Every 5 years MSNCB is required to perform a practice analysis. The purpose of this role delineation/practice analysis is to provide evidence to support the validity of the CMSRN (Certified Medical-Surgical Registered Nurse) exam. The evidence collected helps to ensure that the examination truly reflects current practice, is legally defensible, and is psychometrically sound. The first practice analysis done in 2007 had 649 respondents from 40 states and the District of Columbia. The 2012 analysis had 1,272 respondents from 49 states and the District of Columbia.
It is the job of the Test Development Committee to develop the practice analysis. They did this by reviewing and revising the previous 2007 survey. After completion of the survey, it is also their responsibility to suggest changes in the design of the exam based on the results of the analysis.
The exam blueprint below will go into effect in May 2013 and will be reflected in the paper and pencil tests of May 4, 2013 and beyond. It will also be reflected in all computer-based tests beginning on May 1, 2013.
Each test question is coded for one physiological system and one nursing practice domain.
| Patient Problems by Physiological Systems | % of Test |
|---|---|
| Gastrointestinal | 16-18% |
| Pulmonary | 15-17% |
| Cardiovascular | 15-17% |
| Diabetes (types 1 & 2) and other Endocrine | 14-16% |
| Genitourinary, Renal, and Reproductive | 14-16% |
| Musculoskeletal and Neurological | 12-14% |
| Hematological, Immunological, and Integumentary | 7-9% |
| Domains of Nursing Practice | % of Test |
|---|---|
| Helping Role | 16-18% |
| Teaching/coaching function | 16-18% |
| Diagnostic and patient monitoring function | 23-25% |
| Administering/ monitoring therapeutic interventions | 23-25% |
| Effective management of rapidly changing situations | 11-13% |
| Monitoring and ensuring quality of health care practices | 1-3% |
| Organizational and work-role competencies | 3-5% |
*Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley.
Comparison of Changes
| Patient Problems by Physiological Systems | % of Test | |
|---|---|---|
| 2008 | 2013 | |
| Gastrointestinal | 18-20% | 16-18% |
| Pulmonary | 18-20% | 15-17% |
| Cardiovascular | 14-16% | 15-17% |
| Diabetes (types 1 & 2) and other Endocrine | 14-16% | 14-16% |
| Genitourinary, Renal, and Reproductive | 11-13% | 14-16% |
| Musculoskeletal and Neurological | 10-12% | 12-14% |
| Hematological, Immunological, and Integumentary | 8-10% | 7-9% |
| Domains of Nursing Practice | % of Test | |
|---|---|---|
| 2008 | 2013 | |
| Helping Role | 24-26% | 16-18% |
| Teaching/coaching function | 24-26% | 16-18% |
| Diagnostic and patient monitoring function | 16-18% | 23-25% |
| Administering/ monitoring therapeutic interventions | 16-18% | 23-25% |
| Effective management of rapidly changing situations | 9-11% | 11-13% |
| Monitoring and ensuring quality of health care practices | 2-4% | 1-3% |
| Organizational and work-role competencies | 2-4% | 3-5% |
