|Frequently Asked Questions (FAQs)
are the most frequently asked questions by applicants and NCSNs - and are
posted here for your convenience from previous issues of the NCSN
Newsletter. Additional questions may be directed to firstname.lastname@example.org
or to the email address of the President listed on the NBCSN Leadership
NBCSN Examination Questions
Your Certification Questions
Questions regarding the examination:
Do I have to be working full time to be eligible to take the exam?
To be eligible to sit for the examination the
applicant must show a minimum of 1,000 hours of clinical practice in the
area of school nursing during the past three years; however, NBCSN
recommends a minimum of 4,000 hours (or three full time academic
Clinical practice is school nursing means actively
employed or contracted to provide a direct or indirect professional
contribution to the health and education of students and their families in
public or private school settings.
Direct clinical practice in school nursing is defined
as involvement in the nursing process in a school setting where the
nursing actions and judgments are focused on a particular student, family,
school community, or group of students or their families where there is
oninuing professional responsibility and accountability for the outcomes
of these actions.
Indirect clinical practice in school nursing is
defined as involvement that: (1) includes clinical supervision of school
nurses, education and clinical supervision of baccalaureate/master's nursing
students in school health, administration of school health services, research,
consultation or other engagement in the field of school nursing that
contributes to the specialty's body of knowledge or enhances the quality
of school nursing practice; and (2) entails continuing professional responsibility
and accountability for the outcomes of the involvement.
Not eligible as clinical practice in school nursing
includes: substitute nursing in a school, except as full time substitute
working consecutive days for the required clinical practice hours;
one-to-one nursing as the nurse's sole responsibility within a school; employment
in the direct sales, marketing or distribution of school nursing-related
products or services in pharmaceutical, technology or other school
health-related industries; community health screenings; work in a camp
setting; preceptorship/mentor; and jobs unrelated to school nursing.
Why must you have a bachelor degree to take the NCSN
criteria have generated as much discussion as the eligibility requirement
of a baccalaureate degree for the certification exam.
For the first few years of the exam, from about 1986-91, all
registered nurses, from every educational background, were allowed to take
the certification exam. In
1991, when NBCSN separated from NASN, the Board reviewed the Scope and
Standards and position statements of both the NASN and the ANA, and
established the criteria that the baccalaureate degree would be one of the
eligibility requirements for the certification exam.
There was, and continues to be, much
thought and discussion about this requirement, as the Board does recognize
that there are many great school nurses without degrees who promote the
health of students everyday. However,
there are three primary reasons for the requirement:
Research based evidence demonstrating that the skills needed
for broad-based knowledge, autonomous professional practice and leadership
performance were more often obtained in bachelors programs and implemented
by such graduates.
Respect for the long-established community-nursing model
that required bachelors-level preparation.
Greater equity in negotiating for comparable pay compared to
educators. To do so, school
nurses must be able to demonstrate equivalent academic preparation.
NBCSN Board (Carol Calarco, President): FAQ 2005
American Board of Nursing Specialties does report some certificates
granted by exam for some nursing specialties - however, the NBCSN Board
believes the scope of these hospital-based specialties to be narrow and
limited when compared with the breadth of knowledge and practice of the
specialty of school nursing.
NBCSN Board also strongly supports the Scope, Standards and Position
Statements of the National Association of School Nurses, Inc., and
frequently refers to NASN and its publications to sustain the decisions of
the Board and its expert panels on issues of practice, research and
the statement below is the current position statement of NASN, it has not
deviated from earlier versions supporting the baccalaureate degree as the
minimum recommendation for the practice of school nursing:
nurses, the minimal level of education for preparing for preparation in
independent practice, leadership/management, and community health nursing
is the baccalaureate degree, and licensure as a registered nurse. In
addition, certification at the sate and national levels reflects more than
a minimal knowledge base. As a nursing specialty, school nursing
requires advanced skills that includes the ability to practice independently,
supervise others, and delegate care in a community health setting. (ANA,
the position of the National Association of School Nurses that every
school-aged child deserves a school nurse who is a graduate of a
baccalaureate degree program from an accredited college or university and
licensed by that state as a registered nurse. These requirements are
the minimal preparation for the skills needed at the entry level of school
nursing practice. Additionally, NASN supports state certification,
where required, and promotes national certification of school nurses
NASN Position Statement: Education, Licensure and Certification of
School Nurses (2002)
What are acceptable
degrees to sit for the examination?
Accepted Health Related Baccalaureate Degrees:
Eligible to take NCSN examination:
Natural Sciences: Biochemistry, Chemistry, Human Ecology
Evolution-Behavior, Human Biology, Microbiology, Cell Biology,
Sciences and Disorders
Applied Learning and Development (Early Childhood through grade 6,
Special Education), Health Education, Health Promotion, Health and Physical
Education, Community Health Education
Organization Management, Healthcare Administration
Development: Early Childhood, Child Development, Families and Personal
Relationships, Families and Society
Arts: Biochemistry, Biology, Chemistry, Human Ecology
Including Dietetics, Nutritional Sciences, International Nutrition
Including Medicinal Chemistry, Pharmaceutics, Pharmacology and
Requirements to take NCSN examination for non-BSN or non-health related
Baccalaureate degrees:. The following must be submitted to the NBCSN
Board, c/o President (email is listed on the "Leadership" page), for review and approval prior to submission of
application to take the NCSN exam:
of primary health care problems of children and/adolescents
assessment of children and/adolescents
I am interested in taking the examination
to become a NCSN. Is there a class available to prepare for the exam?
There are no review classes for
the exam that are supported or formally approved by the NBCSN. However, many NASN
affiliate organizations have study groups and review courses to
assist school nurses prepare for the examination. In addition, some
colleges offer online and graduate courses related to school nurse
preparation and content. For more information, contact
the NBCSN liaison in your state for more information.
National Association of School Nurse publishes a School Nurse
Certification Review manual through its publications. Contact www.nasn.org
for ordering information.
I just received my testing results and did not pass. I would
like to know how the passing score is determined, as it seems it changed
from last year. I also have some questions about some individual
items that I would like to discuss with someone.
I am sorry that you did not pass the exam.
I can only imagine how disappointed you are. The results are
un-appealable. In special circumstances, we have allowed
individuals to retake the exam at no further expense upon receipt of a
written request to retake the exam and a review of the
circumstances by the Board, but the scores obtained for the
exam that you took will not change and the results will remain the
There are several issues that I must explain--the
first being that board members and our staff at PTC do not
discuss individual items. This is to protect the integrity of the
exam. So I cannot comment on the questions that you have
related to individual questions. I can however, describe the
process under which they are developed and tested. Items are
solicited from NCSNs and others throughout the year, especially as
a part of the application to participate in the Item Writing
Workshop held during the NASN Conference. During that
Workshop, additional items are developed by participants who
represent a diversity of school nurse roles across the United States. The
facilitator leads the group in developing items that reflect real life situations, have
an answer that can be verified in current school nursing literature,
texts and research, and that are developed preferably to utilize
the analytical skills of the school nurse rather than rote
knowledge. After the items have been reviewed, they are then
reviewed by a panel of practicing school nurses--again verifying
that the situation is current and real, the answer designated
is correct, that the question is as clear and straight-forward as
possible (ie no trick questions) and can be categorized into the content
outline described in the NBCSN Candidate Handbook. In December,
the Board reviews each version of the tests that will be given in
the next year. The test items are weighted by psychometric
measures to ensure that they are balanced (equal difficulty), that the
questions are clear and the answers are validated by current school
nursing literature. Following a review of the demographics and the
disaggregated data, the Board then applies a psychometric tool
called the Angoff method to identify the cut score and the
passing score is set. From this description, you can see that the
exams differ from year to year, and each version given in one year contains
different items. Also, the passing score is set based on the
current Board's review of all the data and the exam. So you
can see that the passing score can change from year to year, based
on our process. Remember too, that the Board represents a
diversity of school nursing practice areas from across the United
States. Our public member does not participate in the review of
the exams nor the activities that set the passing score, as she is not a
As a final review, the exams that are taken during any testing window
are scored together, to ensure that there is not anything abnormal that
is observed in the scoring process (for example, everyone missing a
certain question). If so, the item is reviewed again by the
testing corporation and referred to the Board to determine if the item
should be pulled and all the tests re-scored. This process allows
us to provide the greatest flexibility and fairness to our
candidates--it is possible, from the time when the Board review the
exam in December, that the standards of practice or approach to a school
nursing issue may change completely by the testing window in the
Our process has been reviewed and has met the
standards of accreditation of the American Board of Nursing Specialties,
which includes the use of psychometric methods to develop, review and
set the passing score for the exams.
I would like to know the answers from the
test in order to
learn the missing content. How can I get that information to better
prepare for the next exam?
NBCSN policy prohibits the release of the exams or
specific items. Just as with RN state-boards, the
validity of the test can only
be maintained if its confidentiality and security are not breached, which
includes not releasing any portion of the examination to individuals outside
of the NBCSN Board and the test development company. The Professional
Testing Corporation (PTC) does share the statistics related to the five
areas of the exam with the individual candidate in order that the individual
would be able to note content areas of weakness, so you may study in that
Can you give me contact information for
the NBCSN liaisons?
You can find your state liaison
on the liaison page of this site. Click
I am interested in becoming a liaison, what is the next step?
We allow a maximum of two state liaisons per
state. Please fill out an application to become a state liaison from
the Forms & Applications page and
return to the board office. The Vice President reviews your
application. You are required to submit an annual report which can
also be downloaded from the Forms &
Applications page. For further information please visit the Liaison
Questions regarding recertification:
What type of continuing education credits
are acceptable for re-certification?
NCSNs are required to renew their certification in
order to demonstrate that they have kept current with new practices,
methodologies, equipment, medications, and terminology in the field.
To apply for recertification through continuing
education, 75 hours of continuing education (CE) related to school nursing
practice must be reported. These hours of CE must be related to the
practice of school nursing, sponsored by an approved national accrediting
agency, and must have been completed during the five (5) years prior to the expiration
date of the candidate's certification. Continuing Education Programs may
include workshops, seminars, professional development offerings, home-study courses, and
state/national conferences, which are school health related.
CE hours may be accumulated in any combination of the
Continuing Education Credits
All contact hours must
be in subjects related to school
health practice and be approved by a national accrediting agency (as
described above), state department of health or education, accredited
universities or colleges, etc. These
may include workshops, seminars, professional development offerings, and
state/national conferences. Online
courses, teleconferences, and “webinars” are acceptable, provided
they are approved by a national or state accrediting agency.
Single–offering courses, seminars, workshops or
conferences listed as twenty (20) hours or greater must be accompanied by
a course outline or content agenda attached to the recertification
For conferences with multiple concurrent sessions, each
session attended must be identified individually on the certificate or
Self-paced or online CE programs are acceptable for credit
if approved by one of the credentialing organizations recognized by the
Courses which are considered basic nursing preparation or
staff development are not accepted. Activities
NOT ACCEPTABLE for continuing
education credit include:
Basic CPR, first aid,
blood-borne pathogens training and other state certification and screening
courses, as vision, hearing, Acanthosis Nigricans, spinal assessment, etc.
PALS, ATLS, ACLS will be
accepted for credit only one time during the five year recertification
Basic computer technology
courses, as Windows, Word, Excel and PowerPoint, including computer
training for district specific record keeping
In-service programs that
provide specific information about the work setting’s philosophy and procedures,
including orientation to a work setting, department and district staff
development courses, workshops and committee meetings—unless
pre-approved by an accredited
provider as described above
On the job training and
Refresher courses designed to
Courses that focus on
self-improvement, changes in attitude, self-therapy, self-awareness
Personal weight loss, yoga or
personal appearance, etc.
Economic courses for financial
gain, as investments, retirement, preparing resumes and techniques for job
Liberal art course in music,
art, philosophy, etc, when unrelated to patient/client/student care
Courses for lay people
Academic courses must be taken within the framework of a
curriculum that lead to an academic degree in nursing or any academic
course relevant to nursing practice. An
academic course taken for credit may be used to meet NBCSN requirements if
a grade of “C” or better or “pass” on a pass/fail system is
Each individual academic credit, from an accredited
institution of high learning will be considered as ten (10) contact hours
A transcript of successful completion of each course must be
submitted with recertification documentation
On-line academic courses will be accepted from accredited
Prerequisite courses, such as mathematics, government,
anatomy, physiology, languages, literature, etc. cannot be accepted to
meet any part of the continuing education requirements for a registered
The NBCSN recognizes and supports endeavors that promote and
enhance the role of the certified school nurse and grants credits to
non-academic or typical continuing education events.
Additional activities are listed on the Recertification page
and in the recertification guidelines.
All courses are subject to review. Applicants may be requested to demonstrate how the
course content promotes expertise in school health or is relevant to the
school nursing practice of the certificant.
All CE information must be listed on the Application
for Recertification of School Nurses through Continuing Education and must
include date, program title, CE provider or sponsor (i.e. approved
national accrediting agency), and the number of CE hours awarded.
Do you accept home study course credits
from Nursing Education of
America towards re-certification?
The important issue for NBCSN related to any
organization providing nursing or continuing education credits is that the
agency must be accredited by a national, state or regional accrediting
association. For example, units must be approved by organizations
as, the American Nurse Credentialing Center (ANCC), Continuing Medical
Education (CME), a state health or education agency, or a college or university
accredited by a regional or national accrediting board or listed by the US
Department of Education.
I have noticed that the recertification guidelines related to
continuing education have changed--but many of my courses taken prior to
2007 do not meet the new criteria. My recertifcation date is next
year--will I have to take additional courses this year to make
up those which do not meet the new criteria to meet my 75 credits?
We will grandfather and accept most
courses/workshop/conferences obtained prior to 2008 that certificants
use for recertification credit. All units submitted are
reviewed by Board members to ensure that they are school health related
and will enhance the knowledge and skills of the school nurse. As
the ANCC changed their requirements in 2007, most hospitals and
university providers made the changes if they were accredited ANCC
providers. Universities which granted CEUs are not affected,
as CEUs are academic credits and not nursing credits. I think that
as members attend workshops this year (and last), they will note
that their certificates have more information on them, listing the
provider, the ANCC number if appropriate, date and name of the course.
The Board has been flexible and understanding of
the recertification applications, and mindful that our criteria changed
only last year to reflect the national standards enacted by the ANCC. The
Board's decision was not dependent on our ABNS accreditation, but due to
the increased numbers of commercial and online programs documented on
recert applications which were sometimes biased and did not go
through any review process to ensure timeliness, current research-based
information, or quality/expertise of faculty. All of us
should be mindful consumers of continuing education and verify that the
courses provided meet the standards of continuing education--which
only assure that the program is high quality, has faculty who are
knowledgeable and expert in their fields, has no bias or commercial
interest that is not disclosed, and has learner objectives and content
that are reviewed by expert auditors. The Board tried to make the
guidelines even more flexible, by allowing that programs developed by
the state department of health or education to be accepted.
recently submitted my recertification documentation, and was told that
some of my units were not acceptable, as they were not from an
What does that mean?
My school district accepts all of our staff development hours, why
can’t I use these for my recertification credits?
The Board reviewed the policies and procedures related to
In doing so, they were also mindful of the standards required by
the American Board of Nursing Specialties and the need to ensure that the
NCSN recertification process reflected that the certified school nurse
continued to meet the established standards of maintaining expertise in
the specialty field.
While most programs offered by districts and campuses provide
excellent information, they often do not have the review process and
criteria established by accredited providers. In addition, the Board noted
that many NCSNs were obtaining credit from online courses and commercial
vendors, whose workshops did not have any documentation related to the
validity of the information presented or the expertise of the faculty.
Programs that are accredited by state health and education
departments, or national organizations as those that
provide continuing education courses for counselors, psychologists,
physicians and nursing, are reviewed to ensure that they meet established
criteria related to content, presenters, learners’ objectives, etc.
They are standardized in format to ensure that contact hours meet
definitions of time spent in “class”, speakers’ objectives, and the
Courses taken in an academic setting also must meet the standards
established by the college or university accrediting body.
addition, the Board felt that programs related to orientation,
vision/hearing/CPR/BMI measurements and other skills training were basic
and not reflective of information that would enhance the certified
nurse’s practice and knowledge.
school nurses need to become discriminating consumers and select courses
that enhance their specialty practice.
Courses submitted for recertification credit must be school health
This is not to limit any nurse from taking any course for
relicensure—but courses submitted for NCSN recertification must be
school health related—a wide range when one considers sociology,
psychology, education and other topics that fall within the school
Documentation of attendance at any course should include the number
of contact hours and the name of the accredited
provider, as the ANCC (American Nurses Credentialing Committee),
CME (Continuing Medical Education organization), university, etc.
more information, see http://www.nbcsn.org/recertification
Questions regarding your certification:
I have recently
retired, and am upset that my request for retirement status to enable
me to keep my title of NCSN has been denied.
In July 2004, the Board discussed retired and inactive status, and at
that time voted to eliminate the inactive and retired lifetime status.
Certification is recognized as a mark of current and continuing
competency, and implies an ongoing effort to maintain proficiency and
expertise. The Board observed that economic times had allowed some school
nurses to “retire” but to continue to work in school nursing on a part
or full time basis—and retain a retired or inactive NCSN status
without meeting the requirements for continuing education and maintenance of
expertise. In reality, if a nurse was working part time in a school
health related occupation, then the nurse would be eligible for - and
required to pursue - full active NCSN status. While the Board
regretted that school nurses could not continue to use the NCSN
credentials after retirement ceasing to work in a school health related
field, there are no means available to reliably
track retired, inactive or non-renewing certificants.
The Fall 2004 Newsletter notified members of the elimination of the
Retired/Inactive NCSN status.
I have lost my
certificate and/or card, how do I replace it?
Send a check or money order payable to
NBCSN in the
amount of $12 to the Board office. Please
include a brief note requesting the new certificate along with a current
mailing address and contact phone number.
I have a name change,
how do I let you know?
You may fax or mail to us a copy of your
name change certificate that was issued by the court. If you would
like a new certificate with your new name, please send us a check or money order
payable to NBCSN in the
amount of $12 to the Board office. Please
include a brief note requesting the new certificate along with a current
mailing address and contact phone number.