On January 13 of this year, I took the Informatics Nurse Certification examination, which is sponsored by the American Nurses Credentialing Center (ANCC). I want to describe this experience in enough detail (or lack of!) to encourage many of you to follow suit.

The specialty of Nursing Informatics has great appeal to me. It fits my personal and professional styles and excites me like nothing previously in my career. I have been fortunate enough to obtain job opportunities in the field, and my involvement with the Midwest Alliance for Nursing Informatics (MANI) has convinced me further that this is where I belong. Thus, my motivation to take the exam came from a desire to continue practicing in the field, to force myself to do some reading and studying that had been neglected, and to demonstrate to myself and others that I do indeed have a right to call myself an informatics nurse. So...the adventure began.

The first step was to obtain the Informatics Nurse Certification Catalog from the ANCC, which I did by calling their 800 number. After reviewing the packet, I completed the application form and attached the required documents. Evidence of eligibility was provided by attaching copies of continuing education unit certificates from informatics-related programs that I had either attended or presented within the last 2 years. Additionally, certificates of attendance were included for educational programs attended during MANI meetings, which, it appears, were accepted. A copy of the college transcript for my beccalaureate degree in nursing also was attached. My VISA payment was processed promptly, although I did not receive the "Notice of Receipt of Application" and "Data Correction Form" for several months.

Approximately 6 weeks after the first notice, the Candidate Handbook and Reference Materials arrived. This booklet included information on how to schedule the examination, instructions for the day of the test, a description of the scoring and reporting process, and a practice test (which I found to be easier than the real thing). A detailed test content outline also was included, which is designed to help in exam preparation. After ANCC reviewed my application, I received a PROCTOR enrollment confirmation form. That is when I began to get very nervous...

Scheduling the exam is easy. Any PROCTOR testing site may be called to schedule an appointment, and this must be done within 90 days of your confirmation. The enrollment form assigns an ANCC identification number as well as the name of the exam (Exam 27-ANCC Informatics Nurse). This information, along with a daytime telephone number, is requested when scheduling the exam. I made my appointment for a Saturday at the Vernon Hills, Illinois site, and found the scheduler there to be helpful and extremely cordial.

Along with the enrollment confirmation, I received a hard copy of a tutorial on the Informatics Nurse Certification Examination. This tutorial describes the screen layout and flow of the exam, which is the first computerized exam for the ANCC. We should feel honored that we were deemed to be the best group to find any bugs or glitches in the program! The screens are designed for a Windows environment, and are fairly easy to read and understand. The mouse or keyboard may be used to select letters A, B, C, or D to answer the multiple choice questions. Some testing sites also have touch-screen capability. The examinee may flag an answered question for review, skip a question, page backward to the previous question, or page forward to the next question. Previously answered, skipped, or flagged questions may be reviewed at any point, or you can choose to quit and run. The tutorial accurately describes the format, and receiving the hard copy ahead of time allows it to be reviewed at home in a relaxed atmosphere. The tutorial also may be reviewed on-line before beginning the exam, and the time spent doing so does not count against the total exam completion time.

I prepared for the exam by gathering, reading, and reviewing as many resources as possible related to the test content outline included in the Candidate Handbook. This outline identifies the content areas that are included in the examination along with the percentages and numbers of items in each category. Additionally, a detailed outline is provided, which breaks down each category into sub-categories. Looking back, I should have paid closer attention to this outline, because it accurately reflects the test content. It is a useful guide for concentrating on areas of weakness.

I would highly recommend reading and studying the following American Nurses Association (ANA) publications:

* The Scope of Practice for Nursing Informatics1;

* Standards of Practice for Nursing Informatics2;

* Next-Generation Nursing Information Systems3;

* Computers in Nursing Management4; and

* Computer Design Criteria for Systems that Support the Nursing Process.5

It would also be helpful to read or review a basic computer text, which includes content on computer technology, as well as a basic Nursing Informatics text. I spent a total of 18 hours reading and reviewing the aforementioned publications, as well as some additional articles on Nursing Intervention and Outcome Classification Systems. Because it is my preference to study independently, this approach worked well; however, several other MANI members formed a study group that they found helpful. Additionally, you may benefit from attending one of several review courses being planned by informatics-related groups throughout the country this year.

The day finally arrived, and I was eager to get on with it. I arrived early, and even though my scheduled appointment was not until more than an hour later, I ventured inside the center to make sure this was indeed the right place. I was greeted warmly, and offered the opportunity to begin the exam immediately since there was an empty carrel available. After a quick cup of coffee, I proceeded into the testing area. The proctor asked for two pieces of identification (one photo ID is required), and explained the testing process. A soundproof glass wall separated the proctor's desk area from the testing room. Once in the testing room, I was lead to an available carrel which included a personal computer, keyboard, and mouse. The equipment did not have touch screen capability, so I was instructed to use the mouse to make selections. Dividers between each carrel provided privacy for each examinee and the room was extremely quiet, even though it contained eight or ten people. The main distraction was a slight flicker of the screen, which made my eyes fatigue very quickly. I reviewed the tutorial again, and proceeded with the exam.

A maximum of 31/2 hours is available for completing the exam, which consists of 175 questions. Twenty-five of these questions are not scored since they are being pretested for use in a future exam. I found myself hoping each question I struggled with was one of those twenty-five! It was sometimes difficult to relate terms used on the exam to similar terms used in my own practice. This was primarily a problem with regard to questions from the area of Professional Practice/Trends and Issues. For this reason I would recommend studying the ANA publications listed above. The exam is deemed to be "practicebased," and while I found this to be true, each of us brings a different experience from our practice. Coming from an education and training background, questions related to that topic seemed easy. However, questions about system selection were more challenging, because I have less experience with that process. As described in the test content outline, nearly 50% of the exam is dedicated to system analysis, design, implementation, support, testing, and evaluation. One would benefit from being able to identify which tasks are performed in which phase of this systems life cycle.

A word of caution: during the exam I flagged a total of 17 answered questions for later review. When attempting to review I was asked if I watned to review all of the test questions, only those I had flagged, or the four unanswered ones. This made me quite nervous, since I had not intentionally skipped any questions. I commented on this in the feedback questionnaire, which is available after completing the exam. Be sure to review before quitting, so that no question is missed accidentally. A clock appears in the upper right hand corner of the screen, which tracks the amount of time remaining; however, it can be hidden if it is a distraction. I was finished, including my review of flagged questions and the post exam questionnaire, in 21/2 hours. I let out a big sigh of relief when I clicked on QUIT, and left feeling confident. Later, as I looked up some of the items I was unsure of, my confidence began to fade. This was reminiscent of my feelings after taking state board exams. However, that experience ended on a positive note. This one did, too, when I learned in mid-March that I had passed the exam.

Now, you know about the process, you know how to prepare, and you know that at least one other person survived it, therefore you have nothing left to do but go for it!

References