2021 National Practice Analysis of Clinical Nurse Specialists

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Executive Summary of Adult-Gerontology, Pediatric and Neonatal CNS Exam Development

AACN Certification Corporation conducts regular national studies of practice, also known as practice analyses, as the basis for development of certification test plans, which are based on current clinical practice. The purpose of the ACCNS-AG, ACCNS-P and ACCNS-N study of practice is to describe the job activities of adult-gerontology, pediatric and neonatal clinical nurse specialists (CNSs) across the spectrum of wellness through acute care in sufficient detail to provide a basis for the development of professional, job-related advanced practice certification exams.

A Practice Analysis Task Force (PATF) was appointed by AACN Certification Corporation. The selected subject matter experts represented a wide variety of work-related characteristics such as years of experience, work setting, geographic location and area of specialty. This diversity reduces the risk of bias as the PATF develops a scope of practice reflecting the roles and responsibilities of adult-gerontology, pediatric and neonatal CNSs.

The PATF met in February 2021 to identify the responsibilities of adult-gerontology, pediatric and neonatal CNSs and develop a web-based survey tool. The task force developed and piloted a survey that included 105 task statements and 180 knowledge statements across seven content domains for the adult-gerontology population, 60 task statements and 180 knowledge statements across seven content domains for the pediatric population and 27 task statements and 100 knowledge statements across seven content domains for the neonatal population.

The final web survey was sent to individuals that AACN Certification Corporation identified as certified clinical nurse specialists. The survey yielded 228 usable responses for the adult-gerontology population, 47 usable responses for the pediatric population, and 24 usable responses for the neonatal population, with respondents' ratings displaying an acceptable level of interrater reliability for the patient care problems, skills and procedures, and competencies.

Reviewing the results of the survey, the PATF identified the task and knowledge areas that would comprise the updated ACCNS-AG, ACCNS-P and ACCNS-N test plans and finalized the weighting for each area with content distribution at the competency level as well as the topic level.

Continuing with the exam development, the Item Writer Committees (IWCs) and Item Review Committees (IRCs) for each patient population drafted and fine-tuned exam items for pretesting based on the updated test plans.

The Exam Review Committees (ERCs) then reviewed the complete pool of exam items for relevance, accuracy and fairness, validating each item with at least one reference listed on the exam bibliography.

Last, the Score Evaluation Committees (SECs) analyzed the difficulty of the items within the final item pools to determine the passing standard, also known as the cut score. Each multiple-choice advanced practice certification exam will be composed of 150 scored items plus 25 unscored pretest items.

The ACCNS-AG, ACCNS-P and ACCNS-N test plans are available to exam candidates, program directors, review course instructors and other interested individuals and organizations.

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