479chapter TWENTY-ONE
Refl ective Response 2
Geraldine M. Budd
The American Board of Comprehensive Care’s (ABCC) Doctor of Nursing Practice
(DNP) generalist certification examination has existed for 8 years and was accredited
by the National Commission of Certifying Agencies in 2011 (Carter and Moore, 2015).
In the time the examination has been available, the trend is that less graduates take
the examination each year (American Board of Comprehensive Care, 2016). It is likely
that this will continue and the DNP generalist examination will not gain acceptance or
prominence for nurse practitioners (NPs). Several factors contribute to this perspective
including that the DNP examination (a) neglects the nursing leadership consensus of
the advanced practice registered Nurses (APRN population specialties, (b) negates the
core nursing beliefs, and (c) is not accepted by either individual state board of nursing
or the national council of state boards of nursing. Each is discussed subsequently.
Shortly after the development of the DNP generalist certification examination, the
NP profession transitioned to a paradigm that precludes the inclusion of a generalist
comprehensive NP certification. Driven by the 2008 Consensus Model for Advanced Practice
Registered Nurses (APRN): Licensure, Accreditation, Certification and Education (American
Nurses Association [ANA], 2008), NP licensure, education, and certification now
encompass the population foci of family (across the life span); adult- gerontology; wom-
en’s health; and pediatric, neonatal, or psychiatric population focus. Adult- gerontology
or pediatrics NPs are further clarified as acute care or primary care. Although all types
of NPs are needed, educational preparation has been divided depending on the role,
population, and specialization.
The motivation for the Consensus Model for APRNs (2008) was inconsistencies in
NP education, certification, and regulation. The Consensus Model was developed with
input from more than 60 nursing organizations and on publication it was immediately
endorsed by 48 nursing organizations (Stanley, 2012). As this book nears publication,
the NP state boards, accreditors, certifiers, and professional organizations are closing
in on integrating all the major elements of the Consensus Model (Cahill, Alexander, &
Gross, 2014). Thus, state boards are requiring education and certification to be aligned
with the role and population foci of the Consensus Model. Furthermore, the state board–
approved NP certifying bodies (American Academy of Nurse Practitioners [AANP]
Certification Program [AANPCP], 2016; American College of Cardiovascular Nursing
[AACN] Certification Corporation, 2016; American Nurses Credentialing Center