Victor Hugo wrote, "Nothing else in the world[horizontal ellipsis]not all the armies[horizontal ellipsis]is so powerful as an idea whose time has come" (Smithsonian American Art Museum, n.d.).
Advanced certification in nursing professional development (NPD) has been a topic of discussion for many years. Early discussions began with charter members of the former National Nursing Staff Development Organization, which is now the Association for Nursing Professional Development (ANPD), the specialty organization for NPD. The conversation about advanced certification intensified when the Nursing Professional Development: Scope and Standards of Practice, 3rd edition (Harper & Maloney, 2016) identified two levels of competencies for each standard: those required of every nurse who practiced NPD and those required of the graduate-prepared NPD specialist. These two levels align with the American Nurses Association guidelines for acknowledgment of specialty practice standards (American Nurses Association, 2017). This time, when the conversation about advanced certification intensified, things had changed. This idea's time had come.
Between 2010 and 2016, ANPD expanded significantly in membership, management, and capacity to provide member resources. In 2016, when the advanced certification idea surfaced again, the ANPD Board of Directors approved a membership survey to determine interest and the potential number of members holding both a graduate degree and NPD certification (i.e., NPD specialists) who might potentially qualify for advanced certification. The survey was conducted in early 2017, and the response was overwhelming. Nearly 2,000 individuals responded with 1,851 completed surveys received. Nearly 72% of these respondents (n = 1015) were NPD specialists (graduate-prepared and certified in NPD), and of those, 707 indicated an interest in obtaining advanced certification in NPD.
The Accreditation Board for Specialty Nursing Certification (ABSNC) accredits nursing certifications that adhere to strict guidelines to ensure rigor of the certification process (ABSNC, n.d.-a). Accreditation criteria require the certifying organization to be autonomous (ABSNC, n.d.-b). Under these guidelines ANPD cannot administer an advanced certification in NPD that would be eligible for accreditation. Beginning in 2024, the American Nurses Credentialing Center (ANCC) Magnet Designation Program will only recognize accredited certifications (ANCC, 2021); therefore, ANPD needed to consider an alternative certification board.
Armed with these data, ANPD began looking for a certification board to provide a portfolio-based advanced certification in NPD. ANPD member Bette Case Di Leonardi, PhD, RN, NPD-BC, who was on the ABSNC Board of Directors, suggested that ANPD consider a collaborative partnership with the Competency and Credentialing Institute (CCI) for the development of an advanced certification. Dr. Case Di Leonardi provided introductions, negotiations began, and an agreement was reached in 2019. In this agreement, ANPD would provide members with expertise to develop the certification requirements and processes. In return CCI would administer the certification and submit it for accreditation when eligible. Dr. Case Di Leonardi, along with Gina Reid Tineo, PhD, MS, MPH, RN, NPD-BC, and Mary Harper, PhD, RN, NPD-BC, were appointed by the ANPD Board of Directors to lead the initiative. Advanced certification in NPD-its time had come.
DEVELOPMENT PROCESSES
Overview
In early 2019, ANPD issued a call for volunteers to develop the advanced certification requirements and processes. Volunteers were required to be NPD specialists (graduate degree and NPD certified). Experience in developing certification standards and portfolios was preferred. A Steering Task Force of 12 NPD specialists and a representative from CCI (see Table 1) began meeting monthly in mid-2019. Four additional workgroups, each with several volunteer NPD specialists, were established and led by members of the Steering Task Force to develop eligibility criteria, portfolio content, a portfolio evaluation/scoring rubric, and application resources. A 1-year plan was established to complete the work. The eligibility and portfolio content workgroups completed their respective assignments in the first 6 months. Subsequently, the other two workgroups created the scoring rubric and developed resources (portfolios) to test the new processes. This workflow was iterative with workgroups requesting guidance and suggesting revisions to other groups as they progressed.
Steering Task Force
The Steering Task Force was responsible for reviewing, giving feedback, and approving the work of each workgroup. They also made global recommendations for the advanced certification process. Each Steering Task Force member also served on a workgroup so that each workgroup had two to three Steering Task Force members present for guidance. These Steering Task Force members served as intermediaries who communicated recommendations and updates to the Steering Task Force and feedback to the workgroup. Additional key activities of the Steering Task Force included determining the credential to be awarded, establishing educational requirements for international applicants, responding to feedback from CCI and ABSNC, considering the updated Essentials of Graduate Education issued by the American Association of Colleges of Nursing (AACN), and developing policies for the certification process.
In alignment with the basic certification credential of NPD-BC, awarded by the ANCC (n.d.), the Steering Task Force recommended that the advanced credential be Nursing Professional Development Advanced-Board Certified (NPDA-BC). The ANPD Board of Directors approved the credential and initiated legal processes to trademark the credential. The credential was registered by the U.S. Patent and Trademark Office in October 2021, becoming NPDA-BC.
The Steering Task Force was responsible for key decisions. For example, in alignment with the global reach of ANPD, the Steering Task Force determined that the certification would be available to international members. Because academic degrees are not globally standardized, an investigation of how other accreditation boards manage validation of international applicants' degree status was conducted. Based on this investigation, the Steering Task Force determined that an international equivalent to a master's degree, as deemed by an organization specializing in evaluating degrees, would be accepted. Another key decision was that the duration of the certification would be 5 years, a common certification time frame.
The Steering Task Force also considered recommendations from experts in accreditation. A psychometrician, an expert in test development and measurement, at ABSNC recommended use of a met/not met scoring format, which was adopted by the task force. In addition, CCI recommended assigning two reviewers to each portfolio with a third reviewer to be engaged when the initial reviewers did not agree. This policy was also adopted.
During the advanced certification development process, the AACN (2021) released "The Essentials: Core Competencies for Professional Nursing Education," an updated document commonly referred to as "The Essentials." The Essentials set expectations for nursing education across the continuum from entry into practice to doctorate degrees. The Essentials recognize indirect nursing care as "decisions or interventions" that "create the conditions under which nursing care or selfcare may occur" (AACN, 2021, p. 63) and identifies several nursing specialties that provide indirect care as "advanced nursing practice specialties" (p. 16). AACN formally recognizes administration/leadership, informatics, health policy, and public health as advanced nursing practice specialties, acknowledging that additional indirect care specialties are emerging. The Essentials recognize specialty competencies as one component of graduate education, which prepares graduates for advanced nursing practice specialty competencies. The advanced nursing practice specialty competencies are delineated as additional competencies for the graduate-prepared, certified NPD specialist in Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016, 2022). Spirited discussions centered around the differentiation of the NPD-BC and NPDA-BC certifications. NPD-BC certification is obtained by passing an examination that assesses "entry-level clinical knowledge and skills of registered nurses in the nursing professional development specialty" (ANCC, n.d.). An NPD specialist is identified in the scope and standards as an NPD practitioner who holds a master's degree or higher and is certified in NPD (NPD-BC; Harper & Maloney, 2016, 2022). Conversely, advanced certification in NPD demonstrates application of NPD specialist competencies as delineated in the NPD scope and standards.
The final component of the Steering Task Force's activities included developing policies for the certification. Policies included definition, purpose, and rationale for the advanced certification; eligibility requirements; the certification method (portfolio-based); portfolio requirements; portfolio review process and scoring; and recertification requirements.
Eligibility Workgroup
The Eligibility Workgroup was charged with identifying and making recommendations to the Steering Task Force on eligibility requirements for the initial advanced certification. This group, which began meeting in late September 2019, initially examined other nursing specialties with basic and advanced certification. These specialties included oncology, hospice and palliative care, forensics, genetics, public health, diabetes, nurse executive, and HIV/AIDS. The group reviewed time in specialty practice, hours worked, and educational requirements. All the certifications required a master's degree except one, which has since updated their requirement to a master's degree as well. Practice requirements varied from 500 hours in 4 years to 2,000 hours in the last 5 years.
Nonnursing certifications were also reviewed. The workgroup considered several coaching certifications that did not specify an academic degree but required from 60 to over 200 hours of approved training and completion of a knowledge assessment. The Certified Healthcare Continuing Professional Development Professional certification, offered through the Alliance for Continuing Education in the Health Professions, was reviewed. This certification uses a point system and requires 8 points of formal or informal education but no specific academic degree.
The Eligibility Workgroup aligned requirements with the NPD scope and standards definition of an NPD specialist (Harper & Maloney, 2016), specifying a master's degree and NPD certification as eligibility criteria. They also aligned with the ANCC (n.d.) requirement of 4,000 practice hours for basic certification. (Note that the ANCC requirement has since been reduced to 2,000 hours.) A narrative description of advanced NPD practice was developed that emphasized leadership in the following:
* facilitating professional role development, including practice transitions;
* managing change;
* championing scientific inquiry;
* collaborative partnerships;
* advocating for the specialty as leader and mentor;
* analyzing issues, trends, and supporting data to determine the needs of individuals, organizations, and communities;
* synthesizing data to validate an identified gap in professional practice with the goal of closing the practice gap for individual or team; and
* facilitating professional role competence and growth resulting in organizational impact.
Pursuant to another review of similar certifications, the Eligibility Workgroup recommended criteria for certification renewal. These criteria were needed before initial implementation of the certification process to ensure applicants know the requirements for maintaining the advanced certification. Based on workgroup recommendations, the Steering Task Force approved the stipulation that ongoing basic certification was not a requirement for renewal of advanced certification in NPD. The Steering Task Force noted than an NPD specialist could have a variety of reasons to maintain both the basic and advanced certifications (e.g., employer requirements), and maintenance of both certifications should be an individual decision. As a result, continuing education, current employment in an NPDA-BC role, and 4,000 hours of NPD specialist practice in the past 5 years are required for renewal.
Portfolio Contents
Like the Eligibility Workgroup, the Portfolio Contents Workgroup met monthly and began by brainstorming portfolio contents. The team underwent an iterative process that included reviewing other portfolio-based certifications and discussing the NPD scope and standards, which differentiates the competencies of an NPD specialist from other NPD practitioners.
At first, developing the content expectations for a certification seemed daunting. One team leader researched and presented different methods used to show competence in portfolios such as exemplars, presentations, publications, and so forth. After several brainstorming meetings, the Portfolio Content Workgroup decided to ensure alignment with the NPD scope and standards (Harper & Maloney, 2016). The workgroup recommended that applicants address the six responsibilities (throughputs) from the NPD practice model, writing a narrative about how they demonstrated NPD specialist practice in onboarding/orientation, competency management, education, role development, collaborative partnerships, and inquiry. In addition, the team discerned an advanced certified NPD specialist must embody and fulfill each of the seven NPD roles: leader, mentor, change agent, learning facilitator, champion for scientific inquiry, partner for practice transitions, and advocate for the NPD specialty.
The discussions concerning fulfillment of all roles and responsibilities were challenging given the variety of practice environments and position descriptions affecting the work of NPD specialists. Thoughtful consideration was given to how the practice of an NPD specialist is influenced by numerous factors and can be narrow or broad in scope. For example, an NPD specialist's primary responsibility might be onboarding and orientation: How would this individual engage in each role and responsibility? The workgroup determined that even with this one primary job focus, an NPD specialist applies NPD specialist competencies by engaging in each of the other responsibilities-competency management, education, research/evidence-based practice/quality improvement, collaborative partnerships, and role development-while fulfilling this primary responsibility. Furthermore, the NPD specialist incorporates multiple roles through activities such as leading the orientation/onboarding program, championing scientific inquiry by using the latest evidence-based learner engagement methods, and partnering for practice transitions as learners move from one practice setting to another. The ability to fluidly move among roles and responsibilities was determined to be a hallmark of the expertise of an advanced certification applicant.
As this comprehensive idea progressed, the Portfolio Content Workgroup determined that writing six narrative exemplars might be burdensome to both applicants and reviewers and decided to recommend that applicants write a narrative for only three of the NPD responsibilities. The other three responsibilities could be briefly described in a table format. This table was developed with columns for the responsibility description; the specific standards met at the NPD specialist level, the roles demonstrated, and evidence-such as a manuscript, poster, presentation, or other examples of work-related to the responsibility.
The final requirement developed by the Portfolio Content Workgroup was demonstration of NPD specialist practice in alignment with each standard in the NPD scope and standards. Over the course of the three narrative exemplars and the three responsibilities submitted in table format, the applicant must demonstrate and clearly articulate how one or more NPD specialist competencies from each standard was fulfilled in practice. This requirement completed the comprehensive process of aligning with the NPD roles, responsibilities, and specialist competencies as defined in the scope and standards, positioning the NPD specialty for recognition as an advanced nursing practice specialty (AACN, 2021).
Portfolio Scoring
The Portfolio Scoring Workgroup began meeting approximately 6 months into the advanced certification development process after required contents of the portfolio were established. This group was tasked with creating a scoring methodology for portfolios. Initially, the group reviewed the ABSNC accreditation standards to ensure compliance. The CCI representative also provided guidance for the process by providing prototypes and indicating that the scoring method needed to be valid and reliable.
To begin development, the workgroup used the Nursing Professional Development Human Resources Toolkit, a resource that provides NPD position descriptions, competencies, and performance evaluations based on the NPD scope and standards (ANPD, 2020). The toolkit's performance evaluation, developed by the ANPD Products and Services Committee, delineated key performance criteria for each of the six NPD responsibilities. These criteria were categorized into "does not meet expectations," "meets expectations," and "exceeds expectations" and allowed the Portfolio Scoring Workgroup to identify both acceptable and unacceptable criteria for portfolio scoring.
From the Human Resources Toolkit, the workgroup developed expectations of performance for each NPD responsibility, along with a scoring rubric. At this point, approval was sought from the Steering Task Force. The CCI Executive Director attended the meeting and agreed to obtain feedback from ABSNC concerning use of scoring rubrics. The ABSNC psychometrician advised using a binary scoring mechanism-met or not met. This method was approved, and the Portfolio Scoring Workgroup revised the rubric to indicate met/not met.
The final task for the Portfolio Scoring Workgroup was to use the scoring tool developed to score actual portfolios. Using the exemplars and tables developed by the Application Resources Workgroup, the Portfolio Scoring Workgroup trialed and adjusted the scoring rubric based on feedback from the Application Resources Workgroup. This iterative process led to development of a template for exemplars that consisted of background, problem, goal, description of the intervention/activity, participants, and outcomes. Ultimately, a scoring rubric that yielded consistent results from different reviewers was developed. The group also recommended that advanced certification applicants have an opportunity to revise their submissions if they are not initially approved.
Application Resources
The Application Resources Workgroup was responsible to create portfolio exemplars for scoring by the Portfolio Scoring Workgroup. The work of these two groups occurred simultaneously and was iterative. Each adjusted their processes and products based on feedback from the other. This process was informative and at times frustrating as the Application Resources Workgroup rewrote exemplars several times to create an easily scored format. Decisions that were required included acceptable length of exemplars, amount of detail needed in the responsibility tables, and types of acceptable evidence for responsibilities presented in the tables. Application Resources Workgroup members soon discovered that individual decisions about which responsibilities to describe in exemplars and which to present in the table format was incredibly important and hinged on the type of evidence available. For example, an individual who conducted and published a research study might opt to use the table format for the inquiry responsibility because the evidence of a published manuscript is strong.
Lessons Learned
As the Steering Task Force's project neared completion, members reflected on the thought processes that led to the finished product. One key discussion centered on the definition of "advanced." Questions arose as to whether an NPD specialist achieves an expert level of practice through years of experience, positions held, engagement with the nursing specialty, or other factors. Although time is a principal factor in one's development, variations in settings and practice also facilitate or hinder role development. Ultimately, the group determined that application of NPD specialist competencies, as delineated in the scope and standards, demonstrates expert specialty practice.
To finalize the process, each Steering Task Force and workgroup member was invited to apply for advanced certification in NPD. Creation of individual portfolios enhanced understanding of the proposed processes and resulted in suggestions for improvement. According to one member, "Going through this process after being on the Steering Task Force opened my eyes to the importance of being able to not only demonstrate NPD specialist practice, but to articulate it in a clear, concise, and cohesive manner. I certainly learned a lot as I reflected on my own practice and realize that I have accomplished much in my career, yet I can certainly improve upon my abilities to articulate these accomplishments more fully."
Implementation of the Credential
Pursuant to the work of the ANPD volunteers, CCI assumed responsibility for the administration of the advanced certification in NPD. CCI recruited, selected, and trained reviewers. Steering Task Force and workgroup members submitted portfolios that were used for reviewer training and were awarded the NPDA-BC credential upon successful completion. The certification was officially launched in October 2021. CCI plans to update materials to align with the fourth edition of the NPD scope and standards, which was released in March, 2022. (Harper & Maloney, 2022; T. Kinlaw, personal communication, March 11, 2022). More information about advanced certification is available on the ANPD website (http://ANPD.org), including a link to the CCI website where the handbook is available, and applications can be submitted.
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