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

2. 2018-19 JTA for the CPNP-AC Exam
2003
The inaugural role delineation of acute care PNP practice was performed in 2003, and
This study represents only the third (3rd) – ever follow on job analysis, with new refinements.

3. 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.

4. 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.

5. 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.

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

7. 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

8. 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

9. 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

10. 2018-19 JTA for the CPNP-AC Exam: Results “at a glance”…
Half of the respondents (50%) spent 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%)

11. Acute Care PNPs over time . . .
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 JTA report -- AF: we need to check
LL Says: The Primary Focus of Practice looks correct according to the 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

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

13. 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.

14. How the new study impacted the exam… DIAGNOSIS, as one example:
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

15. 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.
% of items, # of items
per domain
Assessment % (30 items)
Diagnosis % (38 items)
Management % (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

16. How the new study impacted the exam… SUB-DOMAINS
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

17. (See next slide for listing)
How the new study impacted the exam… PROCEDURES
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)

18. 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.

19. 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
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

20. 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

21. FAQs Answers to common questions…
CPNP-AC Job Task Analysis

22. FAQs
Q: When does the updated exam launch? A: New exam forms tied to the updated outline are expected to launch January 20, 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:
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

23. 2018-2019 CPNP-AC Job Task Analysis
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We wish you much success on your upcoming exam.