

BACKGROUND

Although the United States has a long and robust history of credentialing individual nurses, the opportunity exists to expand the dialogue globally, and is supported by globally focused governing bodies who call for increased or expanded investment in nursing certification and credentialing. Foundational work to define and operationalize certification for research purposes and develop an administrative home for stakeholders interested in certification can be leveraged by countries and regions globally. Existing frameworks for credentialing research may be used to drive theory-based research in the future.

SOURCES OF EVIDENCE

PubMed, International Council of Nurses, National Academies of Sciences, Engineering, and Medicine, World Health Organization, American Nurses Association, American Nurses Credentialing Center, and the authors' own experiences.

DISCUSSION

Credentialing as a form of self-governance, as a method for public protection, and as a foundational element in the increasingly new forms of healthcare delivery is intensifying in importance. Credentials provide an opportunity to evaluate relationships between key elements such as nursing practice, environments where nursing care is delivered, and nursing programs with outcomes of interest for the profession such as safety, quality of care, and patient outcomes.

CONCLUSIONS

Establishing rigorous credentials for nurses demonstrates a commitment to excellence. Credentialing frameworks that are universally applied could enable nurses to move seamlessly across geographic boundaries, permit regulators and employers of nurses to have a common set of standards and expectations, and ensure a level of competency for nursing practice that can be interpreted and trusted by various stakeholders.

IMPLICATIONS FOR NURSING POLICY

Policymakers have a pivotal role in advancing credentialing in nursing worldwide. Countries developing credentialing programs in nursing need to study their results to help inform how practice might be required to change over time.

Advancing Excellence in Community Health Nursing Through Evidence-Based National Standards of Practice

BACKGROUND

Current standards of practice are necessary to ensure safe nursing practice in Canada and across the world. This article aimed to describe and present findings from the rigorous review process undertaken to update the 2011 Canadian Community Health Nursing Standards of Practice.

METHOD

A revision process included a scoping review of the literature, focus groups, and a modified Delphi method.

RESULTS

Through the inclusive consultation process, 495 community health nurses enhanced the content of the standards with respect to cultural safety, cultural humility, Indigenous health and ways of knowing, health equity, and evidence-informed practice.

CONCLUSION

This comprehensive revision process can guide other nursing specialty groups developing or revising specialized practice standards in Canada and across the world. [J Contin Educ Nurs. 2021;52(4):168-175.].

Conceptualization of Competency-Based Medical Education Terminology in Family Medicine Postgraduate Medical Education and Continuing Professional Development: A Scoping Review

PURPOSE

To examine the extent, range, and nature of how competency-based medical education (CBME) implementation terminology is used (i.e., the conceptualization of CBME-related terms) within the family medicine postgraduate medical education (PGME) and continuing professional development (CPD) literature.

METHOD

This scoping review's methodology was based on Arksey and O'Malley's framework and subsequent recommendations by Tricco and colleagues. The authors searched 5 databases and the gray literature for U.S. and Canadian publications between January 2000 and April 2017. Full-text English-language articles on CBME implementation that focused exclusively on family medicine PGME and/or CPD programs were eligible for inclusion. A standardized data extraction form was used to collect article demographic data and coding concepts data. Data analysis used mixed methods, including quantitative frequency analysis and qualitative thematic analysis.

RESULTS

Of 470 unique articles identified, 80 (17%) met the inclusion criteria and were selected for inclusion in the review. Only 12 (15%) of the 80 articles provided a referenced definition of the coding concepts (i.e., referred to an article/organization as the definition's source), resulting in 19 highly variable-and 12 unique- referenced definitions of key terms used in CBME implementation (competence, competency, competency-based medical education). Thematic analysis of the referenced definitions identified 15 dominant themes, among which the most common were (1) a multidimensional and dynamic concept that encompasses a variety of skill components and (2) being able to use communication, knowledge, technical skills, clinical reasoning, judgment, emotions, attitudes, personal values, and reflection in practice.

CONCLUSIONS

The construction and dissemination of shared definitions is essential to CBME's successful implementation. The low number of referenced definitions and lack of consensus on such definitions suggest more attention needs to be paid to conceptual rigor. The authors recommend those involved in family medicine education work with colleagues across medical specialties to develop a common taxonomy.

Methods of nursing certification in North America-A scoping review

BACKGROUND

Definitions of nursing certification are lacking in the research literature and research on certification in nursing is remarkably limited.

METHODS

A six-stage scoping review framework was used to identify the nature, extent, and range of certification within the nursing literature.

FINDINGS

Thirty-six articles were included in this scoping review. Most originated in the United States (89%), were classified as research articles (56%), and used a quantitative approach (90%). The majority focused on initial certification (50%), and written examination was the most prevalent approach to certification (39%). Missing and incomplete data were prevalent.

DISCUSSION

The overall lack of nursing certification origin, focus, methodological rigor, and clear certification mastery criteria have hindered meaningful study of the relationship between nursing certification and patient outcomes. Common data elements, reporting standards, and observational studies linking common data elements and patient outcomes could guide future research and improve the transparency of certification processes and reporting.

Keeping Up With Current Orthopaedic Nursing Practice: Results of the ONCB 2016 Role Delineation Study

BACKGROUND

The Orthopaedic Nurses Certification Board (ONCB) conducts a role delineation study (RDS), also known as a job task analysis, every 5 years. Results identify tasks performed by orthopaedic registered nurses and nurse practitioners, as well as musculoskeletal health conditions commonly experienced by their patients.

PURPOSE

The purpose of this study was to define current practice patterns among orthopaedic nurses and nurse practitioners to determine content for future certification examinations.

METHOD

An online survey methodology was used to identify task and knowledge statements representative of orthopaedic nursing practice.

FINDINGS

Of 6,462 e-mails sent, 904 valid responses were returned (response rate 13.9%). This is lower than results of the Orthopaedic Nurses Certification Board's 2010 RDS (22.7% response rate) but is considered acceptable for an RDS.

CONCLUSION

Survey results were analyzed by ONCB Test Committee members with guidance from psychometric staff at PSI/AMP. PSI/AMP staff were used to review and revise examination specifications for the Orthopaedic Nurse Certified (ONC) and Orthopaedic Nurse Practitioner-Certified (ONP-C) certification programs. New examination specification and passing points were implemented with April 2018 testing.