Certification

History of the Certification Examination for Emergency Nurses

In August of 1979, a group of six nurses met, convened by the Emergency Nurses Association (ENA) as the Certification Committee, in New York 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 (BCEN®) accomplished the
following:

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 the Board of Certification for Emergency Nursing, a not-for-profit corporation, which strives to continue evaluation and upgrading the certification examination for emergency nurses.

In February of 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 17 standards that must be met in order to be certified. These standards address board structure, testing security, test development, association autonomy, appeals procedures, and proof of a specialty.

History of the Certification Examination for Flight Nurses

During 1991 the National Flight Nurses Association (now the Air & Surface Transport Nurses Association - ASTNA) began discussion with the Board of Certification for Emergency Nursing regarding the potential for a collaborative ef fort 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, and provide operational management services for the certification process.

History of the Certification Examination for Transport Nurses

In 2004, BCEN in partnership with ASTNA began researching the development of a certification exam for critical care ground transport nurses. BCEN and ASTNA jointly funded the role delineation study for flight and ground transport nursing. This study was completed in the spring of 2005. Examination forms were also developed later that year for the Certified Transport Registered Nurse (CTRN) and CFRN credentials. The CTRN exam launched March 31, 2006.

BCEN Philosophy

The BCEN believes that emergency and flight nursing care 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.

The BCEN endorses the definition of certification as adopted by the National Specialty Nursing Certifying Organization (NSNCO) which reads:
“Certification is the process by which a non-governmental agency or association validates, based on predetermined standards, an individual Registered Nurse’s qualifications and knowledge for practice in a defined functional or clinical area of nursing.”

Certification promotes professionalism and assures various publics that the professional nurse has attained the knowledge necessary to provide competent emergency and flight nursing care.

The BCEN believes that emergency and flight nursing practice are dynamic, fluid, and continually evolving. Therefore the attainment of competence is a continual activity.

Organizational Structure

In October 1984, the BCEN underwent an organizational/structural change. It established the Examination Construction and Review Committee-CEN (ECRC-CEN) which was charged with the responsibility of serving as a resource and research consultant to the BCEN regarding test construction, content, and evaluation for the certified emergency nurses examination. With the creation of the CFRN® credential, a separate Examination Construction and Review Committee-Certified Flight Registered Nurse (ECRC-CFRN) was established and charged with the responsibility of serving as a resource and research consultant to the BCEN regarding test construction, content, and evaluation for the certified flight registered nurse examination.

Testing Corporation

Since 1979 a testing corporation has provided administrative services to the BCEN for the CEN examination and, since its existence, the CFRN and CTRN examination. At present, Applied Measurement Professionals, Inc. (AMP), located in Olathe, Kansas, is responsible for the CEN, CFRN, and the CTRN item bank and the test administration sites.

Development of the Exams

Each item writer has an assigned ECRC preceptor that is responsible for working with that item writer to develop items that are the level required for the CEN, CFRN or CTRN 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 appropriate 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 a nd eliminated, or return to the item bank as a pretest question.

When the CEN, CFRN or CTRN 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 pre-tested 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 feels should not be on that particular form. At the end of the review, the ECRC will have approved a draft exam for the CEN, CFRN and CTRN exam.

Administering and Scoring of Examinations

Once each applicants completed application form has been submitted to and evaluated by BCEN for eligibility, according to the criteria established by the BCEN, the application is processed by entering the data into the computer file at BCEN.

BCEN prepares and e-mails a roster to AMP that contains all the information on the application form for each applicant.

BCEN sends an authorization letter and a handbook to the applicant. The applicant then schedules their 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 e-mails 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 exam twice a year and the CFRN and CTRN exams once per year. BCEN also keeps a database of all CEN’s, CFRN’s and CTRN’s.

Results of Examination

Item analysis is performed for 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 appropriate ECRC for review and action.

Value and Benefits of Certification

Certification for Emergency Nurses

Certification, in general, is a mechanism in which the public and employers are able to identify practitioners who have met certain standards in their particular nursing specialty. Because of this, there are certifications in obstetrics, oncology, surgical nursing, critical care, flight nursing, etc. The CEN® certification is the certification specific to emergency nursing and measures the attainment of a defined body of nursing knowledge pertinent to that particular specialty. A role delineation study is conducted approximately every five years to assure the examination reflects current emergency nursing practice. Although there are CENs throughout the world, the CEN exam is based on emergency nursing practice in the United States.

The Value of Certification

For the emergency nurse, certification provides:

For the institution, employing certified nurses:

CEN Certification Brochure (PDF)