Exploring Staff Nurses' Perceptions of Specialty Certification at a Large Urban Academic Medical Center

Friday, 28 July 2017

Jennifer J. Clair, MS
Department of Nursing, Massachusetts General Hospital, Boston, MA, USA


The Institute of Medicine’s study on medical errors, To Err is Human: Building a Safer Health System, recommends that health professions implement periodic reexaminations and relicensing of providers (Institute of Medicine, 2000). While Registered Nurse (RN) licensure provides entry-level competence, specialty certification provides a platform to consistently validate specialty experience, knowledge, experience, and skills (Altman, 2011).

Certification of staff nurses is also an important component of Magnet designation. Magnet status indicates that a hospital is recognized by the American Nurses Credentialing Center (ANCC) for demonstrating excellence in patient care across the organization (American Nurses Credentialing Center, 2016). The large, urban academic medical center in this study is a Magnet hospital and supports and encourages nurses to become certified. However, nurse leaders express challenges getting staff to sit for specialty certification exams.

The Perceived Value of Certification Tool© (PVCT) is an existing valid and reliable survey tool that assesses nurses’ perceived value of certification. The PVCT has been used in seventeen studies since 2003, totaling over 25,000 respondents.

Reliability of the tool has been shown through three psychometric studies. Sechrist, Valentine, & Carter (2006) performed factor analysis of the tool and found a two factor analysis, labeled intrinsic and extrinsic value, that explained 59.2% of the total variance; Cronbach’s alpha was .94 for the measure as a whole, suggesting high inter-correlation between the subscales (Sechrist et al., 2006).


The purpose of this scholarly project is to assess staff nurses’ perceived value of specialty certification at a large urban academic medical center; with a goal to better educate nursing leadership on potential facilitators and barriers that could in turn affect the number of nurses that obtain specialty certification.



A quantitative descriptive design method was used.

Sample and Setting

A convenience sample was obtained by administering the web-based survey to approximately 4,000 staff nurses via email. Inclusion criteria was English-speaking staff nurses with access to hospital email that are able to read and complete an online survey. Exclusion criteria included advanced practice nurses and nurse administrators.

Permission to use the PVCT was obtained by the Competency and Credentialing Institute and all requirements of this permission adhered to throughout the project. The tool contains eighteen questions that use a five point Likert rating scale, and was modified to include basic demographic questions. The PVCT questions and demographic questions were placed into Research Electronic Data Capture (REDCap), a secure web application for building and managing surveys and databases.

The survey was sent via email to a nurse director distribution list, the directors then deployed the survey using their staff distribution lists. Reminder emails were sent twice at week two and week four using the same method. Participants were given six weeks to complete the survey.

Data Analysis

Data collection is currently in progress for this project. The survey’s response rate will be determined by calculating the number of nurses the survey was sent to and the number of surveys that were completed, reported as a percent. Descriptive statistics will also be used to summarize survey results, and chi-square analysis will be used to make comparisons.

Ethical Considerations

Institutional review board (IRB) approval by the hospital and university were obtained prior to project implementation.

Implications for Practice

Having staff nurses’ baseline perception of certification will help guide intervention efforts to increase the number of certified nurses. Negative perception outcome data can reveal the barriers to certification that require intervention. Sharing this data with administration and staff nurses could lead to removal of these barriers. Additionally, positive perception outcome data can offer tools that administration and staff nurses can use for education and support of certification for nurses.