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Date Updated: August 4, 2011

DNP Certifying Exam - Q&A

NBME’s development of a certifying exam for doctors of nursing practice has led to a number of questions about our scope of services – and, indeed, about how we develop assessments. We hope to answer some of those questions here. If you have additional questions, please contact us:

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Carol Thomson
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Office: 215-747-7700
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E-mail: cthomson@steegethomson.com

E-mail: webmail@nbme.org

See also: NBME Development of a Certification Examination for Doctors of Nursing Practice

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How did the NBME decide to build a DNP certifying exam?

NBME’s mission is “to protect the health of the public through state of the art assessment of health professionals.” We evaluate all requests for service in the terms of this mission. The request of the Council for the Advancement of Comprehensive Care (CACC), a group of nursing, medical, and health policy leaders, to build a certifying exam was consistent with that mission.

Why does an organization with “medical” in its name develop assessments for other professions?

Having established public protection as NBME’s first principle, our mission goes on to state, “While centered on assessment of physicians, this mission encompasses the spectrum of health professionals.” In other words, the public benefits when any group of healthcare professionals uses high-quality assessments to demonstrate they can meet a common standard. We have created assessments for other professions for some 40 years. We provide or have in the past provided services to physician assistants, physical therapists, and medical technicians.

How does this exam protect the public?

The exam is part of a certifying process, created by nursing professionals for themselves. It assures the public that DNPs who complete the process have met a uniformly high standard, no matter what the content of their degree programs.

What if you believe nurses should not be licensed to deliver primary care without a physician’s supervision?

The exam has absolutely nothing to do with licensure. It does not affect the ability of DNPs to practice, or the scope of their practice, in any way. DNPs will continue to practice according to the laws of the various states and territories, whether or not they become certified. Questions of licensure fall outside the mission and scope of the DNP certifying exam.

Aren’t you really taking a position on nurses’ scope of practice by contributing to DNP certification?

We are not. Certification confirms a body of knowledge and skills, not how it is applied. Scope of practice is defined by state legislatures and licensing authorities, not the NBME.

How does the DNP certifying exam use items from the USMLE?

Like some of our other assessments, the exam uses items retired from the USMLE. It is similar to using bricks that were once in one structure to build another structure. The two structures are different, with unique designs, and serve different purposes.

How does the DNP certifying exam differ from Step 3 of the USMLE?

A committee appointed by the sponsoring CACC made final decisions regarding the actual test design, and the design has different dimensions than Step 3. The CACC exam is shorter, contains a different mix of multiple-choice questions, and does not include any items currently in use for the USMLE.

How do the USMLE and this exam differ overall?

The USMLE is an examination sequence that measures the fundamental science, clinical knowledge, and clinical skills that medical doctors need for a broad range of medical practice. The DNP exam tests clinical knowledge necessary for primary care delivered by advanced nursing professionals. It does not test basic science knowledge or clinical skills. Its coverage of patient care content is not the same as USMLE.

Won’t patients be confused about what doctor means?

At present, the public deals with doctors of pharmacy, optometry, podiatry, chiropractic, homeopathy, osteopathy, psychology and medicine. The public seems to sort them out.

How does this fit into the debate over healthcare reform?

The debate around American health care currently revolves around access and cost. In keeping with our mission, we would like to be sure Americans receive quality healthcare as well. In the past, primary care was tightly defined as the purview of physicians. Now demand for primary care services far outstrips the supply of physicians who can provide them, and other healthcare professionals have stepped into the gap. The public seeking care from certified DNPs can know they have set and met a high standard of knowledge for themselves. Their mastery and their demonstration of it contribute to quality healthcare.


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