1. Acute Care Exam: a Profile of Role Delineation Survey Changes (2004, 2010)

2. Description of Demographics of Respondents : Comparisons between 2004 and 2009 Top 7 Primary Clinical Focus Areas 20042009 Critical Care12.4%27.5% Cardiovascular Surgery10.7%5.4% Emergency6.8%10.7% Oncology/Hematology10.7%8.9% General Surgery5.1%4.1% Neonatal8.5%3.4% Neurology2.5%3.4% Other43.3%32.5% Location of Practice20042009 Urban85%86.2% Suburban13%11% Rural2%2.8% Years Experience as Acute Care Pediatric Nurse Practitioner 20042009 Less than 10 yrs23.9% 84% 11-15 yrs20.8% 11% 16 or more yrs55.3%5% Geographic Region 20042009 Both surveys (2004 and 2009) produced equal representation from the Northeast, Southeast, West and Midwest. Additional Comparisons: Formal AC Program ** In 2009, survey respondents who completed a formal Acute Care Program: 47.1%

3. Additional Comparisons: Percent of Time Spent in Practice Area 2004 2009 2004 2009 How well did the survey cover the important activities of your practice?

4. 2004 AC Exam Content Outline & Body System Ranking Body systems (guidelines, for those categorized): o Respiratory 14% o Infectious disease 12% o Gastrointestinal 11% o Cardiovascular 10% o Neurology 9% o Hematology 8% o Renal 7% o Musculoskeletal 5% o Immunology 5% o Metabolic 5% o Endocrine 4% o Oncology 3% o Otolaryngology 2% o Trauma 2% o Mental health 1% o Dermatology 1% o Ophthalmology 1%

5. 2010 AC Exam Content Outline & Body System Ranking CONTENT AREA Total % N Scored N = 150 1. Assessment and Diagnosis48%72 A. Health History8%12 B. Physical Examination and Diagnostics14%21 C. Diagnoses of Health Status26%39 2. Management48%72 A.Implement and Evaluate Therapeutic Interventions4365 B. Education, Collaboration, Consultation and Referral5%7 3. Professional Practice Role to include Research/Evidence based practice, Education and Leadership 4%6 Total100%150 Management Pulmonology1 Cardiology2 Infectious disease3 Neurology4 Hematology / Oncology5 Trauma6 GastrointestinaI7 Renal8 Musculoskeletal9 Endocrine / Metabolic10 Immunology11 Otolaryngology12 Dermatology13 Assessment Pulmonology1 Cardiology2 Infectious disease3 Neurology4 GastrointestinaI5 Hematology / Oncology6 Trauma7 Endocrine / Metabolic8 Renal9 Musculoskeletal10 Immunology11 Otolaryngology12

6. Comparisons of the Detailed AC Content Outlines 2004:  3 Main content areas, with 12 sub-content areas  Professional Practice: 8% of exam items  Systems: % Importance ordered 2010:  3 Main content areas, collapsed sub-content areas.  Professional Practice: 4% of exam items  Systems: Different order, still by importance, specified as Assessment and Management

7. Detailed Content Areas: 2010 Highlights Health History: More specific to acute care practice Physical Examination, Screening and Diagnostics: Formal Developmental screening not as important, but growth and development integrated into all facets of AC PNP practice. Sexual and reproductive issues not important in context of acute care. Education, Referral, Consultation and Collaboration as main content with details related to family, illness, palliative and end of life care with interdisciplinary focus.