Have you ever felt overwhelmed by advertisements for certification and certificate programs? Do you find yourself unsure of what exactly it is these programs are proposing? Ads for programs offering certification or certificates abound, and it can be confusing to understand exactly what a program confers. Both professional organizations and educational companies use the words certification and certificate frequently, sometimes interchangeably. Understanding the differences between these two options is essential to you as a consumer of educational services and for the protection of the public.

Certification, like the CRNI® designation, refers to an earned credential that demonstrates the holder’s specialized knowledge, skills, and experience. Certification is awarded by a third-party, nongovernmental entity such as the Infusion Nurses Certification Corporation (INCC). A separate organization from INS, INCC was created specifically to develop a certification program that promotes public protection. It does so by employing strict eligibility criteria and administering a legally defensible and psychometrically sound exam. The CRNI® exam questions are based on in-depth analyses of the role and responsibilities of the infusion nurse, ensuring the exam is relevant to clinical practice.

Certification candidates receive their credential only after meeting strict eligibility criteria and successfully completing a standardized exam. Credentials are nationally recognized and portable, meaning your credentials will follow you if you move from one organization to another. And unlike certificate programs, professional certification programs include ongoing requirements that must be met to keep the certification current. The recertification process ensures that credential holders have maintained a level of expertise in their specialty and that they participate in activities that support competency in their specialty.

A certificate program is an educational program that awards a certificate after completing the program. Certificate programs are usually open to anyone who applies, and they are geared toward obtaining specific skills or knowledge. While certificate programs may award a certificate of attendance or participation, they do not award a credential.

Some healthcare organizations offer their own internal “credential” programs that teach nurses specific skills or procedures. Usually the organization that offers these certificates design the program to meet their own internal criteria, and the programs involve a combination of classes and an exam or practicum. Unlike a program certified by an independent, third-party agency, these certificates apply only to practice within the organization that offers the certificate. This certificate is not nationally recognized, and it will not follow you from one organization to another. Further, as Bonnie Niebuhr, CEO of the American Board of Nursing Specialties (ABNS), points out, certificate programs “don’t use the same validity or reliability studies as a credentialing program because they focus on a more narrow body of knowledge.”

ABNS defines certification as “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.” While certificate programs teach important skills, they are not as broad-based or as comprehensive as a certification program.

How a Certification Exam Is Different
The end-of-course exams that some certificate programs require participants to complete are very different from a certification exam. The organization offering the certificate determines the course content and the exam questions while certification exams that result in a credential are standardized exams based on national studies of job analyses and nursing roles. The exams are administered in a secure and proctored environment, and they undergo regular statistical psychometric analyses that measure the fairness and difficulty of the exam questions.

INCC works with Applied Measurement Professionals, Inc. (AMP) to develop a comprehensive, evidence-based, and legally defensible exam. The CRNI® exam is based on an in-depth and statistically sound analysis of the infusion nurse role and responsibilities. This is a “key differentiation” according to Lawrence Fabrey, PhD, of AMP. He also stresses the importance of approval from a third-party, independent organization, such as the ABNS. “It’s important to know that a certification exam has met external standards and covers a broad-based spectrum of content rather than one specific skill.”

Bonnie Niebuhr also stresses the importance of accreditation by an outside agency, pointing out that ABNS employs 18 rigorously defined standards when accrediting a certification program. Those standards range from scope of practice and research-based knowledge to eligibility criteria and continued competency. “The credentialing standards for ABNS look at a broad picture” and help to “define the scope of nursing while a certificate program may not address any of those standards because it is more narrowly focused.” 

The CRNI® Credential
Infusion nurses earning the CRNI® credential have achieved a standard of excellence that enables them to provide the optimal infusion care their patients deserve. The knowledge and skill they have achieved by meeting the rigorous standards of an accredited, nationally recognized credential plays a crucial role in improving patient safety and outcomes. Mary Alexander, MA, RN, CRNI®, CAE, FAAN, and CEO of INCC, firmly believes that understanding the differences between certificate programs and certification programs is essential to protecting the public:

INCC is proud of our certification program and holds steadfast to our mission of promoting public protection. Our rigorous certification program ensures that the CRNI® exam is legally defensible and psychometrically sound. I want to caution potential candidates to adopt a buyer-beware attitude and carefully evaluate programs on the market so they fully understand the scope and purpose of a particular program or offering.

The CRNI® exam is accredited by the American Board for Specialty Nursing Certification (ABSNC), formerly the ABNS Accreditation Council. ABSNC is an independent organization that sets rigorous standards for the accreditation of specialty nursing certifications and advocates for consumer protection. For more on the ABSNC standards of certification, please visit their Web site at www.nursingcertification.org.

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