Skip to main content

New Continuing Competency Efforts Come To NCC

Jul 1, 2008

  • Continuing Competency Update:

July 2008

The continuing competency testing has been completed and analysis of the test results is now underway.    A report on the project should be available late summer, early fall. Below you will find a description of the project.

Background Information  

While most professional certification organizations require a certification maintenance or recertification program for those certified by their respective organizations, discussions on the national level for the past five years or more have been held with regulators, consumer advocacy groups, employers and credentialing bodies about how to assess “continuing competency” of professionals. In other words, how do you know what each individual needs to update their knowledge and skills. By and large, now that is left up to the individual and from consumer perspective that system does not always identified those practitioners that need specific direction to assure their continuing competency to perform their specified roles.

NCC has decided to initiate pilot study that will incorporate an assessment of knowledge strengths and weaknesses of individual RNCs. An overview of the project is listed below. This is a pilot and whether this will proceed beyond the pilot is unknown. Data from the pilot will assist the NCC Board of Directors to determine if this is the right path or something or nothing else should be considered. WHNPs will be the selected pilot participants.

Overview of the Continuing Competency Issue

Driven by the need to assure that consumers can rely on the competency of health care professionals and to promote improved quality and safety of health care, there have been several national patient safety initiatives sponsored by many groups in recent years.  In addition, several meetings sponsored by the Citizen Advocacy Center (CAC) have been devoted to the discussion of the continuing competency issue with a goal to determine if methodologies for continuing competency of individual health care providers can be identified.  Currently, evidence would suggest that consumers cannot always rely upon current oversight mechanisms such as licensure or certification maintenance to insure that health care professionals have maintained their knowledge and skill level on a continuing basis.

The Institute of Medicine indicates quality care is often not provided because:

(1)       the complexity of science and knowledge

(2)       an increase in chronic conditions

(3)       poorly organized health delivery systems and

(4)       not adopting health information technologies that foster quality  improvement

While there is a need to address systemic problems within health care delivery, it is also known that there is a need for an ongoing training, licensure and certification of health care providers that incorporates lifelong learning and evaluation of competencies.  Currently, the oversight for assurance that health care providers can demonstrate continuing competency in equal proportion to initial licensure is inconsistent and often times fails to identify those who no longer can demonstrate competency in a chosen field of endeavor. While in many instances, there is no consequence for this failure to maintain continuing competency except through legal challenges, there is also no systemic way that those with knowledge deficits can effectively evaluate their knowledge and skill level and then develop an educational plan so those deficit areas are appropriately addressed.


And while there have been recent major initiatives to promote patient safety in a variety of settings, there is still lacking a direct, cohesive evaluation of a health professional care individuals’ ongoing competencies through accreditation, licensure or certification programs.


At the CAC meetings, core principles were identified that would be essential to bring about more accountability in continuing competency efforts:  collaboration, quality, evidence-based approach, building upon what works, making efforts mandatory and requiring clinician responsibility.  A five step program was promoted and included routine periodic assessment, development and implementation of personal individual competency plans, providing documentation of continuing competency efforts and evaluation and demonstration of competence.


One of the first action steps is to conduct research and the NCC is taking that first step

by initiating a Continuing Competency Pilot Program.

This pilot is designed to

  •  ascertain if RNCs can self assess content areas of weakness to address CE needs for  maintenance of their certification by completing a survey on educational needs
  • collect data through testing regarding whether maintenance could or should relate to basic entry level content or recent practice/research in the field
  • correlate RNC assessment of knowledge to actual testing outcomes
  • provide feedback to the individual RNCs on knowledge and skills and
  • explore development of continuing education activities to address the identified  educational needs of certified NPs based on the plot results.