Happy 30th Anniversary BCEN!History of the Board of Certification for Emergency Nursing
In August of 1979, a group of six nurses met in New York, convened by the Emergency Nurses Association as the Certification Committee with hopes of accomplishing a most important objective. This objective was the formulation of a certification examination that would measure the attainment and application of a defined body of emergency nursing knowledge.
Within eleven months after this initial meeting, the newly formed Board of Certification for Emergency Nursing accomplished the following:
Contracted with a testing corporation for the development and administration of the certification examination. Developed a pool of over 500 questions for the CEN® exam. Developed a test blueprint for test construction. Established meetings for test items (where 300 to 400 new items would be generated or reviewed). Established test review meetings (where the test would be proofed and reviewed prior to their use). Set up procedures for reviewing “problem” questions. Determined the number of test questions for each exam. Established initial eligibility requirements for taking the CEN® examination. Developed the CEN® application form Established testing sites. Decided on a passing score Constructed a handbook for candidates, plus many other significant accomplishments.
In July of 1980, 902 emergency nurses across the United States passed the first emergency nursing certification examination. Since that time, the Emergency Nursing Certification Committee has become BCEN, a not-for-profit corporation, which strives to continue evaluation and upgrading the certification examination for emergency nurses.
In February 2002, BCEN received notice that the CEN certification was approved for accreditation by the American Board of Nursing Specialties (ABNS). Accreditation is a mechanism to ensure that a hospital, business, or certification program meets a specific set of standards. Some institutions give certification differentials if the certification is from an accredited program. ABNS has 18 standards that must be met in order to be certified. These standards address board structure, testing security, test development, autonomy, appeals procedures, and proof of a specialty. The CEN was reaccredited in February 2007.
History of Certification Examination for Flight Nurses
During 1991 the National Flight Nurses Association (NFNA), now the Air & Surface Transport Nurses Association (ASTNA), began discussion with BCEN regarding the potential for a collaborative effort toward developing a certification examination for flight nurses.
Following extensive study of the comparability of flight nursing and emergency nursing practice, an agreement was reached for BCEN to assist with development of a certification program for flight nurses, Certified Flight Registered Nurse (CFRN®), and provide operational management services for the certification process. In September 2007, BCEN received notice that the CFRN certification was approved for accreditation by ABNS.
History of Certification Examination for Critical Care Ground Transport Nurses
In 2004, BCEN & ASTNA jointly funded the Role Delineation Study (RDS), involving an extensive study of flight and ground transport nursing. The following activities were accomplished with regards to the development of a critical care ground transport nursing certification:
History of Certification Examination for Pediatric Emergency Nurses
In 2005, BCEN and the Pediatric Nursing Certification Board (PNCB) entered an agreement to conduct a market feasibility study or needs assessment relative to the development of pediatric emergency nursing certification. The Certified Pediatric Emergency Nurse (CPEN™) is jointly owned by BCEN and PNCB.
The following activities are reflective of the historic partnership between BCEN and PNCB, which lead to the development of the CPEN exam:
BCEN Philosophy
BCEN believes that emergency and transport (both flight and ground) nursing care including pediatric emergency nursing are vital components of the health care delivery system. Achieving and maintaining certification is one mechanism of validating the knowledge required for the competent practice of emergency and flight nursing.
BCEN endorses the definition of certification as adopted by the American Board of Nursing Specialties (ABNS) which reads:
“Certification is the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes.”
Certification promotes professionalism and assures various publics that the professional nurse has attained the knowledge necessary to provide competent emergency and transport nursing care.
BCEN believes that emergency and transport nursing practice are dynamic, fluid, and continually evolving. Therefore the attainment of competence is a continual activity.
Organizational Structure
In October 1984, BCEN underwent an organizational/structural change. BCEN established the ECRC-CEN which was charged with the responsibility of serving as a resource and research consultant to BCEN regarding test construction, content, and evaluation for the certified emergency nurse examination. With the creation of the CFRN credential, a separate ECRC-CFRN was established and charged with the responsibility of serving as a resource and research consultant to BCEN regarding test construction, content, and evaluation for the certified flight registered nurse examination. With the development of CTRN in 2005, the ECRC-CFRN became the ECRC-CFRN/CTRN. Additionally with the development of CPEN in 2008, BCEN and PNCB established a CPEN examination committee.
Testing Corporation
From 1979 until present, a testing corporation has provided administrative services to BCEN for the CEN examination and, since its existence, the CFRN, CTRN, and CPEN examinations. At present, Applied Measurement Professionals, Inc. (AMP), located in Olathe, Kansas, is responsible for both the BCEN exam development and test administration.
Development of the Exams
Each item writer has an assigned ECRC preceptor that is responsible for working with their item writer to develop items that are the level required for the exam. Once the ECRC member has approved the items, they are sent to BCEN where they then will be forwarded to AMP.
Upon arrival to AMP, the items are placed in the item bank. During the ECRC meetings, these items are individually reviewed with one of three outcomes per item; either approved for pretest, approved with changes made for pretest, or eliminated.
Along with reviewing new items for pretest, the ECRC is responsible for reviewing items that have been pretested. The ECRC will review the statistics to each item and determine if the item scored well enough to be a scorable item on a future exam. Items that have changes, even minimal, will be pretested again. At the time of review, the item may be deemed acceptable for the active item bank, not acceptable and eliminated, or return to the item bank as a pretest question.
When the exam is in need of a new exam form, AMP will compose a draft copy of the exam. The draft will meet the blueprint criteria. The items used will have been pretested with statistics that have been approved as acceptable by the ECRC. It is the ECRC’s responsibility to review the draft. During the review process, the ECRC will also watch for any items that cue other items. AMP will have at their disposal, extra items that can be exchanged for items that the ECRC feel should not be on that particular form. At the end of the review, the ECRC will have approved a draft exam.
Administering and Scoring of Examinations
Once each candidate’s completed application form has been submitted and evaluated by BCEN for eligibility, according to the criteria established by BCEN, the candidate’s information is entered into the database and electronically submitted to the testing vendor, AMP. Upon approval BCEN sends an authorization letter with instructions to schedule a testing date and time.
After completing the exam, the test is immediately scored and the applicant receives their results before leaving the testing site. Following each examination, AMP electronically delivers all data back to BCEN where the candidate’s certification file is updated. The candidate’s wallet card and certificate are then mailed out. AMP also submits a technical report of the CEN in June and December and one report a year for the CFRN, CTRN, and CPEN. BCEN also keeps a database of all CEN’s, CFRN’s, CTRN’s, and CPEN’s.
AMP is responsible for the application processing and certificate fulfillment of all CPEN candidates and new CPEN’s respectively.
Results of Examination
Item analysis is a continual quality process with item statistics collected on each test item following the test administration. Items with their statistics are reviewed by the respective ECRC. Summary statistics are calculated regarding the reliability of each exam. Difficulty indexes, performance indexes and discrimination levels are also calculated. All items that show poor results are assembled and given to the BCEN specific ECRCs for review and action.