2018-2019 Job Task Analysis (JTA) for the Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC®) Exam What is it, and why do it?

2018-19 JTA for the CPNP-AC Exam 2003 2009-10 2013-14 2018-2019 The inaugural role delineation of acute care PNP practice was performed in 2003, and This 2018-2019 study represents only the third (3rd) – ever follow on job analysis, with new refinements.

2018-19 JTA for the CPNP-AC Exam The purpose of the Job Task Analysis (JTA) is to: update and validate the inventory of tasks performed by acute care pediatric nurse practitioners update inventories of clinical problems seen and procedures performed in practice and develop new test specifications and a detailed content outline for the CPNP-AC exam.

2018-19 JTA for the CPNP-AC Exam The JTA uses a survey instrument to obtain descriptive information on the demographic information and role responsibilities of acute care pediatric nurse practitioners. This periodic study is required of all nursing certification boards by their accrediting agency. In keeping with best practices, the PNCB conducts JTA studies approximately every 4 to 5 years.

2018-19 JTA for the CPNP-AC Exam In order to develop a content outline for the certification examination, the JTA study identifies tasks, knowledge, skills, or abilities deemed to be important to practice by acute care pediatric nurse practitioners. A task will appear on the updated content outline only if it met validation criteria according to JTA study results.

STEPS INVOLVED & RESULTS “at a glance”… 2018-19 CPNP-AC Job Task Analysis

2018-19 JTA for the CPNP-AC Exam: Steps Involved Over a period of several months between August 2018 and January 2019, the following occurred: Development of the survey instrument with subject matter experts (SMEs) from around the country Pilot testing of the instrument for clarity and comprehensiveness Dissemination of the survey Analysis of survey data With input from the SMEs, development of test specifications and the updated content outline from survey findings

2018-19 JTA for the CPNP-AC Exam: Survey Overview The survey participants responded to the following survey sections: Tasks Domains Clinical Problems Procedures Evaluation of Survey Comprehensiveness Demographic and Professional Questions Exploration of Continuing Competence and Career Advancement

2018-19 JTA for the CPNP-AC Exam: Results “at a glance”… A total of 373 acute care pediatric nurse practitioners completed the survey. This was similar to response rates from prior JTA surveys, and met the industry standard for validation. Location of practice setting: 84% of respondents worked in urban areas. Primary employment setting: 74% of respondents worked in hospital inpatient settings Years of experience: more than two-thirds of respondents had 10 or fewer years of experience in the acute care role

2018-19 JTA for the CPNP-AC Exam: Results “at a glance”… Half of the respondents (50%) spent 31-40 hours per week in clinical practice as an acute care PNP. Nearly all (87%) of respondents indicated they spent more than 50% of their time in a pediatric nursing subspecialty, with the greatest number of respondents working in: critical care (18.5%) or cardiac ICU (12.3%)

Acute Care PNPs over time . . . 2013-14 2018-19 Location & Type of Practice Settings 81% practice in urban settings 62% most of time spent in inpatient settings 87% time spent in direct patient care 83.6% practice in an urban setting 74% practice in inpatient settings 84% time spent in direct patient care Highest Level of Education Obtained 90.6% Master’s degree or Post-Master’s Certificate 8.5% Doctoral degree (6.6% DNP; 1.9% PhD) 79.6% Master’s degree or Post-Master’s certificate 20.1% Doctoral degree (87% DNP, 12% PhD) Primary Focus of Practice Pediatric ICU Cardiac ICU Cardiology Critical Care (medical or mixed unit) Hematology/Oncology Prescriptive Privileges >99%, Yes, I can prescribe - 65.2% Full prescriptive privileges - 34.2% Limited prescriptive privileges 0.6% No, I cannot prescribe - 78% Full: Schedules II – V - 15.8% Partial: Cannot prescribe Schedule II - 5.4% Partial: Limited other Schedules (not II) 0.8% No, I cannot prescribe Added educational level obtained to demonstrate increased number pursuing DNP – AF: good idea! Areas highlighted were not fully clear in 2013-2014 JTA report -- AF: we need to check LL Says: The Primary Focus of Practice looks correct according to the 2013-14 PPT; I un-highlighted. LL Says: The math to add up the Doctoral degree looks good; I un-highlighted. Are prescriptive privileges still interesting? AF: agree, likely not LL Says: Do you want to keep or remove? I kind of like the breakout! Removed clinical problems and put elsewhere to show full extent of changes

CONTENT OUTLINE CHANGES How the new study impacted the exam… 2018-19 CPNP-AC Job Task Analysis

How the new study impacted the exam… DOMAINS The domain structure -- organized by Assessment, Diagnosis, Management, and Professional Practice Role -- remained the same but the content of each domain was revised in noticeable ways: The subdomain structure of the outline was substantially collapsed and updated to reflect contemporary requirements of the role. Many of the tasks in the previous content outline were very specific, so the task list was revised to include only observable behaviors that are performed on the job.

How the new study impacted the exam… DIAGNOSIS, as one example: 2013-14 2018-19 II. Diagnosis A. As part of diagnosing, determine health status specific to: Activity/mobility Age and situation specific diagnostic studies Comfort (e.g., anxiety, sleep, pain) Growth and development Individual variations (e.g., genetic, ethnic) Nutritional status* Pathogenesis, clinical manifestations, trajectory of specific disease and injury Physiologic function and dysfunction Prioritized differential diagnoses Psychological response (e.g., coping, mental health) Sexual/reproductive issues II. DIAGNOSIS A. Integrate history, review of systems, health risks, and physical examination findings to develop and prioritize differential diagnoses B. Establish diagnosis/diagnoses based on evaluation of patient data

How the new study impacted the exam… DOMAINS The Assessment domain increased from 20% of the exam content to 30%, while the Management domain decreased proportionately. 2013-14 2018-19 % of items, # of items per domain Assessment 20% (30 items) Diagnosis 25% (38 items) Management 50% (75 items) Professional Practice Role 5% (7 items) Assessment 30% (45 items) Diagnosis 25% (38 items) Management 40% (60 items) Professional Practice Role 5% (7 items) Total = 150 scored items

How the new study impacted the exam… SUB-DOMAINS 2013-14 2018-19 I. Assessment A. Health History B. Physical Exam   II. Diagnosis III. Management A. Implementation, Evaluation, Revision B. Education, Collaboration, Referral Diagnostic Studies Therapeutic Interventions Collaboration, Referral, and Care Coordination D. Education IV. Professional Practice Role IV. Professional Role and Responsibilities A. Leadership and Evidence-based Practice B. Legal and Ethical

(See next slide for listing) How the new study impacted the exam… PROCEDURES 2013-14 2018-19 With past job analyses, none of many surveyed procedures met validation criteria to be included on the exam. This means that there was not enough consistency in practice across the country such that new exam candidates could be tested specifically on elements of performing procedures. There had been enough evidence to “thread” exam content with what were referred to as “Technical Competencies.” Examples: hemodynamic monitoring, interpretation of laboratory data such as cerebrospinal fluid, cultures, and interpretation of diagnostic results such as EKG, radiographic images, ultrasound. This new outline represents the *first* opportunity to introduce procedures; the limited list of procedures on the next slide did meet validation criteria for inclusion. This now allows candidates to be tested on the knowledge needed to actually perform procedures. (See next slide for listing)

How the new study impacted the exam… PROCEDURES In the Management domain there is now a specific task related to procedures: perform procedures as indicated Interpretation of diagnostic results and laboratory data are now tied to other management tasks in the content outline The 8 Procedures validated to be included on the exam are: Airway adjunct Central line insertion Chest tube removal Lumbar puncture Procedural sedation Ventilator management: invasive Ventilator management: non-invasive Reminder: any exam questions on this content must be pre-tested before candidates are scored.

How the new study impacted the exam… CLINICAL PROBLEM LIST Some clinical problems reworded Ex: Pulmonology is now Respiratory Some clinical problems stand alone Ex: Genetics/ Metabolic are now separate problems with separate ranking There are now 21 clinical problems, compared to the former 18 Some clinical problems combined Ex: Gastrointestinal / Nutrition 2013-14 2018-19 Pulmonology Cardiology Infectious Diseases Trauma/Burns/Maltreatment Neurology/Neurosurgery Oncology Gastrointestinal Pain/Sedation Musculoskeletal Otolaryngology/Cranio-facial/Dental Hematology Renal Allergy / Immunology / Rheumatology Dermatology Endocrinology Genetics/Metabolic Genitourinary Toxicology Respiratory Infectious Disease Gastrointestinal/Nutrition Neurologic Cardiac Oncologic Hematologic Palliative/End of Life Endocrine Behavioral/Mental Health Genetic Otolaryngologic/Cranio-facial Dermatologic Allergic/Immunologic/Rheumatologic Toxicologic Metabolic

How the new study impacted the exam… EXAM DETAILS There were no changes in the number of questions 150 scored items and 25 unscored items You will not be able to distinguish between scored and non-scored questions. There was no change in time allotment 3 hours

FAQs Answers to common questions… 2018-19 CPNP-AC Job Task Analysis

FAQs Q: When does the updated exam launch? A: New exam forms tied to the updated outline are expected to launch January 20, 2020. See PNCB’s website for specific dates and other details as they are available. Q: Is there any advantage in taking one version of the exam over the other? A. No, both will equally assess your knowledge. Q: Do I need to study differently if I choose to take the new exam? A: No, any preparations undertaken will benefit you regardless of which exam you take. The reference list remains the same. Just be sure to use the content outline that matches the time frame for your testing period. Q: Have the eligibility requirements changed as a result of this study? A: No, eligibility requirements have remained the same. Q: Where can I confirm my eligibility? A: Visit PNCB’s website for more information: https://www.pncb.org/cpnp-ac-certification-steps Obviously some loaded questions here that will need tweaking when other decisions are made LL Says: All of this looks pretty good / generic, but did highlight the few words that are TBD

2018-2019 CPNP-AC Job Task Analysis If you have questions, please visit: www.pncb.org or email exam@pncb.org. Our team will be glad to assist. We wish you much success on your upcoming exam.