467chapter TWENTY-ONE
The DNP Certifi cation Examination:
Yes? No? You Decide
Bobbie Posmontier and Sandra N. Cayo
In August 2000, Mary Mundinger, who was both president of the Council for the
Advancement of Comprehensive Care (CACC) and dean of Columbia University
School of Nursing invited educational leaders in nursing and medicine to discuss the
future role and preparation of advanced practice registered nurses (APRNs; National
Board of Medical Examiners [NBME], 2009). The work of this first conference resulted
in suggesting the Doctor of Nursing Practice (DNP) degree as the entry- level degree for
the APRN and set the stage for the eventual development of a DNP certification exami-
nation by the joint efforts of the NBME and the CACC (Mundinger, 2008a). Since the
administration of the first DNP certification examination in 2008, however, a storm of
controversy has ensued regarding its value (Mundinger, 2008b). In order to understand
the controversy, this chapter reviews its major components and explore the arguments
for and against the DNP certification examination.
■ WHAT IS THE DNP EXAMINATION?
The NBME and CACC proposed a voluntary two- tiered examination to assess clinical
knowledge, diagnostic skills, and independent clinical management of patients across
the lifespan in a variety of health care settings in order to validate advanced DNP clini-
cal competencies (American Board of Comprehensive Care [ABCC], 2009). The purpose
of this voluntary examination was to provide an extra level of standardized assurance of
safety and competency to the public and other medical professions (NBME, 2009). Once
the examination was passed, the ABCC would then designate the DNP as a diplomate in
comprehensive care (DCC) by the ABCC and permit use of the title “doctor” in clinical
practice (Landro, 2008; Mundinger, 2009).
The examination consists of questions that evaluate the diplomate candidate’s
ability to assess the severity of disease, make clinical judgments, and manage patient-
centered mainstream high- impact diseases (ABCC, 2009). Although the examination
was mainly designed to test the advanced clinical skills of adult and family nurse
practitioners with a DNP, other APRNs with a clinically focused DNP degree were