Executive Summary
The study of practice, also known as a job analysis, was completed in 2016 at the request of AACN Certification Corporation (the credentialing arm of the American Association of Critical-Care Nurses). The purpose of the job analysis was to describe the job activities of the Clinical Nurse Specialist (wellness through acute care) in sufficient detail to provide a basis for the development of a professional, job-related certification exam.
A Practice Analysis Task Force (PATF) was appointed by AACN Certification Corporation to conduct the activities necessary to identify the responsibilities of a Clinical Nurse Specialist, and to develop the test specifications. The diversity of this group was reflective of the Clinical Nurse Specialist’s job. All PATF members demonstrated expertise in the duties and activities associated with this profession.
The study involved the development of a practice analysis survey, distribution of the survey to people involved in advanced practice nursing, and an analysis of the responses. Test specifications for the Adult-Gerontology, Pediatric, and Neonatal Clinical Nurse Specialist were developed on the basis of these data. The PATF was responsible for the following six tasks:
- Developing a definition of the clinical nurse specialist, wellness through acute care
- Developing a sampling plan for the survey
- Identifying patient care problems, skills and procedures, and competencies for the survey instrument
- Determining rating scales
- Determining the relevant demographic variables of interest
- Integrating the definition, patient care problems, skills and procedures, competencies, rating scale, and demographics into a survey instrument
The draft job analysis survey was distributed to the PATF for pilot testing. Modifications were made and the final survey was prepared for distribution.
Five thousand, seven hundred, ninety-five (5,795) invitations for the web survey were emailed to individuals identified by AACN Certification Corporation as holding Adult, Pediatric and Neonatal CCNS credentials, and/or the ACCNS-AG, ACCNS-P and ACCNS-N certification, as well as those AACN members who held the American Nurses Credentialing Center (ANCC) AGCNS-BC, ACNS-BC or PCNS-BC certifications for Adult, Gerontological and/or Pediatric populations.
In addition to the use of AACN Certification Corporation communications networks and strategies – including e-news blasts, AACN website and social media webpages to solicit participation from clinical nurse specialists, other stakeholders such as the National Association of Clinical Nurse Specialists and the National Association of Neonatal Nurses promoted the survey to CNSs within their membership. It was determined that approximately 21 percent of the sample responded; however, an exact figure cannot be determined because of the various methods used to contact survey participants. Additionally, the respondents' ratings displayed an acceptable level of interrater reliability for the patient care problems, skills and procedures and competencies.
After the survey data were analyzed, the results were reviewed by the PATF and decision rules were established. These rules were used to determine which patient care problems, skills and procedures and competencies were appropriate for assessment, and, therefore, for inclusion in the final test content outline. Application of the decision rules resulted in the retention of 123 patient care problems for the Adult-Gerontology Clinical Nurse Specialist, 151 for the Pediatric Clinical Nurse Specialist and 84 for the Neonatal Clinical Nurse Specialist.
Application of the decision rules resulted in the retention of 56 skills and procedures for the Adult-Gerontology Clinical Nurse Specialist, 52 for the Pediatric Clinical Nurse Specialist, and 24 for the Neonatal Clinical Nurse Specialist. A review of the respondents’ comments did not result in the addition of any tasks. Each multiple-choice exam will be composed of 150 scored items plus 25 unscored pre-test items. The resulting test plans for the Adult-Gerontology, Pediatric, and Neonatal Clinical Nurse Specialist credentials will be used by AACN Certification Corporation’s exam development committees to assemble the exams.
The test plans are available to exam candidates, program directors, review course instructors and other interested individuals and organizations.
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