Education Certification

Obtaining certification can be an empowering, career-building tool. Learn how to get started, what you need to know and what to expect.

Certification is a voluntary process by which a nongovernmental agency, such as the Certified Board of Gastroenterology Nurses and Associates, Inc. (CBGNA), validates an individual’s qualifications and knowledge in a specific area of professional practice, based on a set of standards developed and accepted by members of that profession. The certification program for gastroenterology nurses was developed by the Society of Gastroenterology Nurses and Associates (SGNA) to recognize professional achievement and to promote excellence in the specialty.

Certification is awarded to individuals who meet eligibility criteria based on experience and who pass an examination covering a broad range of knowledge and skills relevant to their professional practice. Those individuals who achieve CBGNA certification can be recognized by designations used after their names — CGRN for the RN, and CGN for LPN and LVN.

A survey of more than 40,000 nurses conducted by the International Program of Research on the Certified Nurse Workforce in 1999-2000 demonstrated that certified nurses experienced personal growth and felt more satisfied, confident and accountable as a professional nurse. In addition, certified nurses were more likely to serve as a resource to staff and were recognized by their colleagues and by their employers as expert in the field. They were more confident in their decisionmaking and more autonomous in their practice.¹

“There are a lot of advantages in terms of your commitment to your professionalism,” says Cindy Friis, RN, MeD, BSN, director of nursing education and practice, SGNA. “It validates your qualifications.

What do you get out of it besides, ‘I have climbed the mountain’? For a professional, it’s a very coveted designation to have, because it says, ‘I’ve gone through this work, I am committed to GI nursing, I know and appreciate the concepts covered in the core curriculum, and it’s reflected in the fact that I’ve passed this exam and have met these qualifications.’”

Today, many employers use certification as a factor in both hiring and annual review procedures. Other personal and professional benefits sometimes accrue, but can vary widely among institutions. Many certified individuals, however, believe that personal satisfaction and increased professionalism are the most important benefits of certification.

Eligibility Requirements

CBGNA certification is open to nurses currently or recently engaged in gastroenterology and gastroenterology endoscopy practice. To qualify, candidates must have been employed in clinical, supervisory, administrative, educational or research capacities in an institutional or private practice setting for a minimum of two years full-time, or its part-time equivalent of 4,000 hours, within the past five years. Each candidate is required to obtain the signatures of two practitioners in the specialty (or physicians, supervisors or human resources specialists) who can verify this work experience.

CBGNA Examinations

There are two CBGNA certification examinations, one for RNs and one for LPNs and LVNs. The examinations are based on role delineations — surveys of practitioners that define the scope of practice and the knowledge and skills required to function in the field. All examination items are written by certified individuals with expertise in the field of gastroenterology and/or gastroenterology endoscopy nursing practice.

Examination Content

The RN and LPN/LVN examinations each consist of 150 multiple choice questions. Each question has four choices and one correct answer. Candidates have three hours to complete either examination.

The RN examination contains questions from four major content areas: general nursing care, gastroenterological procedures, patient care interventions and professional standards and responsibilities. All questions are directly related to the GI specialty.

The LPN/LVN examination contains questions from the same four major areas but in different proportions reflecting the differences in professional practice. Again, all questions are directly related to the GI specialty.

Test Dates and Sites

The RN certification examinations are offered twice each year, in the spring and in the fall. Due to its small number of candidates, the LPN/LVN examination is offered only in the fall. In the spring, the RN examination is offered at the SGNA Annual Education Course and at one or two other sites. In the fall, the examinations are offered at approximately 10 sites. Dates and sites for any given year are established in the fall of the prior year.

In addition to the published test sites, special test sites are available for one candidate or for a group of candidates. Often SGNA regional organizations schedule special test sites.

Application Deadlines

The application deadlines are set approximately eight weeks prior to the examination dates. Late registration deadlines, approximately six weeks prior to the examinations, are available, but require payment of additional late registration fees.

Fees

CBGNA strives to ensure that cost is not a barrier to candidates seeking certification by keeping fees as low as possible. Vendor support, product sales, SGNA grants and other sources of income underwrite the cost of the program. Applications for scholarships are available online. Candidate fees, however, reflect the cost of implementing this program.

Current fees are $300 for SGNA members, and $385 for nonmembers, and should accompany the completed registration application.

How to Prepare

The CBGNA publishes an examination handbook which helps applicants become acquainted with the exam process. The handbook contains current application forms, sample questions and answers, as well as a schedule and fees and locations for the year’s upcoming examinations. The handbook can be downloaded free from the CBGNA Web page at www.cbgna.org.

“The SGNA has a one-and-a-half day prep course in which we go over the basic foundations in GI,” says Friis. “There are contact hours available for the course, so it’s a win/win situation.” Dedicated to helping applicants become familiar with exam material and to build confidence in their test-taking abilities, the SGNA certification course provides an overview of the areas covered on the exam and suggests resources for further study. Though clinical content is not reviewed in detail, the course will help participants identify their knowledge, strengths and weaknesses, and assist them in preparing a study plan. The course is divided into five areas of concentration: Certification, Professional Issues, Pathophysiology, Clinical Issues and Procedures, and Questions, Discussion/Evaluation.

Recertification

Gastroenterology certification is granted for a period of five years. The certification period begins with the date certification is granted (the exam date) and ends on Dec. 31, five years later. In most cases, candidates may recertify either by taking the then-current certification examination or by submitting an application for recertification by contact hours. The recertification handbook is also available online and may be downloaded free of charge. Scholarship applications for certification and recertification are also available online.

Candidates who choose to recertify by examination undergo exactly the same procedure as candidates for initial certification.

They must meet the same eligibility criteria and take the same examinations as new candidates.

To qualify for recertification by contact hours, candidates must submit documentation of 100 approved contact hours, including copies of contact hours certificates, writings, programs, etc. Since contact hours are accepted in lieu of re-examination, approved contact hours must be in specific categories and must include specific content which mirror the content of the examination. For example, 80 of the 100 required contact hours must be gastroenterology-specific, and 50 of those GI-specific contact hours must be earned through participation in approved nursing seminars or workshops.

In the year of expiration, CGRN candidates will have four opportunities to recertify — a spring and a fall examination and a spring and a fall deadline for recertification by contact hours.

LPN/LVN candidates will have three opportunities to recertify — a fall examination and a spring and a fall deadline for recertification by contact hours. Candidates who unsuccessfully attempt to recertify either by examination or by contact hours early in the year may try again later in the year.

Pass or Fail

Certification is on a pass or fail basis. There is no limit to the number of times an applicant may sit for the certification exam. If unsuccessful the first time, an applicant will at least have a better idea of the content and type of questions included on the examination. A separate registration fee is required each time the exam is taken.

Fear of failure is the largest single barrier for individuals taking the exam. To eliminate this fear and to protect privacy, CBGNA does not release the names of candidates. “The testing company notifies applicants in writing, generally three to four weeks after the test,” says Carol Shaner, executive director of CBGNA. “First, they receive a score report from the testing company, and then about two weeks after that they receive their certification packet, with their certificate and their pin. Their certification is in effect as of the day they receive their notification from the testing company.” A list of successful applicants is published in the CBGNA pages of the SGNA newsletter.

ASGE Releases New Guideline for Prevention of Infection During Endoscopy

OAK BROOK, Ill. — With multi-society endorsement, the American Society for Gastrointestinal Endoscopy (ASGE) has published a position statement for reprocessing flexible gastrointestinal endoscopes in its journal, Gastrointestinal Endoscopy (GIE).

Released in the July 2003 issue of GIE, the guideline, “Multi- Society Guideline for Reprocessing Flexible Gastrointestinal Endoscopes,” establishes critical, semi-critical, and non-critical disinfection classifications, further defines pathogen transmission and GI endoscopy reprocessing, and provides recommendations for healthcare providers and operators of endoscopic equipment.

“The reprocessing of endoscopes is an integral component of the overall endoscopy experience,” said ASGE president Christopher J. Gostout, MD, Mayo Clinic, Rochester, Minn. “This process has been and continues to be monitored by the ASGE so that the cleaning and disinfection of flexible endoscopic instruments will be maintained for the safety of any patient at any time. It is important for the public to be reassured that there is such an on-going effort.”

The guideline stems from the Prevention of Infection During Gastrointestinal Endoscopy Consensus Conference held in 2002 by ASGE and the Society for Healthcare Epidemiology of America (SHEA). This guideline is also being concurrently published in SHEA’s journal, Infection Control and Healthcare Epidemiology (ICHE).

In addition to ASGE and SHEA, this new guideline is endorsed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Colon and Rectal Surgeons (ASCRS), the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), the Society of Gastroenterological Nurses and Associates (SGNA), the Association of Perioperative Registered Nurses (PERI), the Association for Professionals in Infection Control (APIC) and the Federated Ambulatory Surgery Association (FASA).

The ASGE, founded in 1941, is the preeminent professional organization dedicated to advancing the practice of endoscopy. ASGE promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. ASGE, with more than 7,800 physician members worldwide, serves the medical profession and the public by developing and advocating responsible positions for the benefits of patients, the public and medical professionals.

The Centers for Disease Control and Prevention (CDC) guidelines require that gastrointestinal endoscopes undergo high-level disinfection (HLD), in accordance with FDA recommendations. ASGE, SGNA, APIC, ASTM have developed rigorous standards of mechanical cleaning and high-level disinfection. These standards work well; transmission of infectious organisms during gastrointestinal endoscopy is an extremely rare event. In all cases where transmission has occurred, the cause was a failure to follow established guidelines. When established cleaning and disinfection protocols are followed, transmission of infection has not occurred.

Some recommendations have proposed sterilization techniques instead of high-level disinfection. Currently available “sterilization” techniques do not eliminate the possibility of human error, and have not been shown to provide a greater level of safety than accepted high level disinfection techniques.

ASGE members are very aware of the risk of transmission of infectious organisms during these procedures and are committed to patient safety. Physicians and hospitals go to great lengths to make sure that patients are protected from cross infection. The ASGE has confidence that current cleaning and high-level disinfection protocols, when used properly, prevent the transmission of infection and ensure the highest levels of patient safety.

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