474 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
ACNM are working side- by- side with other professional nursing organizations on The
Consensus Model for Advanced Practice Registered Nurses (APRN Consensus Work Group
& the National Council of State Boards of Nursing APRN Advisory Committee, 2008).
Representatives from both groups will need to come to the negotiating table to
decide on the values they hold in common and work to achieve high standards of qual-
ity and safety from a common vision. Do they both agree that they need to meet the
growing needs for primary care, remove barriers to practice, and better define prac-
tice as separate yet complementary to medicine? Do they agree with the majority of
nurses in the ANCC survey who support a DNP certification examination? Both groups
will need to discuss their differences and find a path that meets their diverse needs.
Representatives from both groups will need to better define and determine the dif-
ference in competencies between the DNP and the master’s- prepared APRN so that
the purpose of a national DNP certification examination is clearer. They will need to
address whether a competency examination endorsed by medicine is necessary for pub-
lic confidence in DNP practice.
If both groups can agree on the value of the DNP certification examination, they
will need to address the reasons for its low pass rate. Because the DNP certification
examination is currently designed to evaluate the competence of DNPs from adult and
family practice, representatives from both groups may need to discuss the possibility of
revising or developing other specialty versions of examination so that it is a more valid
measure of other clinical APRN specialties. In addition, both groups will also need to
discuss the possibility of revising the DNP competency examination to better reflect the
population- based focus of the DNP curriculum.
■ SUMMARY
As the doctoral APRN moves into the future, the nursing profession and individual APRN
specialties will need to define the competencies that result in the highest- quality care for
patients and their families, as well as set them apart from the practice of medicine. Both
opponents and proponents of the DNP competency examination are needed at the negoti-
ating table to explore what is ultimately best for patient care. As properly managed inter-
personal conflict can result in opportunities for new learning and growth, the opinions
of both sides may be needed to drive the growth of doctoral APRN practice to its fullest
potential. So now, after having read this chapter, are you prepared for the new DNP certi-
fication examination? Yes? No? Perhaps you want to think about it more, and then decide.
■ CRITICAL THINKING QUESTIONS
- What are the major differences between master’s- and doctoral-level certifications?
- What do you think are pros and cons of the NBME’s designing the DNP certification exami-
nation? Would another certifying body be more appropriate and why? - What are the major factors that differentiate the DNP practice from physician-based pri-
mary care practice? - Does the DNP certification examination promote or obstruct multidisciplinary collabora-
tion? Why? - Does the DNP certification examination enhance public confidence? Why or why not?
What is your rationale?