Defense Date


Document Type


Degree Name

Doctor of Philosophy


Social Work

First Advisor

Lynn D. Nelson


This research involved an analysis of data for 3,387 candidates who took the National Qualifying Examination for pediatric nurse practitioners/associates between 1977 and 1982. Those data were available from the National Board of Pediatric Nurse Practitioners and Associates, which administers the examination, and its testing agency, the National Board of Medical Examiners. Included in the data were sociodemographic characteristics of examinees, characteristics of their nurse practitioner educational programs, and their composite examination scores.

The purpose of the research was to determine the ability of these sociodemographic and educational program variables to predict examination performance. Sociodemographic variables included: examinee age; highest level of education; months of experience as a registered nurse and as a nurse practitioner; formal or informal preparation as a nurse practitioner; current function (nurse practitioner skills or not); employment setting; year of examination; and, status as a first-time examinee or repeater. The educational program variables available for study were: current program status (operational or not); educational level (certificate or masters); institutional setting/sponsors; accreditation status; administrative control; discipline of program director(s); year established; class size; and length in hours and weeks.

The data were analyzed by descriptive and multivariate techniques. There were statistically significant differences in the sociodemographic and program profiles of examinees from year to year. Between 1977 and 1982 the average age and, consequently, the length of experience of examinees decreased. Their highest level of education increased, and there were a larger proportion of masters programs and masters program graduates. In terms of functions and settings, the number of examinees who were not functioning as nurse practitioners increased, as did the number who were unemployed. Over this 6 year period, educational programs have moved into the mainstream of nursing education: they are typically located in schools of nursing that are accredited by the National League for Nursing, with administrative control vested in nursing and with a nurse director or nurse and physician co-directors. Additionally, programs have increased in both length in hours and in weeks.

Regression analysis was used to evaluate the relationships between examination scores and the various predictor variables. An exploratory analysis using stepwise regression procedures eliminated those variables with little predictive significance. Further analyses with the five sociodemographic and five program variables remaining in the regression equations indicated that the largest contributions to differences in examination scores were made by the following variables: examinees' status as first- time takers or repeaters, their highest education, their age, and the educational level and accreditation status of their nurse practitioner program.

At the individual level of analysis, sociodemographic variables were better predictors than program variables and explained between 8-26% (R = .28 to .51) of the variance in examination scores. On the other hand, the program variables explained 28% (R=.53) of the variance in average performance from program to program. That is, at the aggregate level of analysis (by program) there is obviously less individual variation around the program means and, therefore, greater predictive ability. Based on the results of this research the investigator made recommendations regarding educational and regulatory policy and suggestions for further research. In particular, further research on certification in nursing was encouraged.


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