CNA certification: Neonatal nurses celebrate birth of specialty exam

September / October 2017   Comments

In January 2018, neonatal nurses will have their first-ever opportunity to apply for CNA specialty certification. Those with the requisite educational and practice background will be eligible to write CNA’s new neonatal exam, to be offered in May.

“We want to make sure that newborns and their families have the best possible care, and, in order to do that, you’ve got to have the best possible nurses,” said Doris Sawatzky-Dickson, president of the Canadian Association of Neonatal Nurses (CANN). “I think that certification is the key to that.”

The comprehensive exam will be the outcome of a rigorous process that began in 2012, when CANN’s membership identified certification as a top priority, said CANN past president Linda Boisvert.

“A [critical care] pediatric certification program and also a perinatal certification program [have] been around for a long time. Neonatal nursing wasn’t recognized as having its own base of knowledge,” she said, explaining that neonatal nurses care specifically for ill and/or premature newborns and their families. “It was very important that we have this recognition as a distinct area of practice.”

To be eligible for certification, CANN had to prove that neonatal nursing met the definition of a specialty practice, with unique competencies and skills. CANN gathered subject matter experts from across the country, including clinical practitioners, researchers, managers and teachers, to develop national standards of practice, which they validated with their network of neonatal nurses.

Additionally, for reasons of exam validity and financial feasibility, CNA requires that there be enough nurses in a proposed specialty to ensure 100 candidates will write the exam each year.

After CNA gave the go-ahead, subject matter experts from CANN gathered with psychometricians from the testing company Assessment Strategies Inc. (ASI). During four days in May, the experts wrote more than 400 multiple-choice exam questions based on the standards of practice.

“The questions address every single competency. And there’s three domains: knowledge, application and critical thinking,” said Sawatzky-Dickson. “Every exam question is referenced in two places, mostly [in] neonatal textbooks.”

A group of CANN experts will gather again in September to set the exam, using about 165 of the 400 questions. They’ll use other questions to create a practice exam, while the remainder will return to the item bank for potential future use.

After the first year, the exam results will be analyzed to see if any questions had an unusually high failure rate, which could indicate unclear or misleading phrasing. Faulty questions will be eliminated. Three years later, the exam will undergo a currency review to eliminate questions that no longer reflect practice. In the final phase of the life cycle of the exam, experts will conduct a thorough review of the competencies to ensure they reflect the most current evidence at that time.

To help prepare nurses for the exam, CANN is compiling a database of study resources and planning for a two-day exam preparatory workshop at its annual meeting next April.

Kate Jaimet

Kate Jaimet is a freelance journalist in Ottawa.

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