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

The Primary Care CPNP® Exam
2012 Role Delineation Study
 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® Exam
2012 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.

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

The Primary Care CPNP Exam
2012 Role Delineation Study
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 survey
 Analysis of survey data
 Development of test specifications and the updated content outline from survey findings and input from the
SMEs

The Primary Care CPNP Exam
2012 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

The Primary Care CPNP Exam
Over Time
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
* Includes private practice

The Primary Care CPNP Exam
2012 Role Delineation Study
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.

The Primary Care CPNP Exam
2012 Role Delineation Study
Results at a glance...
 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

The Primary Care CPNP Exam
2012 Role Delineation Study
Results at a glance...
 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.

The Primary Care CPNP Exam
2012 Role Delineation Study
Results at a glance...
 30 of 34 knowledge ratings achieved high importance ratings.
 The knowledge/skill rated borderline was:
 Global health
 The knowledge/skills rated failing were:
 Adoption, disaster preparedness, and palliative care
 Respondents 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 Exam
How 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)

The Primary Care CPNP Exam
How the new study impacted the exam...
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 – 15
3. Management – 21
4. Professional Issues – 20
Total = 75
1. Health Promotion – 20
2. Assessment & Diagnosis – 21
3. Management – 30
4. Professional Role – 15
Total = 86

The Primary Care CPNP Exam
How the new study impacted the exam...
Prioritization of
Clinical Problems
2008 2012
1.
Respiratory
2.
EENT
3.
Gastrointestinal
4.
Behavioral/Psychological Problems
5.
Dermatology
6.
Musculoskeletal
7.
Allergy
8.
Nutrition
9.
Neurology
10. Cardiovascular
11.
Hematology
12. Endocrinology
13. Oncology
14. Immunology/Rheumatology
15. Environmental Health
1.
Eyes/Ears/Nose/Throat
2.
Respiratory
3.
Gastrointestinal
4.
Dermatology
5.
Behavioral/Psychological
6.
Nutrition
7.
Allergy
8.
Musculoskeletal
9.
Genitourinary
10. Cardiovascular
11.
Neurology
12. Endocrinology
13. Hematology
14. Pain
15. Environmental Health
16. Oncology
17. Genetics
18. Immunology/Rheumatology

The Primary Care CPNP Exam
2012 Role Delineation Study
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

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 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 Exam
2012 Role Delineation Study
Summary of Changes...
 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.”

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 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.”

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 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.”

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 Under Management:
• Added to the Content Outline, a specific list of procedures:
• Audiometry
• Cerumen removal
• Reduction of nursemaid’s elbow
• Removal of foreign body
• Fluorescein staining
• Incision and drainage
• Removal of sutures and staples
• Visual acuity
• Rapid tests

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 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 Referral
2.
Case Management

The CPNP Exam
2012 Role Delineation Study
Summary of Changes...
 Under Professional Issues:


Added / Reorganized within the Domain:

4 distinct subcategories:
1.
2.
3.
4.
Leadership and Professional Development
Research
Business Management
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

The Primary Care CPNP® Exam
 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® Exam