480 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
[ANCC], 2016; Pediatrics Nursing Certification Board [PNCB], 2016) have all adopted
the Consensus Model tenets. Role and population education consistent with the model
is required to register for certification examinations. All the NP certification examina-
tions direct testing toward the role and population foci. And, in the case of pediatrics
and adult- gerontology, education and certification must be attained either as an acute
or primary care NP (AANPCP, ACCN Certification Corporation, ANCC, and PNCB).
The ABCC DNP certification website lists the benefit of the ABCC certified dip-
lomate certification as providing comprehensive care to complex patients across the
life span (ABCC, 2016). ABCC applicants must be eligible for NP licensure, but no role
of NP is specified. No population focus is indicated, although it is required that the
applicant be educated in the area of “across the life span,” and have completed a DNP
program. Furthermore, Carter and Moore (2015) describe the examination as verifying
that the ABCC- certified NP diplomate is prepared to deliver direct comprehensive care
to complex individuals of all ages across the continuum of settings. A review of the web-
site does not reveal any mention of the examination’s congruence with the Consensus
Model nor is this discussed in the two recent publications about the examination (Carter,
2013; Carter and Moore, 2015).
The core nursing beliefs are represented in the American Association of Colleges
of Nursing (AACN, 2006) competencies. These competencies relate to the integra-
tion of science, leadership, quality care, technological literacy, inquiry, health policy,
ethics, and independent practice. For NPs, the DNP competencies are intended to be
complemented by the National Organization of Nurse Practitioner Faculties (NONPF)
specialty competencies (NONPF, 2016). In contrast, the established DNP competen-
cies do not suggest a single clinical proficiency pathway for either family across the
life- span NPs, other specialty NPs, or for other APRN roles. Yet, the ABCC certifica-
tion examination eligibility singles out the generalist or “across the lifespan” NP prac-
tice competencies as the defining characteristic of a qualified DNP. This incongruence
negates the potential that different NP specialty competencies offer toward advancing
the U.S. health agenda.
The likelihood of wide adoption of a generalist DNP certification examination is
also unlikely because of the increased market demand for APRNs in various special-
ties. Some authorities have reasoned that the need for specialty health care is what
drove the development of the licensing, accreditation, certification, education (LACE)
Consensus document (ANA, 2008; Rounds, Zych, & Mallory, 2013). The aging of the
American population and a shortfall of physicians in specialty care by 2025 (Dall,
West, Chakrabarti, & Iacobucci, 2015) will undoubtedly increase the need for NPs to
provide specialty care (Coombs, 2015 ). Furthermore, NPs often desire and seek spe-
cialty care employment because of prior hospital experience in a similar specialty area
(Budd,Wolf, & Hass, 2015).
The huge need for specialty care has extended beyond the original specialties rec-
ommended in the Consensus Model and has spawned a number of secondary specialty
NP certifications for those already certified. New specialty examinations in oncology,
cardiology, dermatology, and emergency medicine have been developed (Tegler, 2016).
These secondary certifications will likely continue to expand as the need to hire more
specialty NP providers expands. The specialty certification examinations are aligned
with the Consensus Model (2011) and can help to ensure the NP is operating within
particular scope of practice. This enhances public safety and promotes the profession.
In 2011, the Institute of Medicine (IOM, 2011) published The Future of Nursing
Report: Leading Change, Advancing Health. The publication’s goal of removing practice
barriers has promoted nursing organizations to work to change state legislative and
regulatory language so that NPs will have full practice authority and be able to move