Test-taking strategies for CNOR certification

AORN Journal, Feb, 2007 by Mary Kobel Lamonte

Becoming board certified in perioperative nursing is a laudable goal, and CNOR is a credential of which perioperative nurses can be proud. Unfortunately, many nurses have not attended school in many years and believe that they do not remember how to study. Some nurses freeze up when taking tests or believe they would find it difficult to take a computerized test. If a nurse would like to be CNOR certified but feels overwhelmed at the thought of preparing for a four-hour examination, reading this article may help reduce his or her apprehension or reluctance to face the challenge.

BENEFITS AND BARRIERS

Certification is a voluntary process by which an individual demonstrates his or her specialized knowledge and skills in a professional practice field. (1) The 2006 CNOR application defines perioperative certification in nursing as

   the documented validation of the professional
   achievement of identified standards
   of practice by an individual registered
   nurse providing care for patients
   before, during, and after surgery. (2)

Nurses may face barriers to achieving certification including

* costs of materials and test fees,

* lack of institutional support rewards,

* lack of time, and

* lack of access to preparation materials.

The benefits of being certified, however, may include

* recognition by peers as being an expert in the field,

* a possible increase in salary,

* possible career advancement,

* personal growth, and

* greater satisfaction as a professional nurse.

Certification can increase a nurse's confidence in caring for patients. It also can be an indicator to an employer of a nurse's commitment to career development and patient care. Professional commitment is the primary motivation for seeking certification. Many nurses believe that certification enhances professional credibility and marketability. (3) Economic reasons also can apply, because specialty certified nurses earn an average of $6,873 more than those who are not certified. (4) A nurse is more likely to become certified if he or she is encouraged by a manager. (4)

OVERVIEW OF THE EXAMINATION

The CNOR application provides an examination overview. The examination is computerized and consists of 200 multiple-choice questions. Four hours are allowed for a nurse to complete the examination, and candidates may take the examination at any time during the year. The computerized format of the examination does not require a nurse to have previous computer experience. The pre-examination tutorial provides adequate instruction on how to take the examination on the computer. It also provides examples of how to select answers or to mark a question for later review before the test-taker submits the examination for grading. A question can be left unanswered and the nurse may return to it later. As long as there is time remaining and the test has not been submitted for grading, the nurse can go back and change his or her answers. When the nurse submits the examination for scoring, he or she will receive an immediate notification of whether the outcome is a pass or a fail.

Fifteen of the 200 examination questions are not scored. They are "pretest" test questions that are being evaluated for statistical validity and will then be used as scorable items on future examinations. The test-taker will not be able to discern which of the 15 questions are being pretested. All scored test questions have been pretested to ensure that they are statistically valid before they are included as part of the actual test. (5)

Test questions either measure knowledge of basic facts or pose a situation that requires the application of knowledge. Most CNOR test questions will be application questions because clinical practice requires that a nurse have an ability to apply principles and facts to patient situations.

Examination scores are based on the number of correct answers. Incorrect answers do not take away from the number of questions answered correctly. Several different versions of the CNOR test exist and there are varying levels of difficulty among the examinations. The passing score of 620 is a scale score, which is based on the total number of questions a test-taker correctly answers, a total commonly known as the raw score. After arriving at the raw score, a unique, statistically equated test scale is used for each test to convert the raw score into a scaled score. Accordingly, the final score does not directly represent a particular number or percentage of questions answered correctly. The current pass rate for nurses taking the CNOR examination is 87%. (6)

The examination is offered internationally, but it is based on a job analysis study of perioperative nursing practice in the United States. The questions are based on established research and current recommended practices (RPs), including those published by AORN, so nurses should become familiar with these. Nurses preparing for the examination must think beyond how things are done in the specific facility in which they work, because individual facilities may not be complying with current RPs.