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The value of orthopaedic certification is measured and described in different ways by various stakeholders. Biel (2007) described primary stakeholders as members of the profession, with secondary stakeholders to include the public and other healthcare professionals. Certification is defined by the American Board of Nursing Specialties (ABNS, 2009) as "the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal patient care." As part of the 2011 strategic plan, the Orthopaedic Nurses Certification Board (ONCB) plans to examine the evidence surrounding the value of orthopaedic certification and tailor messages to targeted audiences.
In 2003, the ABNS Research Committee performed a national study designed to validate nurses' perceptions, values, and behaviors related to certification. Using the 18-item Perceived Value of Certification Tool (Competency and Credentialing Institute, 2011), the study classified perceived certification value statements into two rewards: intrinsic (internal motivators) and extrinsic (defined by others). High agreement of the value statements was seen intrinsically related to personal accomplishment and satisfaction and professional challenge and commitment. Less agreement was seen with the extrinsic factors: recognition from peers, other professionals, and employers, and consumer confidence (ABNS, 2006). Of note, the ONCB was a participating organization in the ABNS study.
In 2010, the ONCB partnered with Cynthia Allen, MA, of SeaCrest Consulting during the Annual NAON Congress (Seattle, WA) to facilitate a focus group. The goal was to gather additional, ONCB-specific information to help prioritize and structure strategic initiatives. A survey was provided prior to the session. Eleven orthopaedic-certified nurses provided additional feedback to a series of questions. Several trends emerged that are consistent with the research highlighted earlier from other nursing specialties regarding the value of certification. Ms. Allen provided the following summary to the ONCB (C. Allen, personal communication, June 15, 2010):
* Orthopaedic nurses seek certification to fulfill intrinsic rewards, such as personal achievement, professional challenge, and validation of their knowledge. They also believe that certification builds their credibility with other healthcare professionals.
* Orthopaedic nurse certified (ONC) nurses approach nursing as a "profession" versus a "job."
* Organizations certifying nurses in a specialty are challenged by a new generation of nurses who may not be as willing to commit to a specialty early in their careers before having the opportunity to work in other practice areas.
* Orthopaedic certification fills in knowledge gaps and promotes a more holistic approach to a nurse's knowledge.
* Orthopaedic certification is valuable to the hospital, but employers need more persuasive information to convince them to support certification and remove the most obvious barrier-cost.
Feedback from surveys of examinees following ONC examinations provides additional support of these value propositions. Although results are anecdotal, it appears that the value of orthopaedic certification is largely intrinsic. Orthopaedic nurses seek the ONC credential as a measure of personal pride, recognition, accomplishment, and achievement. The ONC credential is used to demonstrate a commitment to practice excellence and lifelong learning as well as a standard for career advancement.
More information and efforts should be aimed at communicating the value of orthopaedic certification to secondary stakeholders. How can we ensure that the ONC credential generates peer, employer, and other healthcare professional recognition? Can we somehow increase consumer awareness and improve confidence? Will patient satisfaction help remove barriers to certification? Incidentally, the ABNS study identified barriers that included cost of examination, lack of institutional reward and support, and access to preparation courses and materials (ABNS, 2006).
The ONCB is determined to strengthen the value of orthopaedic certification and will continue to address both intrinsic and extrinsic factors. As a specialty certification board, we have supported the ABNS research agenda with the ongoing review of National Database of Nursing Quality Indicators (NDNQI) data and potential outcomes related to certified nurses. The ONCB continues to offer reduced fees to NAON members and is investigating institutional discounts. The ONCB is thankful for your continued participation in our surveys and acknowledges the members of our various focus groups. We place high value on orthopaedic certification and welcome ideas and comments to improve stakeholder communication. Please visit the ONCB Web site (http://www.onb.org) for any certification information.
American Board of Nursing Specialties. (2009). Frequently asked questions. Retrieved January 23, 2010, from http://www.nursingcertification.org/questions.html#1[Context Link]
American Board of Nursing Specialties. (2006). Specialty nursing certification: Nurses' perceptions, values and behavior. Retrieved January 23, 2010, from http://www.nursingcertification.org/research-study.html[Context Link]
Biel M. (2007). Infusion nursing certification: Identification of stakeholders and demonstration of the value of certification. Journal of Infusion Nursing, 30(6), 332-338. [Context Link]
Competency and Credentialing Institute. (2011) Value of certification. Retrieved January 23, 2010, from http://www.cc-institute.org/research_value.aspx[Context Link]
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