New scheduling flexibility benefits nurses and employers
CNA’s Certification Program turns 25 in 2016, and big changes are coming. New and renewing candidates will apply for specialty certification exclusively online and take the exams at computer-based testing centres across the country.
The move to fully digital application and testing has been in the works for about five years, says Lucie Vachon, nurse advisor with the program. Researching various application and testing platforms, resources and costs, as well as meetings with various stakeholders led CNA to move the program online. Although the format may have changed from paper to online, Vachon is quick to point out that the content of the exams has not changed.
“The certification exams are created by registered nurses for registered nurses,” she says. Subject matter experts from across Canada collaborate with testing and measurement consultants from Assessment Strategies Inc., which CNA hired to create and then update each exam with the latest research evidence and workplace best practices. Through the process, a national standard is set for all knowledge in a specialty area. For example, while a nurse may have experience with dialysis, the nephrology exam also includes questions about hemodialysis and kidney transplant, testing advanced knowledge in the full spectrum of the specialty. Each exam has 160 to 165 multiple-choice questions that reflect realistic situations nurses may encounter in their areas of specialty practice.
While the Canadian Network of Nursing Specialties has members from 45 specialty groups, only 20 specialties have certification exams. “To develop and maintain a specialty certification exam, a significant number of nurses are needed to write/renew each year,” says CNA’s Patricia Elliott-Miller, Certification and Professional Development executive lead.
Saying farewell to paper applications and testing will save money and trees, but Vachon acknowledges that some nurses may not feel comfortable with the new format. To help them navigate the new system, CNA will provide tutorials and webinars to go through the process step by step. The program already offers online practice tests, which are identical in format to the new exams.
The online application process for the 2016 exams will be open from April 11 to July 1 for initial certification and renewal by exam and from April 11 to Nov. 30 for renewal by continuous learning. The exams will be offered from Sept. 19 to Oct. 7. CNA is also planning exams for two weeks each in the spring and fall of the following years. Licensed RNs with a minimum of two years’ experience in the specialty, confirmed by a supervisor, can apply. To complete the exam, they will be able to call the nearest specified computer-based testing centre and book a seat for whichever date during the testing window works best for their schedule. Previously, CNA offered certification exams on a single Saturday each year, which created challenges for employers to free their nurses on the same day and for nurses who could not get to the testing centre on that day.
RNs need to renew their certification every five years, which can mean writing the updated test or completing 100 hours of specialty-specific learning activities during their five-year term. For example, nurses attending presentations at CNA’s biennial convention or being members of their specialty groups can claim some of those hours toward their certification renewal. “Our new online system will allow nurses to create their profile and their continuous learning profile,” Vachon says. “It will facilitate the tracking of their learning activities as they go along, with the end result that it will make their certification renewal faster and easier.”
The cost to complete the initial or renewal exam is $570 and $756, plus applicable GST or HST, for CNA members and non-members, respectively; however, to renew certification by continuous learning is $328 and $395, plus tax, respectively.
Updated regularly, the CNA Certification Program section on NurseONE.ca lists available financial resources, Vachon says. For example, the Nursing Education Initiative Grant Program, funded by Ontario’s Ministry of Health and Long-Term Care, provides funding. According to its website, the Canadian Nurses Foundation will reimburse the fees of exams or renewal by continuous learning for at least one nurse in each of the 20 specialty areas. “Certified nurses in Newfoundland and Labrador and in Nova Scotia now receive a pay premium for their specialty certification,” Vachon adds.
As well as financial assistance, many national specialty associations offer other support. For example, the Canadian Association of Perinatal and Women’s Health Nurses has a national perinatal certification exam study group and the Canadian Society of Gastroenterology Nurses and Associates offers an annual session on certification exam preparation at their national conference. Also, the de Souza Institute offers a national certification exam study group for oncology and hospice palliative care nurses.
The Canadian Association of Nurses in Oncology (CANO) believes so strongly in specialty certification that, in August, it released a position statement encouraging RNs working with cancer patients or in cancer systems to obtain oncology certification by their fifth year of practice. The CANO position statement also recommends organizations providing oncology services have at least 75 per cent of their eligible RNs certified.
“Oncology certification demonstrates positive outcomes for patients/families, nurses, and organizations. Nurses have indicated that the specialty certification process has a positive impact on them, both professionally and personally,” the position statement reads. “Organizations which support RNs with Canadian Nurses Association (CNA) certification reflect an appreciation of specialized knowledge and a commitment to life-long learning.”
“Many employers support their nurses to pursue their specialty credential, as they see it as an investment in high standards for the best care in their organizations,” Vachon says, adding that employers recognize that certification means nurses have met national standards of competency and specialized knowledge, which translates into safe, quality care.
The nursing department at Toronto’s Mount Sinai Hospital is just one of the Canadian employers that covers the cost of successfully obtaining certification. In 2010, the department set a goal to increase the number of its certified nurses. The multi-pronged approach ensured nursing leadership was available to provide advice to RNs considering taking the exam; offered reminders of certification deadlines in inpatient and ambulatory units; provided a variety of free onsite study groups and ensured managers and unit leadership planned schedules to allow nurses to attend; and provided weekly drop-in sessions overlapping shift changes so nurses could attend before or after work. The program worked; Mount Sinai has 256 certified RNs on staff, greatly exceeding their goal of 206.
Pierre-Le Gardeur Hospital (PLG), a regional facility in Terrebonne, Que., received the 2015 CNA Employer Recognition Award for its certification support. The entire PLG oncology centre team — including pharmacists, psychologists and oncologists — participated in a study group to support the centre’s oncology RNs through the process and prepare for the exam.
According to Annie Jean, an oncology nurse at PLG, the effort was well worth it. Certification has given the nurses additional tools to reassure patients and has enabled nurses to become more proactive in detecting oncological emergency situations that require immediate referral. “Since there are a growing number of highly skilled nurses, the quality of care and services administered at the oncology centre is improved overall,” Jean says.
It’s not just the nurses and patients who are reaping the rewards of certification. The program enhances the oncology centre’s reputation, Jean says, and has a positive impact on recruitment initiatives for nursing and other health-care professionals.
With files from Sue Cavanaugh
Number of valid CNA certifications by specialty area for select years [PDF, 294.7 KB]