The Primary Care CPNP ® Exam

The Primary Care CPNP® Exam

2012 Role Delineation Study: What is it, and why do it?

The purpose of the role delineation study is to:validate the inventory of the tasks and

knowledge related to work performed by primary care pediatric nurse practitioners;

ensure that the tasks and knowledge statements identified were congruent with the objective of certifying entry-level primary care pediatric nurse practitioners; and,

develop test specifications for the Primary Care Pediatric Nurse Practitioner Examination.

The Primary Care CPNP® Exam2012 Role Delineation Study

A role delineation study is typically done through the use of a survey instrument to obtain descriptive information on demographics and role responsibilities every 3-5 years.

This periodic study is required of all nursing certification boards by their accrediting agency.

In order to develop a content outline for a certification examination, a role delineation study should identify tasks, knowledge, skills, or abilities deemed important to practice by pediatric nurse practitioners.

The Primary Care CPNP® Exam2012 Role Delineation Study

Outline of Changes to the Primary Care CPNP Exam

2012 Role Delineation Study: Steps Involved & Results “at a glance”...

Steps Involved... Over a period of several months, the following occurred:

Development of the survey instrument, with subject matter experts (SMEs) from around the country

Pilot testing of the instrument for clarity and comprehensiveness

Dissemination of the surveyAnalysis of survey dataDevelopment of test specifications and the updated

content outline from survey findings and input from the SMEs

The Primary Care CPNP Exam2012 Role Delineation Study

Results at a glance...A total of 1,435 responses were used for

analysis. The majority of respondents work in primary

care outpatient or subspecialty clinics and work with children of all ages.

The respondents responded to the following survey sections: Section 1: Background and General Information Section 2: Tasks (4 domains covering 108 task statements) Section 3: Knowledge (34 statements) Section 4: Recommendations for Test Content Section 5: Comments


2008 2012

Location of Practice Setting

• 45% practice in urban community settings• 41% practice in suburban settings• 12% in rural settings

• 44% practice in urban inner city settings• 44% practice in suburban settings• 12% practice in rural settings

Top Primary Practice Settings

• 36% primary care outpatient• 28% private practice• 16% specialty clinic• 8% hospital inpatient

• 48% primary care outpatient*• 24% specialty clinic• 9% hospital inpatient• 7% academic setting

The Primary Care CPNP ExamOver Time

* Includes private practice

Results at a glance...

Overall, 110 of 144 tasks and knowledge/skills, (76.39%) achieved high means for task and knowledge importance ratings, thereby validating their importance to competent performance for primary care pediatric nurse practitioners.



Because the 2008 content outline did not delineate types of procedures performed in primary care (under Management), this 2012 study sought validation on a list of 29 possible procedures. 9 specific procedures were added to the content

outline for exam content (see slide 21)the remaining 20 procedures did not meet

threshold and were not included



80 of 110 task statements achieved high importance ratings.The tasks that did not achieve high performance ratings

included: Tele-health assessment Procedures that are not being performed in primary care by the

majority of respondents (e.g. nail removal, pap smear, tooth varnishing)

Respondents indicated that the survey covered the important professional activities well to very well.



30 of 34 knowledge ratings achieved high importance ratings.The knowledge/skill rated borderline was:

Global healthThe knowledge/skills rated failing were:

Adoption, disaster preparedness, and palliative careRespondents indicated that the survey covered the

important professional activities well to very well.


2012 Role Delineation Study: How the new study impacted the exam...

Content Outline Changes from 2008 to 2012


The Primary Care CPNP ExamHow the new study impacted the exam...

2008 2012

Content Domains

• Health Promotion/ Prevention/Anticipatory Guidance • Assessment • Management • Professional Issues

• Health Promotion• Assessment and Diagnosis• Management• Professional Issues

Number of Items / Time Allotment

• 3 hours• 175 Exam Questions

(150 scored/25 pre-test items)

• 3 hours• 175 Exam Questions

(150 scored/25 pre-test items)

No Major

Change

No Change


2008 2012

Percentage of Items per

Content Domain

1. Health Promotion/Prevention/ Anticipatory Guidance – 23%

2. Assessment – 35%3. Management - 35%4. Professional Issues – 6%

1. Health Promotion – 30%2. Assessment & Diagnosis – 35%3. Management – 30%4. Professional Role – 5%

Number of Tasks per

Content Domain

1. Health Promotion/Prevention/ Anticipatory Guidance – 19

2. Assessment – 153. Management – 21 4. Professional Issues – 20

Total = 75

1. Health Promotion – 202. Assessment & Diagnosis – 213. Management – 304. Professional Role – 15

Total = 86


2008 2012

Prioritization of Clinical Problems

1. Respiratory 2. EENT 3. Gastrointestinal 4. Behavioral/Psychological

Problems 5. Dermatology 6. Musculoskeletal 7. Allergy 8. Nutrition 9. Neurology10. Cardiovascular 11. Hematology 12. Endocrinology 13. Oncology 14. Immunology/Rheumatology 15. Environmental Health

1. Eyes/Ears/Nose/Throat2. Respiratory3. Gastrointestinal 4. Dermatology5. Behavioral/Psychological6. Nutrition7. Allergy8. Musculoskeletal 9. Genitourinary10. Cardiovascular11. Neurology12. Endocrinology13. Hematology14. Pain15. Environmental Health16. Oncology17. Genetics18. Immunology/Rheumatology

Summary of Changes...

Majority of content areas from 2008 Role Delineation research continue to be valid Restated for clarity

Categories of Assessment and Diagnosis clearly outlined

Clinical problems to be represented on new exam forms by volume in ranking order No longer by specific number of items



Under Health Promotion:o Added to the Content Outline:

• “Counsel… about growth and development for [all age groups].”

• “Counsel… regarding age appropriate response to death, dying, and loss.”

• “Counsel about age appropriate transition to adult care.”

• “Counsel about young adult concerns (homelessness, college and vocational concerns).”

The CPNP Exam2012 Role Delineation Study


Under Health Promotion: Deleted from the Content Outline:

“Discuss with prospective parents issues of family preparation.”

Clarified / Condensed within the Content Outline: “Counsel about …injury prevention and safety for

[specific topics].” Moved from Professional Issues to Health Promotion:

“Educate the community regarding pediatric health and wellness.”



Under Assessment and Diagnosis:o Added to the Content Outline:

• “Perform developmental screening with standardized assessment tools.”

• “Perform behavioral and mental health screening.”• “Assess barriers to adherence to therapeutic

regimen.”• Subcategory of “analyzing information”:

• “Integrate evidence based practice and individual findings in the plan of care.”



Under Assessment and Diagnosis:• Clarified within the Content Outline:

• “Order and interpret office/clinic based screening tests.”

• Moved from Management to Assessment and Diagnosis:• “Perform telephone triage.”



Under Management:• Added to the Content Outline, a specific list of

procedures:• Audiometry• Cerumen removal• Fluorescein staining• Incision and drainage• Rapid tests


• Reduction of nursemaid’s elbow

• Removal of foreign body• Removal of sutures and

staples• Visual acuity


Under Management:• Deleted from the Content Outline:

• “Participate in emergency preparedness.”• Clarified / Condensed within the Content Outline:

• Subcategory of Counseling and Education• Expanded / Delineated within the Content Outline:

• Collaboration and Case Management (now two separate subcategories):1. Collaboration and Referral2. Case Management



Under Professional Issues: Added / Reorganized within the Domain:

4 distinct subcategories:1. Leadership and Professional Development2. Research3. Business Management4. Legal and Ethical Issues

Deleted within the Content Outline: “Promote palliative care principles to ensure patient

dignity.” “Precept or mentor students or others.”


2012 Role Delineation Study: Additional Information


Q: When does the updated exam launch?A: The new exam is expected to launch April 22,2013.

Q: Is there any advantage in taking one version of the exam over the other?A: No, both will equally assess your knowledge.

Q: Do I need to study differently if I choose to take the new exam?A: No, any preparations you undertake will benefit you

regardless of which exam version you take. The reference list remains the same because the tasks listed on the new outline have not changed significantly from the older one.

The Primary Care CPNP® ExamQuestions others are asking...

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The Primary Care CPNP ® Exam

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