not only for their current position, but also for the next one (Patterson, 2001; Taylor, Ogle, Olivieri, English, & Dennis, 1999).

Certificate Programs in Continuing Professional Education Ruth Falk Craven, EdD, RN, BC, FAAN, and Martha Bassett DuHamel, MPH ABSTRACT Background: Career-long learning is a concept at the heart of professional disciplines such as nursing. Nursing shortages, especially in some areas of practice, have stimulated the need for in-depth education and training in specific knowledge content areas. One approach to career-long learning is certificate programs. Method: Factors, trends, and strategies to consider in creating certificate programs are reviewed, and guidelines for developing certificate programs are presented. Career-long learning is a concept at the heart of professional disciplines today, and nursing is no exception. The highest degree a professional nurse holds is not the end of learning. In fact, academic degrees in nursing probably should come with maintenance contracts providing for periodic tune-ups and upgrades. Career-long learning must be planned, nurtured, and managed by individual nurses. It also must be encouraged and supported by their employers. One approach to career-long learning is the certificate program. A certificate program can be a single course or a linked series of credit or noncredit courses that constitute a coherent body of study in a discipline. The demand for certificate programs has increased in many disciplines and is expected to continue to grow for the foreseeable future. At the University of Washington, for example, from 1987 to Dr. Craven is Professor, Department of Biobehavioral Nursing and Health Systems, and Associate Dean, Educational Outreach and Community Relations, and Ms. DuHamel is Director, Continuing Nursing Education, University of Washington, School of Nursing, Seattle, Washington. Address correspondence to Ruth Falk Craven, EdD, RN, BC, FAAN, University of Washington, School of Nursing, Box 357260, Seattle, WA 98195-7260. Findings: Certificate programs are increasingly in demand by both employers and nurses. Certificate programs provide individuals with a chance to refresh their study skills and raise their abilities and levels of confidence for mastering new learning. Certificate programs also serve as a recruitment and retention strategy for hospitals and agencies. Conclusion: Certificate programs are a viable continuing professional education activity and offer opportunities for nurses to develop specific skill sets and in-depth knowledge in specialized areas of nursing practice. 2002, the number of certificate programs across the campus increased from 15 to more than 90, and the number of individuals graduating from certificate programs rose from 200 to 2000. Nursing is experiencing a similar demand for certificate programs. Factors stimulating demand include rapid growth in nursing science, advances in diagnostic technologies and therapeutic modalities, persistent nursing shortages in a variety of settings (e.g., critical care and perioperative nursing), and regulatory standards that mandate the use of certified nurses for certain types of care. Even nurses with graduate degrees find themselves in need of new skills and knowledge to enhance their marketability and change career paths. Certificate programs also have become a strategy for schools to entice nurses with an associate, baccalaureate, or masters degree to return to academia before they are ready to apply for a degree program. Certificate programs provide individuals with a chance to refresh their study skills, raise their abilities and levels of confidence for mastering new learning, and, in programs with an option for earning academic credit, get a jump-start toward a new degree. Earning elective credits before entering a degree program can shorten the time needed 14 Volume 34, Number 1, January/February 2003

CRAVEN & DUHAMEL to complete a degree and reduce two of the barriers to going back to school, i.e., the amount of time required to be away from home and the loss of income while away from gainful employment. Certificate programs are also a recruitment and retention strategy for hospitals and agencies needing a larger pool of qualified personnel. Programs in perioperative nursing, advanced cardiac life support, ambulatory care nursing, nursing leadership, diversity training, and laser safety are just a few examples of certificate programs offered by hospitals, health care organizations, and agencies. Typically, these programs provide a certificate of contact hours or continuing education units. They vary widely in length, number of classroom versus clinical hours of teaching, and credits earned. The fact that any agency, organization, or individual can offer a certificate program means there can be wide variation in the nature and quality of education provided. If certificate programs as a form of midcareer retraining are to be successful, applicants must be assured of the value of the certificate they earn and agencies must be assured an employee s certificate correlates with certain levels of knowledge and skill. The growing need for certificate programs to help nurses update their skills and move into new careers within nursing is an important challenge for nurse educators and an increasingly important continuing professional education activity. The highest degree a professional nurse holds is not the end of learning. In fact, academic degrees in nursing probably should come with maintenance contracts providing for periodic tune-ups and upgrades. TRENDS IN CREATING CERTIFICATE PROGRAMS Certificate programs are increasingly in demand by both employers and nurses (Irby, 1999; Kerka, 2000; Schuett, 2001). Employers who are willing to spend large amounts on education for their employees want documented outcomes and defined results for the current job as an outcome of their investment. In today s climate of rapidly changing health care system needs and increasing complexity of knowledge and skills, employers need the flexibility to implement role changes in response to supply and demand issues and emerging concerns. Formal academic programs generally are unlikely to provide the rapid turnaround and flexibility that many positions require. Similarly, nurses want comprehensive programs rather than one-shot overviews (Kerka, 2000). They recognize the need for in-depth study in knowledge and skill areas required for new levels of care, new venues of care, and new career objectives. They want an objective source to validate their level of knowledge and skill, and they want documentation of their learning, not only for their current position, but also for the next one (Patterson, 2001; Taylor, Ogle, Olivieri, English, & Dennis, 1999). CREATING CERTIFICATE PROGRAMS Factors to consider in creating quality certificate programs include: Defining areas of strength of the providing unit. Leveraging those strengths through alliances with agencies or organizations. Showcasing unique strengths and dynamism of organizations and faculty in developing the curriculum. Developing collaborations/partnerships with related groups by building on the strengths of coproviders. Monitoring all costs, both direct and indirect, related to educational activities so the program can become self-sustaining. Because assessment, management, and marketing processes are critical to the financial stability and academic integrity of a certificate program, every activity must be considered, monitored, and documented carefully prior to, during, and following program implementation. Guidelines to assist in developing a certificate program are offered in the Sidebar. Defining Areas of Strength of the Providing Unit Even though the need for certificate programs is on the rise, continuing education providers should be wary of joining the effort without careful planning. Certificate programs, if well done and successful, are time intensive and require considerable up-front financial investment. The unique strengths of the providing unit need to be matched with the content of the certificate program to be offered. For example, if a provider unit wants to offer a certificate program in long-term care administration, coherency between the depth of knowledge and expertise of the unit in longterm care and administration, and the reputation or image of that unit as expert in the specialty area by the potential consumers of the program needs to exist. A business plan that considers the market, financial The Journal of Continuing Education in Nursing 15

CERTIFICATE PROGRAMS GUIDELINES FOR DEVELOPING A CERTIFICATE PROGRAM 1. Establish and define the purpose for the program. A certificate program should help participants achieve specified learning objectives and competencies in a defined field of study. It is intensive and comprehensive, covering a given subject area in depth. 2. Develop a curriculum for the program. The curriculum is characterized as a body of knowledge, a set of skills, or a systematic presentation of facts and information. Content is organized into a structured progression of classes/content for participants who will achieve specified learning objectives. A measurable set of outcomes is associated with a curriculum and assessed by examinations, written papers, and demonstration of a set of skills. 3. Recruit an advisory board. A certificate program should have an advisory board consisting of representatives of the target professional community and the providing unit. This board helps define the target audience, admission standards, curriculum content, and instructional qualifications of faculty. In addition, the advisory board monitors the progress and quality of the program on an ongoing basis. 4. Select instructors/faculty. Professionals qualified to teach certificate programs include specialists certified by the national accrediting body for the discipline and professionals in related fields. Criteria for selection of faculty must be clearly defined. 5. Establish the program s standards and scope. The program must have published minimum standards, established by the advisory board or another recognized group or organization, for the level and scope content, learning objectives, number of hours of instruction, qualifications of faculty, education, experience, and preparation of learners, and criteria for successful completion of the program. 6. Implement a system to assess participants performance. A system for assessing skill and knowledge acquired and how well participants meet the learning outcomes of the program should be carefully communicated in print. Grading systems may vary with academic and continuing education programs, e.g., a successful completion/noncompletion system in which successful completion constitutes the equivalent of a B grade or better, or another easily recognizable assessment system. 7. Develop a system to evaluate and assess the program. A system for evaluating the certificate program itself and faculty should be in place to ensure the quality and integrity of the program. The fiscal outcomes of the program also must be carefully assessed. strengths, faculty, employment opportunities for graduates, and the need for clinical training sites is essential to a successful program (Cherif, 2000). Education providers should ask several questions such as: What are the financial reserves for underwriting the costs? Has the unit been successful in marketing and completing other intensive educational activities? What are the unit s collaborative relationships with health care employers in the region? Does the unit have access to the target market niche? What is the experience level of unit staff for handling a complex certificate program? Are clinical experts readily available to participate as program faculty? Is the unit appropriately accredited by a related and nationally recognized organization so the certificate program has credibility? Leveraging Strengths Through Alliances To successfully market a clinically specialized certificate program, a providing unit needs to develop alliances and collaborations with potential employers. Potential employers are the providing unit s greatest allies (Charlton, Machin, & Clough, 2000). These are the administrators and managers who have determined areas of need within their agencies and the health care community and who will potentially hire the graduates of the certificate program. They have a vested interest in developing successful training and education programs to have access to highly skilled and knowledgeable professional nurses. These are the professionals who should serve on the advisory board for the certificate program. Advice that organizers need from an advisory board include identifying the target audiences, setting admission standards, developing the curriculum, and, on an ongoing basis, monitoring the progress and quality of the program. Having a voice in these programs is important to administrators, and they are generally both anxious and happy to be involved. Organizers of the certificate program need to be good stewards of the time and expertise of the members of the advisory board. If the right people are on the board, they typically will be busy professionals whose time is best spent on critical issues, not mundane matters. Unproductive meetings lead to reduced involvement. Organizers will find more success if meetings are scheduled well in advance and generally early in the morning (preferably with coffee and some type of breakfast) before members go to their offices. No matter how good their intentions, if a meeting is scheduled later in the day, members often encounter situations or events that interfere with their ability to attend the meeting. Finally, it is imperative that an agenda for each meeting be developed and distributed. Board members can come to the meeting better prepared and assured their time will be well spent. Keeping the number of meetings to a minimum and being punctual in both starting 16 Volume 34, Number 1, January/February 2003

CRAVEN & DUHAMEL and ending the meeting lets them know their input is valued. Providing board members with feedback and minutes as soon as possible helps them stay connected. If the planning group needs specific help from board members, needs should be stated clearly and board members should be asked to volunteer to assist with recruitment of participants, review of the curriculum, or recruitment of faculty. Well-defined, discrete tasks are more readily accepted and accomplished by board members, leading to a more successful program than the organizers could plan alone. Showcasing Unique Strengths and Developing the Curriculum Determining the content of a certificate program depends on outcomes of a needs assessment and input by the professional nursing community as well as the strengths of the faculty who will provide the content. For example, the shortage of perioperative nurses in acute care agencies may be the impetus for developing a certificate program to train nurses in perioperative nursing. The shift in health care from inpatient to outpatient care units may be the stimulus for a certificate program on transitioning from one venue of care (such as acute care) to another (such as ambulatory care) and acquiring new skills. As the number of nurses prepared in critical care decreases, the availability of a certificate program in critical care nursing may be the point of convergence. In any of these examples, the provider unit must make a decision regarding whether the strengths and expertise of the faculty reflect the unique strength of that organization. For example, if the provider unit were to offer a certificate program in wound management, there should be a wound management expert in the parent organization or school of nursing who is providing leadership in the content area. The strength and reputation of the faculty will affect both the quality and the appearance of quality of the certificate program (Kerka, 2000; Patterson, 2001). After the certificate program focus is selected, a planning group reflective of the target market, employers, experts, and continuing education planners is convened to begin the planning process. This group steers the curriculum development, final faculty selection, and marketing. A curriculum is most effective when organized into a structured progression of classes and content aimed at helping participants achieve specified learning objectives. A measurable set of outcomes usually is associated with a certificate curriculum. Outcomes can be measured through examinations, written papers, and demonstration of a set of skills. Depending on the topic A certificate program can be a single course or a linked series of credit or noncredit courses that constitute a coherent body of study in a discipline. and content, there may be an existing standard curriculum from a nationally recognized specialty group, such as the perioperative curriculum of the Association of Perioperative Registered Nurses (AORN). Use of standards and curricula developed by experts from throughout the nation lends credibility to a certificate program, particularly if successful completion of the curriculum is linked to eligibility for national accreditation and related certification. Typically, successful completion of a certificate program does not guarantee certification as a practitioner in that specialty by a national group. Depending on the certification and the organization offering the certificate, a masters degree in nursing or a specified number of years of experience and clinical hours precepted by certified individuals may be required. Only the certification examination offered by the accrediting body and passed by individual nurses leads to national certification. Determining whether a certificate program should carry continuing education contact hours or academic credit is another task of the planning group. Depending on the program and national certification requirements, a certificate program may need to carry academic credit and may need to be part of a masters degree program and not a continuing education activity at all. In that case, the providing unit needs to be in or linked to a university setting and able to interface with appropriate departments and approving mechanisms. Academic credit may be an important determinant in whether a certificate program is a match for a providing unit. Developing Collaborations by Building on the Strengths of Coproviders Nursing, as a clinical discipline, depends heavily on clinical partners for learning experience sites, preceptors, and clinical expertise. For example, if an organization and its provider unit are linked with a well-known, credible perioperative clinical area and clinical experts, then developing a perioperative certificate program is more likely to be a successful venture. Clinical partners and coproviders add to the reliability and trustworthiness of the certificate program (Charlton et al., 2000). Additionally, when these coproviders are linked The Journal of Continuing Education in Nursing 17

CERTIFICATE PROGRAMS Certificate programs provide individuals with a chance to refresh their study skills, raise their abilities and levels of confidence for mastering new learning, and, in programs with an option for earning academic credit, get a jump-start toward a new degree. with the certificate program, they become allies and partners in developing the program, recruiting for the program, and ensuring the success of the program. The benefits for coproviders include increased visibility, improved recruitment potential, and other tangible benefits that may be included in a coprovider letter of agreement (e.g., reduced fees for employees). Monitoring Costs Certificate programs can be costly enterprises. Typically, a certificate program in nursing has a limited enrollment. Controlling the number of enrollees means tuition increases. To have adequate time and opportunity for learning and practice in a specialized area, the faculty-to-student ratio must be appropriate. The involvement of faculty with the desired clinical expertise and credentials is not inexpensive. The direct and indirect costs of planning, marketing, implementing, and evaluating a certificate program are substantial and include staff salaries for planning and preparation, ongoing overhead unit expenses, and advising participants at all stages of the program. Implementing the program includes such items as handouts, facility costs, catering, audiovisual equipment, on-site staffing time, Website maintenance, clinical supplies, and accreditation expenses. Evaluating the program involves not only standard approaches to soliciting faculty and participant feedback on content, program planning, and faculty, but also careful evaluation of the cost/benefit to the unit offering the certificate program. No matter how well designed the program, if it loses money, it is time for significant decision-making. Were there adequate numbers of participants? Was the content of the program matched to the community s need? If answers to these questions are positive, then was the tuition appropriate for the total costs of the program? If the program is offered again at a higher tuition, will the number of participants be affected? SUMMARY Certificate programs in nursing offer opportunities for nurses to develop specific skills and in-depth knowledge in specialized areas of nursing practice required by rapidly changing health care system needs and to offset nursing shortages. Employers and professional nurses need the flexibility to implement role changes in response to supply and demand issues and emerging concerns regarding knowledge and skills. Providers of continuing education face the challenge and opportunity of addressing these issues in an educationally sound and fiscally responsible manner. REFERENCES Charlton, R., Machin, S., & Clough, A. (2000). Collaborating with the consortium: the development of a foundation in critical care skills programme. Nursing Critical Care, 5(2), 62-67. Cherif, K. (2000, Fall) A seven-step business plan methodology to develop and manage certificate programs. Continuing Higher Education Review, 64, 56-64. Irby, A. (1999). Postbaccalaureate certificates: Higher education s growth market. Change, 31(2), 36-41. Kerka, S. (2000). Career certificates: High quality and cutting edge? (Trends and Issues Alert No. 16.) Columbus, OH: ERIC Clearinghouse on Adult, Career, and Vocational Education Patterson, W. (2001, Fall). Ensuring the quality of certificate programs. Continuing Higher Education Review, 65, 112-127. Schuett, F. (2001). Vying for lifelong learners: Competitive credit programs and competitive workforce training. Michigan Community College Journal: Research and Practice, 7(1), 9-43. Taylor, C., Ogle, K.R., Olivieri, D., English, R., & Dennis, M. (1999). Taking on the student role: How can we improve the experience of registered nurses returning to study? Australian Critical Care, 12(3), 98-102. 18 Volume 34, Number 1, January/February 2003