The Dermatology Nurse Practitioner Certification examination was established in 2008. Since then, nearly 250 nurse practitioners (NPs) from across the nation have achieved Dermatology Certified Nurse Practitioner (DCNP) status. The purpose of the examination is to ensure the provider has sufficient qualifications to provide safe, appropriate, effective care to the dermatology patient. This certification establishes a standard that ensures confidence for patients, employers, and providers in the assessment, diagnosis, and treatment provided by the DCNP. Certification is valid for a period of 3 years. Recertification may be attained through contact hours of continuing education credit or by examination.
In 2016, the Dermatology Nurse Practitioner Certification Board began work to review the examination and to update it as appropriate to reflect current dermatology practice. The Center for Nursing Education and Testing was engaged to organize and manage the process. The goal was to develop a practice analysis survey tool to validate current items or to provide information to revise the test specifications (blueprint) for the DCNP examination based on current dermatology NP practice.
A Practice Analysis Task Force was established to undertake the project. DCNP representatives from the Dermatology Nurse Practitioner Certification Board, the Dermatology Nurses' Association, and the American Association of Nurse Practitioners' Specialty Practice Group were selected based on geographical distribution and diversity of practice settings and subspecialties. The initial meeting of the Task Force was in Dallas, TX, from November 19 to 20, 2016. The Task Force members first reviewed the previous Practice Analysis findings and process that provided the foundation for the initial examination. They performed a detailed review of the dermatology NP core competencies, which were developed the previous year by the Dermatology Nurse Practitioner Coalition, composed of the three previously mentioned organizations.
This information was then used to develop the new Practice Analysis. This document was distributed via email to all DCNPs and to all members of the Nurse Practitioner Society of the Dermatology Nurses' Association. In addition, a link was provided on the American Association of Nurse Practitioners' Dermatology Specialty Practice Group forum. The Practice Analysis included demographic data to be collected from dermatology NPs. This gathered data regarding academic preparation, years in practice, geographic distribution, and age groups of patients seen. It asked the participant to rank a detailed list of 57 NP activities he or she performs (assess, diagnose, treat, educate, professional activities).
The Practice Analysis also asked the participant to quantify the frequency with which he or she sees patients with certain dermatology patient problems, namely, neoplasms, adnexal disease, papulosquamous and eczematous dermatoses, and so forth. Finally, it asked the participant to qualify the procedures and therapies that he or she performs or prescribes, for example, patch testing, photodynamic therapy, and cutaneous excisions.
The Task Force next met in Charlotte, NC, on July 21, 2018, to review and analyze the data obtained from the 167 Practice Analysis respondents from 41 states. Demographic information identified 19% with doctoral degrees in nursing, 79% with master's degrees in nursing, and nearly 50% holding dermatology NP certification.
The 57 activity statements were then reviewed and analyzed by rank order of NP activities performed. The NP activities most frequently performed by dermatology NPs include performing skin examinations, developing differential diagnoses, prescribing medical treatments, establishing a relationship with the patient, and educating the patient regarding prescribed treatments. The Task Force then designated which of the following categories each of these activities fell under: assessment and diagnosis, evidence-based treatment, therapies and procedures, education regarding prevention and management, and consultation.
The Task Force then assessed the knowledge, skills, and ability statements specific to dermatology. The respondents ranked how important each knowledge, skill, or ability statement was to their successful performance as a dermatology NP by determining if the statement was essential, important, useful, or irrelevant to current practice. The highest ranked dermatology-specific knowledge, skills, and ability statements were anatomy and physiology of the skin, dermatological assessment skills, physical assessment skills, normal/abnormal laboratory findings, and communication skills.
A rigorous line item analysis of the dermatology patient problems was then performed to ensure that the blueprint revisions would reflect the current practice environment. It was determined that roughly a dozen of the 110 dermatology diagnoses that figured on the previous examination were seen too infrequently to include on the revised version. The remaining items were reclassified into larger diagnostic categories to simplify examination preparation. The revised categories include neoplasms; papulosquamous and eczematous dermatoses; adnexal disease; urticarias, erythemas, purpuras, and photosensitivity; infections, infestations, bites, and stings; vesiculobullous, autoimmune and connective tissue disease; and genodermatoses, systemic, neutrophilic, and granulomatous diseases.
The data obtained from the Practice Analysis respondents that were analyzed and assessed by the Task Force ensures the validity of the revised DCNP examination. In turn, it provides a detailed blueprint that gives DCNP examination item writers a foundation to ensure that the upcoming revised examination reflects current dermatology NP practice by relating directly to the Practice Analysis.
Victoria Lazareth, MA, MSN, NP-C, DCNP