PNCB Continuing Competence
Background
How nursing professionals stay current and continue to grow and learn in their role is critical, especially when taking care of kids. This monitoring of continuing competence is also a shared responsibility – shared among the professional, the employer, the state regulatory boards, and the certification board.
Starting in 2013, PNCB's Board of Directors launched research projects to better understand the relationship between a certification board and the competence of those who hold its certifications.
This project sought to answer questions like:
- What does recertification mean for the nurse, the profession, and health care consumers?
- What emerging methods to document competence should certification boards consider for the future?
- How can PNCB enhance recertification so that maintaining certification through renewal is more meaningful—and evidence-based—for the certificant and others, like employers?
During the project, we refined our definition of continuing competence and evaluated our Recert processes with robust feedback from stakeholders like yourself. The process we followed was based on the experiences of other organizations and best practices, but tailored to the unique needs of our practice area. We followed our core values throughout the project and involved certificants in the moving pieces to keep everyone informed.
Objectives
In examining PNCB's recertification program, we are guided by these objectives:
- Evaluate the recertification program to determine the extent to which current practices effectively promote and measure the ongoing competence of certificants.
- Determine if there are elements of the program that are unnecessarily burdensome to certificants which do not contribute to an assessment of their competence.
- Explore the possibility of incorporating new components that more effectively assess continuing competence for pediatric nursing professionals.
The first phases of changes are described below. At the end of the current process, we expect to have clear requirements that align each component with the competencies they serve. We will continue to study the ecosystem to determine if further changes are needed.
TIMELINE & RESULTS
2022: Changes Announced
The research described below has led to these results which impact recertification:
- Change the Recert option "Clinical Practice Hours" to simply "Practice Hours" to avoid the myth that only bedside / direct care / hands-on care is allowed. To recognize the many ways in which pediatric nursing professionals grow and advance in their careers, we will recognize all active practice in a variety of roles that impacts pediatric nursing care. Effective November 2022.
- Change the Recert option "Professional Practice Learning" to "Professional Practice Linkages" to reinforce that in this option you are facilitating learning or development beyond yourself to impact others. Effective November 2022.
- Increase PPL value from 5 to 10 contact hours. PPL options (like precepting, authorship, QI projects, etc.) are a big commitment. We feel they should be worth more credit. Effective November 2022.
- Add Awards, either national or international, as a PPL option. Award recipients embody outstanding characteristics and should be rewarded. Effective November 2022.
- The Pediatric Primary Care Mental Health Specialist certification is currently renewed every 3 years. To align with other PNCB credential renewal intervals and make the hours requirement more manageable, PMHS Recert will go annual via a phased approach. PMHSs will be contacted in spring 2022 about their new renewal process and dates. Phased approach starting November 2022.
- Embarking on a Competency Framework study for Acute Care and Primary Care Certified Pediatric Nurse Practitioners.
- All certificants documenting practice hours will select from a list of choices to describe how the hours are assessed in the workplace. Effective November 2023.
- Certified Pediatric Nurses (CPNs) will map Recert activities to the 6 roles in PNCB's Pediatric RN Competency Framework. This will help PNCB and nurses explore strengths and learning needs. Effective November 2023.
2021: Research Concludes in Stakeholder Summit
- Held a Continuing Competence Summit with stakeholders representing credential holders, students, faculty, accreditation organizations, employers, researchers, and more.
- Validated that all current methods of recertification promote and measure ongoing competence of certificants.
- Determined new small-scale components to better reward nurse accomplishments and more clearly gather data on activities used by employers to confirm competence.
- Approved name change to assist in clarifying Clinical Practice Hours and Professional Practice Learning recertification options.
- Approved new phase of research to develop a competency framework for Acute Care and Primary Care Certified Pediatric Nurse Practitioners.
- Interviewed health care professionals responsible for nursing competency development and assessment in various acute and primary care institutions that
- Engaged pediatric nursing professionals, as well as schools of nursing and one accrediting organization to explore the lived context of pediatric continuing competence and certification. The interviews demonstrated that PNCB’s recertification process is largely in sync with the activities PNCB-certified pediatric nursing professionals currently complete to maintain their continuing competence.
2020: Pediatric RN Competency Framework Developed
- Completed a study with a sampling of Certified Pediatric Nurses to validate our Competency Framework for Pediatric Nurses. The nationwide data collected describes the evolution of pediatric nurse professional competence across six key roles and how increased proficiency may evolve over time during their careers. PNCB will use findings to evaluate current CPN recertification activities.
2019: Certificant & Employers Surveys Completed
- Requested input from all PNCB certified nursing professionals in a major survey about possible recertification activities. They were also asked to review our pediatric nurse mindset concept and see how well it resonated. More than 16,000 certified RNs and PNPs responded!
- Requested input from employers on their perception of recertification options and what other activities are valued in the workplace.
In the certificant study, nursing professionals were asked to help us test several hypotheses:
- Non-cognitive methods (e.g., practical skills demonstrations) of demonstrating competence may be preferable to a purely cognitive methods (e.g., continuing education or multiple-choice tests).
- Competence for the newly certified is different from competence for someone who has been certified multiple years.
- Specialization in some competencies at the expense of others is acceptable within forthcoming PNCB guidelines.
- Clinical practice is a strong indicator of competence but is neither solely sufficient nor necessary to maintain competence.
- A well-designed recertification program will accommodate many forms of demonstration of competence when the demonstration method aligns with the competency.
In our exploration of what makes PNCB’s certifications unique, we hit upon a central theme: CPNs, CPNP-ACs, and CPNP-PCs all approach practice not with a collection of clinical skills, but with a unique outlook that distinguishes them from other nurses. We identified a “Pediatric Nurse Mindset” that represents not just a set of competencies, but a way of approaching care for children that sets certificants apart. As we all know, children aren't little adults. We used the Mindset concept as a focal point for our exploration of the ways certificants currently demonstrate competence.
2017-2018: Value Chain Ethnographic Research Conducted
- Conducted 15 extensive "value chain" interviews with a targeted group of pediatric nursing employers and health care team members in representative practice settings for each PNCB credential. This study examined how PNCB certification creates value for non-nursing stakeholders and how pediatric nursing professionals themselves, whether PNCB-certified or not, add value to their practice setting’s final product, which is optimized patient care. This unique approach used ethnographic research techniques to understand contexts and observe organic interactions holistically in the workplace. This approach helped PNCB ask the correct questions aligned with whom we serve.
2016: Work to Date Presented Nationally
- Presented information about the goals and components of PNCB's Continuing Competency Initiative, as well as the national landscape of continuing competence efforts, at the National Association of Pediatric Nurses (NAPNAP). See the presentation.
These are a few of the discovery questions we sought to answer:
- How does specialization and advancement in a pediatric nurse’s career impact continuing competence?
- What is the public's awareness of or expectation for renewal activities of pediatric nursing professionals?
- What activities are appropriate and reasonable for the nurse / nurse practitioner?
Note that any changes to requirements will be introduced through a process that respects the commitments nurses have already made.
2013-2015: Research in the Field Begins
- Conducted focus groups as well as certificant and staff interviews to explore project goals and validate future survey questions.
Frequently Asked Questions
PNCB embraces the definition of continuing competence from the American Board of Nursing Specialties, as "the ongoing commitment of a registered nurse to integrate and apply the knowledge, skills and judgment with attitudes, values and beliefs required to practice safely, effectively and ethically in a designated role and setting." (Di Leonardi, BC & Biel, M., 2012)
We want to ensure that recertification provides an opportunity to demonstrate competence throughout one's career. Another goal is to add meaning and value to certificants, employers, and other stakeholders. We especially wanted to understand how pediatric nursing professionals are evaluated in the workplace.
We have undertaken a deliberate process to define the essential competencies of our credentials and will use this information to evaluate each requirement and component in the recertification program. We recognize that many individuals advance and/or specialize in narrower practice settings.
- We explored lessons learned from other certifiers and other relevant research to create programs that reflect the best measures of continuing competence.
- We asked certificants and stakeholders for their input.
- Information was presented to PNCB's Board of Directors who approved the changes to date as outlined in the timeline above.
The most important change is that we will have a solid rationale for each requirement and component in the recertification program. Current approved changes are minimal and are described above in the timeline starting with "2022."
There have been many steps in our process, and throughout this exploration, we are involving various stakeholder groups to provide feedback. As we reach tangible conclusions, we will present them to stakeholders through email and paper communications, as well as presentations at conferences.
Any changes that result from research and stakeholder input will be carefully planned and announced. See "2022" and following years above for details on approved changes.
Thank you
Thank you for choosing PNCB certification and reading this important update. We look forward to involving you in this process as we move forward. Please contact PNCB at info@pncb.org for any questions about this initiative.
