An overview of global CME/CPD systems.

PURPOSE: Engagement in CME/CPD has a positive impact on healthcare professionals' (HCPs) knowledge, skills, and performance, and on patient outcomes, therefore it is critical to better understand the components of CME/CPD systems that foster engagement, high-quality education, and impact. METHODS: An assessment of CME/CPD systems was conducted using a mixed-methods approach that included interviews with in-country subject matter experts and qualitative and quantitative data from practicing in-country physicians. RESULTS: Results demonstrate areas of consistency in CME/CPD systems across world regions that included: types of educational providers; types of credit; educational formats; self-tracking of participation; high-degree of compliance when education is mandatory; overall satisfaction with available education; strong support for interprofessional education; and lack of alignment or evaluation of engagement in education with population health outcomes. Areas of variation included: whether engagement in education is required as a condition to practice medicine; whether regulations are uniformly applied; if mechanisms to ensure independence existed; and physician perceptions of independence. CONCLUSION: Results of this assessment maybe used by a variety of different stakeholders to assess how well country-level CME/CPD systems are meeting the needs of practicing physicians and determine what, if any, changes might need to be implemented to improve outcomes.

An Overview of Continuing Medical Education/Continuing Professional Development Systems in China: A Mixed Methods Assessment.

Aims of this assessment were to describe requirements for physicians to engage in CME/CPD; explore perceptions of In-Country SMEs of their CME/CPD systems; describe perceptions of In-Country physicians about interprofessional continuing education (IPCE) and independent CME/CPD; and provide recommendations that may be adopted to improve quality and effectiveness. This assessment used a mixed-methods approach that included 1:1 interviews with in-country subject matter experts and an electronic survey capturing qualitative and quantitative data from practicing in-country physicians. This assessment reflects a country invested in the education of its physician workforce. CME/CPD systems have embedded governance structures, organizations authorized to provide education, and a recognized credit system. Governing bodies have implemented regulations to limit influence from commercial interest organizations on CME/CPD, and there is opportunity to expand delivery systems to reach physicians across diverse geographic regions, better align content to individual physicians' gaps and learning needs, and reduce cost. There is opportunity to invest in IPCE within a country with a strong professional hierarchy system. This assessment reflects CME/CPD systems that are relatively mature and identifies several opportunities to expand and enhance systems to better meet educational needs of physicians and to positively impact practice and patient outcomes.

Nurse Practitioner Certification Examination Development: From Reflecting Clinical Practice to Ensuring Lifelong Learning.

OBJECTIVE: Certifications in psychiatric-mental health nursing promote safe practice by psychiatric-mental health nurse practitioners (PMHNPs) and nurses (PMHNs) and help protect the public from harm. This protection begins with the development of an examination that meets rigorous national education, practice, and accreditation standards and reflects PMHNPs' or PMHNs' clinical practice. Achievement and maintenance of a certification is a journey that involves a commitment to lifelong learning and the improvement of the field of psychiatric-mental health nursing through involvement in the examination process. METHODS: This discussion paper outlines the role nurses can play in the development of certification examinations. It describes the process of developing an effective certification examination, including the role of standards, accrediting bodies, and content experts; determining necessary tasks, knowledge, and skills; surveying practitioners to validate information; writing test questions; and ongoing analysis of examination content. The Psychiatric-Mental Health Nurse Practitioner (across the lifespan) Certification (PMHNP-BC) is presented as an example of the process. RESULTS: This discussion paper raises awareness of how certification exams are developed, PMHNPs participate in certification development, and volunteering promotes career development. CONCLUSION: The PMHNP-BC examination is based on education, practice, and certification accreditation standards and reflects current clinical practice. PMHNPs can (a) point to the rigor of certification as an indication of the quality of care they deliver, (b) volunteer to participate in the examination process to ensure examination rigor, and (c) advance their careers through the development and application of a valuable skill set.

Credentialing and certification: Overview, science, and impact on policy, regulation, and practice.

AIM: To engage the global nursing community in sharing knowledge, experiences, and lessons learned about credentialing of individual nurses to improve nursing practice, patient safety, and quality of care. BACKGROUND: Although the United States has a long and robust history of credentialing individual nurses, the opportunity exists to expand the dialogue globally, and is supported by globally focused governing bodies who call for increased or expanded investment in nursing certification and credentialing. Foundational work to define and operationalize certification for research purposes and develop an administrative home for stakeholders interested in certification can be leveraged by countries and regions globally. Existing frameworks for credentialing research may be used to drive theory-based research in the future. SOURCES OF EVIDENCE: PubMed, International Council of Nurses, National Academies of Sciences, Engineering, and Medicine, World Health Organization, American Nurses Association, American Nurses Credentialing Center, and the authors' own experiences. DISCUSSION: Credentialing as a form of self-governance, as a method for public protection, and as a foundational element in the increasingly new forms of healthcare delivery is intensifying in importance. Credentials provide an opportunity to evaluate relationships between key elements such as nursing practice, environments where nursing care is delivered, and nursing programs with outcomes of interest for the profession such as safety, quality of care, and patient outcomes. CONCLUSIONS: Establishing rigorous credentials for nurses demonstrates a commitment to excellence. Credentialing frameworks that are universally applied could enable nurses to move seamlessly across geographic boundaries, permit regulators and employers of nurses to have a common set of standards and expectations, and ensure a level of competency for nursing practice that can be interpreted and trusted by various stakeholders. IMPLICATIONS FOR NURSING POLICY: Policymakers have a pivotal role in advancing credentialing in nursing worldwide. Countries developing credentialing programs in nursing need to study their results to help inform how practice might be required to change over time.

The Importance of Board Certification.

The investment to support and obtain board certification demonstrates a nurse leader's commitment to their staff, the organization, and the communities they serve. It is important for nurse leaders to appreciate how organizational support of board certification can positively impact patient care and to be advocates for funding to support board certification for their staff. This month's Magnet® Perspectives column discusses the empirical evidence, as well as the professional value of certification.

Definitions of Physician Certification Used in the North American Literature: A Scoping Review.

INTRODUCTION: The authors sought to identify how physician specialty certification is defined in the North American literature. METHODS: A rigorous, established six-stage scoping review framework was used to identify the North American certification literature published between January 2006 and May 2016 relating to physician specialty certification. Data were abstracted using a charting form developed by the study team. Quantitative summary data and qualitative thematic analysis of the purpose of certification were derived from the extracted data. RESULTS: A two stage screening process identified 88 articles that met predefined criteria. Only 14 of the 88 articles (16%) contained a referenced purpose of certification. Eighteen definitions were identified from these articles. Definitional concepts included lifelong learning and continuous professional development, assessment of competence and performance, performance improvement, public accountability, and professional standing. DISCUSSION: Most articles identified in this scoping review did not define certification or describe its purpose or intent. Future studies should provide a definition of certification to further scholarly examination of its intent and effects and inform its further evolution.

Methods of nursing certification in North America-A scoping review.

BACKGROUND: Definitions of nursing certification are lacking in the research literature and research on certification in nursing is remarkably limited. METHODS: A six-stage scoping review framework was used to identify the nature, extent, and range of certification within the nursing literature. FINDINGS: Thirty-six articles were included in this scoping review. Most originated in the United States (89%), were classified as research articles (56%), and used a quantitative approach (90%). The majority focused on initial certification (50%), and written examination was the most prevalent approach to certification (39%). Missing and incomplete data were prevalent. DISCUSSION: The overall lack of nursing certification origin, focus, methodological rigor, and clear certification mastery criteria have hindered meaningful study of the relationship between nursing certification and patient outcomes. Common data elements, reporting standards, and observational studies linking common data elements and patient outcomes could guide future research and improve the transparency of certification processes and reporting.

A Collaboration Between Government and the Continuing Education Community Tackles the Opioid Crisis: Lessons Learned and Future Opportunities.

In 2016, 116 people died each day from opioid-related drug overdoses and in 2017, the Department of Health and Human Services declared the opioid crisis a public health emergency. During the preceding years, the continuing education (CE) accreditors in the health professions identified a need for a strategic, coordinated effort that would involve an interprofessional coalition of multiple stakeholders to respond to this emerging public health challenge. The Conjoint Committee on Continuing Education, a national coalition of organizations in the professions of medicine, nursing, dentistry, pharmacy, and physician assistants, stepped up to assume a leadership position. To address the scope of safety issues involved in opioids, the US Food and Drug Administration required that extended-release and long-acting opioid analgesic product manufacturers make training available to prescribers of their products and recommended that the training should be conducted by accredited, independent CE providers. CE accreditors in the health professions initiated an unprecedented collaboration that leveraged the accredited CE community to deliver prescriber education as part of the Food and Drug Administration Opioid Analgesics Risk Evaluation and Mitigation Strategy. This article describes the history of this interprofessional collaboration including lessons learned and opportunities for future collaboration to address public health issues.

Constructing a Sensitizing Definition of Certification in Nursing for Research Purposes: A Hybrid Methodology Using Consensus-Building Approach.

OBJECTIVE: The aim of this study was to construct a sensitizing definition of certification in nursing for research purposes that can provide a foundation from which to further develop a coherent research program building evidence about the impact of certification on healthcare outcomes. BACKGROUND: The lack of a single definition of certification in nursing makes it difficult to draw conclusions about the relationship between specialty certification and patient outcomes. METHODS: This study was guided by the Delphi-Chaffee hybrid methodology proposed by Grant et al. DISCUSSION: Constructing a single, sensitizing definition of certification: 1) provides coherency for direction of certification research; 2) serves as a guide for researchers; and 3) facilitates multimethodological approaches to exploring the relationship among the different components of the definition of certification. CONCLUSION: A sensitizing definition of certification provides an opportunity for researchers to study the relationship between nursing certification and patient outcomes.

A conceptual framework for planning and assessing learning in continuing education activities designed for clinicians in one profession and/or clinical teams.

PURPOSE: The purpose of this article is to provide a more actionable description of the components of the outcomes framework published in 2009. METHODS: Synthesis of recent research in the learning sciences. RESULTS: The authors propose a conceptual framework to be used planning learning activities and assessing learning in CPD. CONCLUSIONS: CPD practitioners will have a more explicit approach to help clinicians provide the very best care to their patients.

An interactive faculty development workshop designed to improve knowledge, skills (competence), attitudes, and practice in interprofessional continuing education.

PURPOSE: Interprofessional continuing education (IPCE) health care educators must plan activities as members of interprofessional teams and deliver activities to an interprofessional audience. Evidence in the literature suggests they are not well prepared to meet this challenge. This paper reviews one strategy to improve the knowledge, skills, attitudes, and practices of IPCE educators. METHODS: Seven faculty development workshops were conducted within the USA, Europe, Asia, and the Middle East. Approximately 250 learners participated in the workshops in total, with 107 in an IRB-approved research study. RESULTS: From the research cohorts demonstrated improved knowledge and skills over a 12-month period. Knowledge and skills scores increased most significantly from baseline to 3 months and remained above baseline at 6-12 months. The workshop was not an effective strategy to improve attitudes towards IPCE, though attitude scores were already high prior to participating. CONCLUSIONS: All participants actively engaged in the workshops. There were no observed differences in engagement by geographic region, gender, age, or profession. Participants stated they were better able to understand the roles of other team members; perspectives of patients, families, and caregivers; and their own roles on clinical teams. Participants described gaining a new appreciation for the complexity of designing IPCE.

Conceptualization and Operationalization of Certification in the US and Canadian Nursing Literature.

OBJECTIVE: To identify how certification is defined, conceptualized, and discussed in the nursing literature. BACKGROUND: Although it is hypothesized that credentialing is associated with better patient outcomes, the evidence is relatively limited. Some authors have suggested that the lack of consistency used to define certification in nursing literature may be one of the dominant obstacles in credentialing research. METHODS: This scoping review was guided by Arksey and O'Malley's framework, and quantitative and qualitative analyses were conducted. RESULTS: The final data set contained a total of 36 articles, of which 14 articles provided a referenced definition of certification. Thematic analysis of the definitions yielded 8 dominant themes. CONCLUSION: The lack of a common definition of certification in nursing must be addressed to advance research into the relationship between certification processes in nursing and healthcare outcomes.

Using the Magnet® Criteria to Document New Graduate Nurses' Transition to Practice.

Nursing professional development practitioners are partners in practice transitions for new graduate nurses. Organizations seeking Magnet® designation need to demonstrate how new graduate nurses transition in the written documentation submitted to the American Nurses Credentialing Center. This article explores current strategies used by Magnet®-designated organizations and connects the strategies to the six new elements of the new 2019 Magnet® criterion, Structural Empowerment 9.

The Relationship Between Specialty Certification of Individual Nurses and Outcomes: Developing a Standardized Taxonomy for Research.

Specialty certification is an important method to demonstrate that RNs possess advanced training, knowledge, and competencies required to provide safe, high-quality care for specific populations.