CNA Certification General Application Guide - For Certification Renewal by Continuous Learning or by Exam

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CNA Certification
                             2015
                             General
                             Application
                             Guide
                             F or Certification Renewal
                              by Continuous Learning
                              or by Exam

                             Application Period
                             › September 2 to December 1, 2014

Care tothe
        BeBest               Apply early and get your online
                             exam prep resources sooner!

  Apply Online!
  getcertified.cna-aiic.ca
Quick Reference                                                                                                                                     Exam Date                 › April 18, 2015
                 Online and hard-copy applications will be accepted from September 2 until December 1, 2014.

                                                                                 Residents of BC, AB, SK, MB, NU, NT and YT
2015 Certification Renewal Fees (fees include tax, which is subject to change)

                                                                                     Renewal by continuous learning — CNA members: $308.70
                                                                                     Renewal by exam — CNA members: $536.55
                                                                                     Substitute writing centre fee: $168 (additional)
                                                                                 Residents of ON
                                                                                 Please see page 12 of this guide.
                                                                                     Renewal by continuous learning — CNA members (proof required): $332.22
                                                                                     Renewal by continuous learning — Non-members: $415.84
                                                                                     Renewal by exam — CNA members (proof required): $577.43
                                                                                     Renewal by exam — Non-members: $819.25
                                                                                     Substitute writing centre fee: $180.80 (additional)
                                                                                 Residents of QC
                                                                                 Please see page 12 of this guide.
                                                                                     Renewal by continuous learning — CNA members (proof required): $308.70
                                                                                     Renewal by continuous learning — Non-members (QC): $386.40
                                                                                     Renewal by exam — CNA members (proof required): $536.55
                                                                                     Renewal by exam — Non-members: $761.25
                                                                                     Substitute writing centre fee: $168 (additional)                Remember:
                                                                                 Residents of NB and NL                                            › Include proof of your current nursing
                                                                                     Renewal by continuous learning — CNA members: $332.22             registration/licence.
                                                                                     Renewal by exam — CNA members: $577.43                             •  Online applicants: Only your RN licence
                                                                                     Substitute writing centre fee: $180.80 (additional)                    registration number is required.
                                                                                                                                                        •  Hard-copy applicants: Include a copy of your
                                                                                 Residents of NS                                                            RN status or a copy of an e-mail confirming
                                                                                     Renewal by continuous learning — CNA members: $338.10                  membership in your provincial/territorial
                                                                                     Renewal by exam — CNA members: $587.65                                 nursing association.
                                                                                     Substitute writing centre fee: $184 (additional)              ›   Indicate your preferred writing centre (code and city)
                                                                                                                                                       if you are renewing by exam.
                                                                                 Residents of PE
                                                                                     Renewal by continuous learning — CNA members: $335.16
                                                                                                                                                   ›   Include payment for all applicable fees by credit
                                                                                                                                                       card or by cheque or money order made payable to
                                                                                     Renewal by exam — CNA members: $582.54                            the Canadian Nurses Association. If the payment
                                                                                     Substitute writing centre fee: $182.40 (additional)               total is not correct, your application will be delayed.
                                                                                                                                                   ›   Ensure that all additional forms and/or information
                                                                                 All fees include an administrative fee of $59 + GST or HST            is included as necessary.
                                                                                 for renewal by continuous learning or $101 + GST or HST           ›   Hard copy applicants must sign and date their
                                                                                 for renewal by exam.                                                  application form.
                                                                                                                                                   ›   Complete your application fully and accurately
                                                                                                                                                       and retain proof.
                                                                                                                                                        •  Online applicants: You will receive an e-mail
                                                                                                                                                            confirming that your payment and application
                                                                                                                                                            have been received.
                                                                                                                                                        •  Hard-copy applicants: You are advised to
                                                                                   Candidates choosing to renew by exam, please see
                                                                                                                                                            keep a copy of your application and all
                                                                                 pages 16-17 of this guide for writing centre information.                  accompanying documents.
2015 CNA Certification Program
National certification in nursing specialties and areas of nursing practice offered by the
Canadian Nurses Association (CNA)

General Application Guide for Certification Renewal by
Continuous Learning or by Exam

This application guide contains all of the information you need to apply for certification renewal by continuous learning or
by exam. For hard-copy applicants, all the required forms are available on the certification website.

Please read this guide completely before applying.

                                                                   ›
Contact CNA certification staff to discuss eligibility criteria
or professional issues about CNA and certification.
                                                                                     Online application available
CANADIAN NURSES ASSOCIATION
Certification Program
50 Driveway
Ottawa, ON K2P 1E2
                                                                            Hard-copy applicants: applications received
Website: getcertified.cna-aiic.ca
                                                                            close to deadline dates will require a longer
E-mail: certification@cna-aiic.ca
Toll-free: 1-800-361-8404                                                                   processing time.
Fax: 613-237-3520

Contact the CNA Certification Program Processing Centre
staff to discuss any questions about the processing of your             CNA Certification Program Processing Centre
application for certification. You may send your application            • Hard-copy applicants: Send your application
to the processing centre.                                                 directly to the processing centre address.
CANADIAN NURSES ASSOCIATION                                               We strongly recommend that you send your
Certification Program Processing Centre                                   application by a guaranteed courier service.
1400 Blair Place, Suite 210                                               CNA is not responsible for lost or misdirected
Ottawa, ON K1J 9B8                                                        mail. We also recommend that you photocopy
                                                                          your application before mailing.
Website: getcertified.cna-aiic.ca
                                                                        • Contact the processing centre staff if you wish to
E-mail: certification@cna-aiic.ca
                                                                          change current information, order promotional
Toll-free: 1-800-450-5206
                                                                          materials, ask about or revise your candidate status,
Fax: 613-237-6684
                                                                          or if you have any other questions.

Canadian Nurses Association getcertified.cna-aiic.ca                                                                              i
Contents
SECTION 1 Applying for certification renewal.................................................................................................... 1
Introduction............................................................................................................................................................. 1
General information ................................................................................................................................................ 2
Eligibility criteria...................................................................................................................................................... 2
     Specific eligibility criteria................................................................................................................................... 2
     Calculating hours of experience......................................................................................................................... 3
     Inactive status for certification renewal candidates............................................................................................. 3
     General guidelines for earning CL activities....................................................................................................... 4
     Specific guidelines for recording CL activities.................................................................................................... 4
Aligning the CNA certification renewal process with continuing competence.......................................................... 7
    Introduction...................................................................................................................................................... 7
    Continuing competence.................................................................................................................................... 7
    Five-step process for renewal by CL................................................................................................................... 8
    Keeping track of CL activities............................................................................................................................ 8
    Quality assurance audits.................................................................................................................................... 8
Fees for certification renewal.................................................................................................................................. 10
Financial support for certification candidates.......................................................................................................... 10
    Employer support............................................................................................................................................ 10
    Funding support from the Canadian Nurses Foundation................................................................................ 10
    Government financial support......................................................................................................................... 10
    Receipts........................................................................................................................................................... 10
Completing your application.................................................................................................................................. 11
   1. Identification information.......................................................................................................................... 11
   2. Registration and CNA membership........................................................................................................... 11
   3. Verification of experience in the nursing specialty/area of nursing practice................................................. 13
   4. Continuous learning activities.................................................................................................................... 14
   5. Endorsement and verification of experience by a supervisor/consultant
      in the nursing specialty/area of nursing practice ........................................................................................ 14
   6. Nursing education history.......................................................................................................................... 15
   7. Statement of understanding ...................................................................................................................... 15
   8. Writing centre information........................................................................................................................ 15
   9. Payment information................................................................................................................................. 18
Additional materials............................................................................................................................................... 20
Policies and procedures........................................................................................................................................... 21
     Withdrawal and refund policies....................................................................................................................... 21
     Incidental fees................................................................................................................................................. 22
     Other policies.................................................................................................................................................. 22
SECTION 2 Frequently asked questions ............................................................................................................ 24
SECTION 3 Information on nursing specialties/areas of nursing practice ....................................................... 27

                                                                           All rights reserved. The General Application Guide for Certification Renewal by
      Prepare for CNA certification exams                                  Continuous Learning or by Exam and supporting forms required for application
      by visiting getcertified.cna-aiic.ca                                 may be copied for the purpose of preparing an application for submission.
                                                                           © Canadian Nurses Association
       for the nursing competencies and
                                                                           50 Driveway
     bibliography for your nursing specialty                               Ottawa, ON K2P 1E2
            or area of nursing practice.                                   published in 2014
                                                                           ISSN 1913-3065

ii                                    General Application Guide for Certification Renewal by Continuous Learning or by Exam
Section        1
Applying for certification renewal
Introduction

Care to Be the Best                                               The CNA Certification Program
                                                                  is linked to the following national
Renewing your CNA National
                                                                  nursing associations:
Certification Credential
                                                                  Canadian Association of Critical Care Nurses (CACCN) –
Since 1991, the Canadian Nurses Association (CNA)                 www.caccn.ca
Certification Program has recognized an increasing number of
                                                                  Canadian Association for Enterostomal Therapy (CAET) –
registered nurses (RNs) for having achieved CNA certification     www.caet.ca
in their nursing specialty or area of nursing practice — a true
                                                                  Canadian Association of Medical and Surgical Nurses
mark of distinction!                                              (CAMSN) – www.medsurgnurse.ca

You have held this mark of distinction for its full term and      Canadian Association of Nephrology Nurses and
it is now time to renew your certification. This application      Technologists (CANNT) – www.cannt.ca
guide describes the process for certification renewal and the     Canadian Association of Neuroscience Nurses (CANN) –
requirements you will have to meet.                               www.cann.ca
                                                                  Canadian Association of Nurses in Oncology (CANO) –
There are 20 nursing specialties and areas of practice listed     www.cano-acio.org
here with their certification designation. Those available for
                                                                  Canadian Association of Perinatal and Women’s Health
certification renewal are indicated with an (R).
                                                                  Nurses (CAPWHN) – www.capwhn.ca
• Cardiovascular, CCN(C) (R)                                      Canadian Association of Rehabilitation Nurses (CARN) –
• Community Health, CCHN(C) (R)                                   www.carn.ca

• Critical Care, CNCC(C) (R)                                      Canadian Council of Cardiovascular Nurses (CCCN) –
                                                                  www.cccn.ca
• Critical Care Pediatrics, CNCCP(C) (R)
                                                                  Canadian Federation of Mental Health Nurses (CFMHN) –
• Emergency, ENC(C) (R)                                           www.cfmhn.ca
• Enterostomal Therapy, CETN(C) (R))                              Canadian Gerontological Nursing Association (CGNA) –
• Gastroenterology, CGN(C) (R))                                   www.cgna.net
• Gerontology, GNC(C) (R)                                         Canadian Hospice Palliative Care Association (CHPCA) –
• Hospice Palliative Care, CHPCN(C) (R)                           www.chpca.net
                                                                  Canadian Occupational Health Nurses Association Inc.
• Medical-Surgical, CMSN(C)
                                                                  (COHNA) – www.cohna-aciist.ca
• Nephrology, CNeph(C) (R)
                                                                  Canadian Orthopaedic Nurses Association (CONA) –
• Neuroscience, CNN(C) (R)                                        www.cona-nurse.org
• Occupational Health, COHN(C) (R)                                Canadian Society of Gastroenterology Nurses and
• Oncology, CON(C) (R)                                            Associates (CSGNA) – www.csgna.com

• Orthopaedics, ONC(C) (R)                                        Community Health Nurses of Canada (CHNC) –
                                                                  www.chnc.ca
• PeriAnesthesia, PANC(C)
                                                                  National Association of PeriAnesthesia Nurses of Canada
• Perinatal, PNC(C) (R)
                                                                  (NAPAN©) – www.napanc.org
• Perioperative, CPN(C) (R)
                                                                  National Emergency Nurses Affiliation (NENA) –
• Psychiatric and Mental Health, CPMHN(C) (R)                     www.nena.ca
• Rehabilitation, CRN(C) (R)                                      Operating Room Nurses Association of Canada (ORNAC) –
                                                                  www.ornac.ca

Canadian Nurses Association getcertified.cna-aiic.ca                                                                       1
General information

What is certification renewal?                                    accommodate certification renewal candidates who wish
                                                                  to renew by exam and provides time for a thorough review
CNA certification is valid for a five-year term, after which      of the continuous learning activities. It also allows time to
you can renew your national credential either by submitting       process all of the applications and send new certificates to
a list of continuous learning activities or by rewriting the      candidates before their certification term expires.
exam. Maintaining your certification is also contingent upon
maintaining your RN registration/licence and meeting all
certification renewal eligibility criteria. If you do not renew
                                                                  Lapsed certification
your credential, it will lapse, and you will no longer have       If you do not renew when the five-year term has ended,
the privilege of using it in your nursing specialty/area of       your certification credential is considered lapsed. To earn the
nursing practice.                                                 credential again, you must meet the current eligibility criteria,
                                                                  submit an application for initial certification and write the
When to renew                                                     certification exam. If you have any questions about your
                                                                  certification renewal or the eligibility criteria needed to renew,
You must complete your online or hard-copy application            do not hesitate to contact the CNA Certification Program at
for certification renewal by the last day of the renewal          1-800-361-8404.
application period. For 2015 certification renewal
candidates, the application period will run from
                                                                  Note: Your fee will be processed immediately.
September 2 until December 1, 2014. Application form
                                                                  Processing of your fee does not confirm eligibility.
available online. The application deadline is necessary to

Eligibility criteria

You can renew your certification only in the nursing
                                                                  Note: One full-time year = 1,950 hours (including
specialty/area of nursing practice in which you are
                                                                  vacation time).
currently certified. To renew, you have two basic options.
Choose only one option.

                                                                  Specific eligibility criteria
Option 1: Continuous Learning                                     (required for both options)
Submit a record of continuous learning (CL) activities in your    To be eligible for certification renewal, you must meet the
nursing specialty/area of nursing practice accumulated during     following criteria:
the five-year certification term (minimum 100 hours).
                                                                  • You hold a current registration/licence as an RN in Canada.
Option 2: Exam                                                    • You have accumulated a minimum of 2,925 hours of
                                                                    experience as an RN in your nursing specialty/area of
Write the certification exam. See the application form for
                                                                    nursing practice during your current five-year certification
the exam date.
                                                                    term in full-time, part-time or casual employment.
                                                                  • You have accumulated a minimum of 100 hours of
     All of the information requested as part of your               continuous learning (CL) activities related to your nursing
    application must be completed clearly and in full               specialty/area of nursing practice during the five-year term,
                                                                    or you have successfully written the current exam in your
     for your eligibility to be accurately determined.
                                                                    specialty/area of nursing practice.
    Otherwise your application will not be considered.

2                          General Application Guide for Certification Renewal by Continuous Learning or by Exam
• Your supervisor/consultant in your nursing specialty/area          The request for inactive status must be made before
  of nursing practice must verify that you have the                       the end of the candidate’s certification term.
  required experience.
  • Online applicants: The information stated on your
                                                                    The fee for inactive status is $168 plus GST/HST and is
    application will be sent electronically to your supervisor/
                                                                    non-refundable.
    consultant for validation and endorsement.
  • Hard-copy applicants: The Endorsement and                       The Inactive Status Application form is to be sent to the
    Verification of Experience section of the application form      processing centre address listed along with the fee.
    must be completed by your supervisor/consultant.
                                                                    The candidate cannot use the CNA certification credential
• You have either completed the online certification                during the inactive period.
  renewal application process or, in the case of hard-
  copy applications, completed the Certification Renewal            Certification status can be reactivated at any time during
  Application form, submitted the necessary documents               the three-year term as long as the candidate meets all of the
  and paid the appropriate fees.                                    renewal eligibility requirements in effect at the time, including
                                                                    any changes in requirements that may have occurred during
Calculating hours of experience                                     the period of inactivation. The certification credential will be
                                                                    reactivated when the Certification Renewal Application form
Here are some important points to remember as you calculate         and fee are submitted and the application has been approved
your hours of experience.                                           by CNA Certification Program staff.

• The hours you include must all be RN experience in your           If a candidate does not apply for reactivation of their
  nursing specialty/area of nursing practice. This experience       credential before the end of the three-year inactive status term,
  can be in any of the five following areas: direct patient care,   the credential will lapse. In order to earn the credential at a
  education, research, policy or administration.                    future date, the candidate will be required to meet all of the
• Hours of RN experience in your nursing specialty/area of          current eligibility criteria and write the exam.
  nursing practice can be earned outside of Canada.
                                                                    If there are extenuating circumstances affecting reactivation
• You can include all hours completed, or forecast to be            that require special consideration from the CNA Certification
  completed, by the end of your certification term.                 Program, you must contact CNA certification staff to discuss
• Remember, one full-time year = 1,950 hours (including             these circumstances before the three-year inactive status
  vacation time).                                                   term ends.

Inactive status for certification                                   Example
renewal candidates
                                                                    Jane’s CNA certification renewal term is from April 16, 2010,
Nurses who must let their certification lapse owing to personal     to April 17, 2015. She is due to renew her certification in
or professional reasons may apply to the CNA Certification          2015. In the autumn of 2014, she applies for inactive status,
Program for inactive status. Inactive status provides CNA-          pays $168 (plus tax) and is granted inactive status from April
certified nurses with an additional three-year period to meet       19, 2015, to April 17, 2018. In October 2017, Jane applies
their renewal requirements.                                         in writing to reactivate her CNA certification status, using
                                                                    her experience and continuous learning accrued during the
Inactive status begins the day after the last day of the            five-year period from November 2012 to November 2017. The
certification term.                                                 renewal application is approved and her certification is renewed
It cannot be extended past one three-year term. The request         for the period of 2018 to 2023. Jane will receive a new CNA
for inactive status must be submitted before the certification      certification number for the reactivation of her credential.
period expiry date using the Inactive Status Application form       If Jane does not apply for status reactivation before the end of
(available at getcertified.cna-aiic.ca, Certification Renewal).     her inactive term, her certification will lapse, and she will need
                                                                    to write the scheduled exam to reclaim certification.

Canadian Nurses Association getcertified.cna-aiic.ca                                                                                3
Candidate notification                                               • One clock hour equals one CL hour.

Once a decision is reached, CNA will contact you in writing.         • Subtract any time taken from the CL activity for lunch,
Because extra steps are involved in reviewing an application           breaks, etc.
for inactive status, the notification process may take longer        • Pre-authorization from CNA is not required for your CL
than eight weeks.                                                      activities to count.

Please contact the certification nurse consultant at                 • CL activities can be earned outside Canada. International
1-800-361-8404 for further details.                                    CL activities are not only accepted, they are encouraged.
                                                                     • Some examples of CL activities include attending
General guidelines for earning                                         conferences, workshops, seminars and employer in-services;
continuous learning (CL) activity hours                                taking formal courses at college or university; making
                                                                       presentations; and writing articles.
All provinces and territories now have continuing competence
and quality assurance programs. This means registered nurses         Specific guidelines for recording
need to maintain and enhance their competencies through
                                                                     CL activities
continuous learning to ensure their practice is based on the
knowledge and skills relevant to client health needs.                Once you have developed your learning plan, there are
                                                                     many ways in which you can achieve your CL requirements.
Once you have assessed your learning needs in your nursing           For CNA certification renewal purposes, you will need
specialty/area of nursing practice and developed your learning       to demonstrate that you have completed 100 hours of
plan to address those needs, your next step is to select the         CL activities related to the competencies in your nursing
most appropriate and effective learning opportunities.               specialty/area of nursing practice during your five-year
To renew your certification credential, you will need to earn a      certification term. Your choice of CL activities should improve
minimum of 100 CL hours related to your nursing specialty/           your knowledge and skills in your nursing specialty/area of
area of nursing practice during your five-year certification         nursing practice and should not be part of your primary
term. CNA is flexible about how you can earn these hours.            responsibilities as defined in your job description (e.g., a nurse
                                                                     educator responsible for the orientation of new staff would
Here are some general guidelines for earning CL hours                not count the orientation as a CL activity).
for your certification renewal.
                                                                     Please note that the CNA Certification Program allows a
• Each CL activity must relate to your nursing specialty/            great deal of flexibility with regard to the type of CL activities
  area of nursing practice and to at least one of the                that you undertake. CNA will, however, provide guidelines
  competencies for that specialty/area of nursing practice.          for a maximum number of hours you can claim for some CL
  Visit getcertified.cna-aiic.ca, Certification Renwal, to           activities. Below are examples of the types of CL activities
  view the nursing competencies list for your nursing                you may wish to count toward your CL hours.
  specialty or area of nursing practice.
• Each CL activity must be a minimum of 30 minutes.                  Note: Nurses can use the CL requirements of their
                                                                     jurisdiction toward their certification renewal.
• If you repeat an identical CL activity (e.g., basic cardiac life
  support [BCLS]) during the five-year certification term, it
  counts only once. If you take the activity at a higher level,
  then you can count both (e.g., BCLS and then advanced
  cardiac life support [ACLS]).
• Each CL activity must be earned during your five-year
  certification term. You can project your CL hours up to
  the last day of your current certification term, even though
  you will be applying for certification renewal a few months
  before your term ends.

4                           General Application Guide for Certification Renewal by Continuous Learning or by Exam
Academic courses                                                     CNA certification exam development
• The course content must be applicable to your area                 • Activities include sitting on the certification exam
  of certification.                                                    committee or translation committee, or serving as an item
• You can count courses taken toward degree completion and             writer or item reviewer.
  advanced degrees if they apply to your certification area.         • CNA will provide you with proof of participation.
  For example, if an emergency nurse taking an ethics course
  toward her nursing degree has focused her assignments on           CNA Certification Mentorship Program
  ethical issues in emergency nursing, the course now has a
                                                                     • You will receive 10 CL hours from CNA for each year you
  specialty focus and can count toward certification renewal.
                                                                       participate as a mentor.
• You cannot count academic credits or courses that
                                                                       • CNA will provide you with proof of participation.
  are outside your nursing specialty/area of nursing
  practice (e.g., English literature, history, music, general
                                                                     Independent study
  computer courses).
                                                                     • You may include reading articles and answering the test
CL hours allotted:                                                     questions that appear in professional nursing journals
• In general, a college or university semester course (e.g., from      (e.g., CEU articles). You must complete the questions and
  September to December) is equal to 36 CL hours. This also            have the activity scored. CNA will grant the same number
  applies to a distance education course.                              of CL hours as stated in the journal.

• If you do not know how many credits are allowed for a              • Participation in a journal club related to your nursing
  course, calculate one CL hour for every clock hour you               specialty/area of nursing practice can also be considered
  spent attending the course (e.g., 3 hours/week x 12 weeks =          for CL. Count the number of hours the journal club
  36 CL hours).                                                        meets as CL.
                                                                     • You may also include participation in e-learning tutorial
Conferences, teleconferences, seminars,                                programs, online courses, discussion groups and forums.
workshops                                                              As proof of your participation, print and retain hard
                                                                       copies that clearly show your involvement in such
• Calculate the total hours attended (it is not necessary to break
                                                                       programs and discussions.
  down every individual conference session attended). On
  average, you should claim 6 hours per day at a conference.         • These activities must relate to your nursing specialty/area of
                                                                       nursing practice.
• Remember, if you repeat the exact educational activity
  within the five-year term, it counts as a CL activity only
                                                                     Leading a study group to prepare for the
  once. However, similar activities at different levels can count
                                                                     certification exam
  as separate CL activities (e.g., BCLS, ACLS). Follow the
  general guidelines previously outlined.                            • The maximum number of hours you can claim for this
                                                                       activity category is 40 hours.
Employer in-services
                                                                     • You can count organizing and leading a study group to help
• These are generally short CL activities of 30 minutes or             other RNs prepare for the CNA certification exam, as long
  an hour.                                                             as the study group is in your certification nursing specialty/
                                                                       area of nursing practice.
Note: If the in-service is offered regularly (e.g.,                  • Remember that one clock hour equals one CL hour when
nursing grand rounds once a month), keep a running
                                                                       calculating your leadership of a study group.
list of the sessions you have attended with all of the
pertinent information. Ask your nursing supervisor or
nurse educator to sign the list annually. This decreases
paperwork and makes it easy to document your
CL activities.

Canadian Nurses Association getcertified.cna-aiic.ca                                                                                5
Professional specialty committee/                                  Preceptorship
association membership or participation
                                                                   • The maximum number of hours you can claim under this
• The committee activity must be related to your certification       activity category is 40 hours.
  nursing specialty/area of nursing practice. Examples             • The preceptorship must be in your specialty or area of
  include serving on the planning committee for a specialty          nursing practice.
  conference or on the executive of the association for your
  area of nursing practice. The activities should not be part      Preceptorship is a frequently employed teaching and learning
  of your job description’s regular responsibilities. You may      method using nurses as clinical role models. It is a formal,
  volunteer for the committee or be elected or appointed to        one-to-one relationship of pre-determined length between an
  it. The maximum number of hours you can claim for this           experienced nurse (preceptor) and a novice (preceptee) and
  category is 25 hours.                                            is designed to assist the novice in successfully adjusting to a
                                                                   new role. The novice may be a student or an already practising
• Membership in the national association representing your         nurse moving into a new role or setting.
  specialty, you may add 4 CL hours/year.
                                                                   The organizations or departments involved in a preceptorship
Presentations, lectures, posters                                   program provide an administrative plan for the program
                                                                   based on a needs assessment as well as on their organizational
• These are credits for presentations you make to other health
                                                                   philosophy. Administrative support of the program and its
  professionals on topics related to your area of certification.
                                                                   participants is essential for successful implementation of
• You can also count your preparation time. To calculate your      the program.
   preparation time, double the presentation time (e.g., 1 hour
   presentation + 2 hours preparation = 3 CL hours).               The preceptor
• If you repeat the exact presentation within the five-year
                                                                   • acts as clinical teacher, professional role model and
   term, it counts as a CL activity only once.
                                                                     colleague;
• However, if you change the presentation significantly or give
                                                                   • facilitates the preceptee’s introduction into the organization;
  it at a different level, you can count the activity more than
  once (e.g., level one: presentation on respiratory assessment,   • collaborates with the preceptee to assess learning needs and
  followed by level two: advanced respiratory assessment).           set learning goals;

• For an oral presentation to a provincial or national             • determines client care responsibilities appropriate to the
  conference, you may claim a maximum of 10 CL hours for             preceptee’s preparation in consultation with the preceptee;
  your preparation and presentation.                               • provides encouragement and guidance to the preceptee; and
• For a poster presentation to a provincial or national            • participates with the preceptee in evaluating specific
  conference, you may claim a maximum of 10 CL hours for             learning outcomes and the program in general.
  your preparation and presentation.
                                                                   The preceptee

                                                                   • participates in the program as an active learner and
                                                                     colleague;
                                                                   • participates with the preceptor in assessing learning needs
                                                                     and setting learning goals;
                                                                   • clearly states when assigned care exceeds his/her preparation;
                                                                     and
                                                                   • participates with the preceptor in evaluating learning
                                                                     outcomes and the program.

6                          General Application Guide for Certification Renewal by Continuous Learning or by Exam
Articles, book chapters, research projects                           Other activities
• You can include publication of materials relevant to your          • External examiner for thesis defence.
  area of certification.                                             • Learning activities completed as annual continuing
• Your publication can appear in a recognized professional             competence/quality assurance requirements for the
  journal or newsletter, or can be issued by a recognized              provincial/territorial colleges or regulatory bodies can
  publishing house.                                                    be counted toward certification renewal. The maximum
• The format can be a manuscript, research paper, book                 number of hours you can claim under this category is
  chapter or book.                                                     15 CL hours.

• A copy of the publication may be requested.                        • Volunteering related to your nursing specialty (e.g., with
                                                                       a not-for-profit organization or charity, serving as a board
• For authorship or co-authorship of a book, allot 25 CL hours.        member or delivering presentations to clients/consumers.)
• For a book chapter, manuscript article or paper, allot               The maximum you can claim under this category is
  15 CL hours.                                                         15 CL hours.
• If you count a research project, the project must have been
  completed during the five-year certification term. You must
  be one of the recognized researchers, and the research must
  apply to your area of certification.
• Remember that one clock hour equals one CL hour when
  calculating your participation in research.

Aligning the CNA certification renewal process with
continuing competence

Introduction                                                         Continuing competence
As a CNA-certified nurse you understand the importance               As an RN you are required to carry out a yearly self-assessment
of renewing your credential. The vast majority of CNA-               as part of your provincial or territorial continuing competency
certified nurses renew their credential through the continuous       requirements. To maintain licensure, RNs assess their general
learning option (see p. 2 for renewal options). You can extend       competence by reviewing and reflecting on their practice
the benefits of your certification renewal process by aligning       related to provincial and territorial regulatory standards.
the requirements of your provincial or territorial continuing        Competence in these standards assures the public that RNs
competence program with those of your certification                  possess at least the minimum competencies to practise
credential when you undertake your CL activities.                    nursing and demonstrate the ability to integrate and apply the
                                                                     knowledge, skills, judgment and personal attributes required
CNA has consulted with certified nurses about ways to keep           to practise safely and ethically in a designated role and setting.
track of CL requirements during the five-year certification
term. One suggested strategy for efficient CL tracking is to         RNs are lifelong learners who seek learning opportunities and
organize your CL activities on a yearly basis. Although the list     develop learning plans with set time frames to meet provincial
of CL activities is only submitted to CNA every five years,          and territorial competency requirements. CL requires that
organizing it annually helps align the process with the specific     nurses reflect on their competencies in relation to societal
requirements of your provincial or territorial continuing            changes and changes in the health-care environment and, as
competence program. Since the requirements for continuing            a result of that reflection, take action to acquire and develop
competence programs vary from jurisdiction to jurisdiction,          new competencies.1
it is important that you carefully review the specific criteria in
the jurisdiction in which you are registered.                        1
                                                                       For more information about continuing competence for RNs,
                                                                     read the position statement “Promoting Continuing Competence
                                                                     for Registered Nurses” at www.cna-aiic.ca.

Canadian Nurses Association getcertified.cna-aiic.ca                                                                                 7
The following figure shows the continuous circle of the
five-year CNA certification renewal timeline.

Figure 1: Five-Step Process for Renewal by CL
                                                                               Step    1                     Step    2
                                                                                 PLAN IT!                      DO IT!
                                                                                                CNA
 Reminder: Even though the CL activities list                                               Certification

                                                                              5
    is submitted to CNA only every five years,                                             Renewal by CL
     we recommend that you organize your                              Step               Track your CL activities
                                                                     REFLECT ON
                                                                                                                             3
                                                                                           annually and submit
    certification renewal on an annual basis
                                                                    ACHIEVEMENTS             your list to CNA
                                                                                              every 5 years
                                                                                                                       Step
    so that you can align the process with the                    AND PLAN IT AGAIN!                                DOCUMENT IT!
    specific requirements of your provincial/
 territorial continuing competence program.

                                                                                         Step        4
                                                                                        SUBMIT IT!

Keeping track of CL activities                                        Quality assurance audits
Online applicants: Document your CL activities (one-at-a              Audits ensure the quality of the CNA Certification Program
time) on the electronic form, indicating the CL sponsor/              and help maintain and continuously improve the program.
provider/institution and the CL activity length, then link your
learning activity with one of the competencies of your nursing        They are conducted by randomly selecting 10 per cent of
specialty/area of nursing practice.                                   the candidates who apply for certification renewal by CL.
                                                                      Audited candidates will receive a notification and are expected
Hard-copy applicants: CNA provides some helpful forms for             to submit proof of their CL activities. Examples of proof
keeping track of your CL activities during the five-year term.        of CL activities include certificates of attendance, receipts,
                                                                      transcripts of marks, letters from supervisors, copies of
• You may have been keeping your own list (e.g., an electronic        articles written and lists of committee participants.
  version). If so, submit a copy with your application.
• You can also use the CNA forms as templates to create your          Do not hesitate to contact the CNA Certification Program if
  own tracking forms. Be sure to record the total number              you have questions about CL activities.
  of CL hours in the appropriate box on the Certification
  Renewal Application form.
• Submit your list of CL activities only at the time you apply
  for certification renewal.
• Keep all official documents confirming your attendance at
  CL activities. You do not need to send these documents
  to CNA when you apply for certification renewal, but we
  suggest you keep them on hand in case you are audited.
• Professionally and ethically, you are the best person
  to decide which CL activities apply toward your
  certification renewal.

8                          General Application Guide for Certification Renewal by Continuous Learning or by Exam
CNA CERTIFICATION PROGRAM
                                                                             CONTINUOUS LEARNING FOR CERTIFICATION RENEWAL: ACTIVITIES AND COMPETENCIES

                                                                                                                                             Perinatal
                                                       Name: ____________________________________ Specialty/Area of Nursing Practice: ______________________________ Certification #: ______________

                                                       Use of this form is highly recommended; however, CNA accepts other forms and tools used to record learning. Please submit in a format similar to the following. Although the list
                                                       of CL activities is submitted to CNA only every five years, documenting the activities annually will help you align the process with the specific requirements of your provincial or
                                                       territorial continuing competence program, as well as achieve the criteria for CNA certification renewal. This form is available for downloading from the certification site at
                                                       getcertified.cna-aiic.ca (see renewal section).
                                                       We recommend that you keep an ongoing log of CL activities during the course of your five-year certification term. This example is based on an individual who received initial CNA certification in Perinatal Nursing in 2011.
                                                       You can claim and project your CL activities up to the end of your five-year certification term

                                                                  Date                      Learning Opportunities                         Sponsor/Provider/Institution                         Competency Related to Learning Opportunity                            Number of         Office Use
                                                                                                                                                                                                  Competencies per Specialty/Area listed under the                    CL Hours             Y/N
                                                                EXAMPLE
                                                           May 13-14, 2011          2-day workshop on postpartum                     Ottawa Hospital, General Campus
                                                                                                                                                                                                 Certification Renewal tab at getcertified.cna-aiic.ca/
                                                                                                                                                                                          4.3 Identifies key elements of maternal physical assessment)                      14
                                                                                    assessment – 2 days (7 hrs each)
                                                           May-August 2012          Preceptorship                                    University of Ottawa nursing student in              Intrapartum competencies from 3.1 to 3.24 – All are relevant on                   40

Canadian Nurses Association getcertified.cna-aiic.ca
                                                                                                                                     perinatal nursing                                    the perinatal unit on which the preceptorship occurred
                                                             June 25, 2012          Neonatal Resuscitation Program                   Ottawa Hospital, Civic Campus                        3.12 identifies indications for and risk factors associated with                   8
                                                                                                                                                                                          induction of labour.
                                                         September 14, 2013 Breastfeeding workshop                                   Ottawa Hospital, General Campus                      4.18 Selects appropriate nursing interventions to deal with                        4
                                                                                                                                                                                          common breastfeeding challenges
                                                             October 2013           ALARM course – x 2 days                          SOGC Obstetrical emergencies                         3.10 selects appropriate nursing interventions to respond                         12
                                                                                    (6 hours each)                                                                                        to the following urgent and emergency situations in the
                                                                                                                                                                                          intrapartum period:
                                                               May 2014             Postpartum care education session                CAPWHN’s continuing education program                4.3 Identifies key elements of maternal physical assessment                       12
                                                                                                                                     CAPWHN annual conference in Winnipeg
                                                          January-December          Perinatal Nursing Grand Rounds                   Ottawa Hospital, General Campus                      Perinatal competencies 3.12, 4.2 & 4.3                                             8
                                                                2014                Once per month x 8 months =
                                                                                    1 hour x 8
                                                             Projected              Identification, screening and                    CAPWHN’s continuing education program, 4.2 Selects nursing interventions to promote healthy parenting                                  12
                                                          March 15-16, 2015         management of intimate partner abuse             workshop                               and family development

                                                        Total CL hours during five-year certification term*                                                                                                                                                                  110 hours
                                                       *Eligibility criteria include completion of at least 100 hours of continuous learning (CL) activities related to your nursing specialty/area of nursing practice; see the guidelines in the CNA certification renewal guide for details.

                                                       *You can claim and project your CL activities up to the end of your five-year certification term. Please add the word “projected” in the front of the CL activity.

                                                          To submit: Hard-copy applicants: Include your list with your renewal application form.
                                                                     Online applicants: Transcribe your CL activities into the electronic application form.

9
                                                                                                                                                                                                                                                                       Revised February 2014
Fees for certification renewal

All related fees can be found in the front section of this guide.       Note: For withdrawal and refund information, refer to
                                                                        the Policies and Procedures section on page 21 of this
• Applications will not be processed until the full fee
                                                                        application guide.
  is received.
• This is the only certification fee you will pay during your
  next five-year term.

Financial support for certification candidates

Employer support                                                        Government support
You may wish to investigate the possibility of financial support        Some provincial and territorial governments have funds
from your hospital or employer.                                         available for nurses involved in continuous learning,
                                                                        certification or both. For more information, look on the
If your employer is funding your certification (in full or in           website of your provincial or territorial government, contact
part), please submit the total amount with your application.            the chief nursing officer in your province or territory or

                                                                    ›
It is your responsibility to make the appropriate financial             contact your jurisdiction’s nursing regulatory body.
arrangements with your employer so that CNA receives only
one payment with your application.                                      Consult the “Resources” section of the CNA
                                                                        certification website for more information about
Each year, CNA gives a health-care facility the Employer                financial support for certification candidates and
Recognition Award for showing exemplary, sustained support              the Employer Recognition Award.
of the CNA Certification Program and CNA-certified
registered nurses. If you want to nominate your employer,
go to the CNA Certification website and follow the                      Receipts
nomination procedures.                                                  Receipts will be issued with your renewal eligibility letter.
                                                                        Certification fees do not meet the requirements of the Income
Funding support from the Canadian                                       Tax Act and therefore do not qualify as a tuition tax credit.
Nurses Foundation                                                       There is a fee for duplicate receipts.

The Canadian Nurses Foundation (CNF) will award one
bursary per nursing specialty/area of nursing practice to
successful candidates who have applied for this award.
All candidates eligible for certification renewal will receive
CNF funding information in their letter of eligibility
from CNA. For more information visit CNF’s website at
www.cnf-fiic.ca or call 613-237-2133.

10                          General Application Guide for Certification Renewal by Continuous Learning or by Exam
Completing your application

Online and hard-copy application options are available by           1. Identification information
visiting the “Certification Renewal” section of the certification
                                                                    • Insert your name exactly as you wish it to appear on
website. Online applicants must create an account and follow
                                                                      all correspondence. For hard-copy applicants, please
the onscreen instructions. Hard-copy applicants can download
                                                                      print clearly.
and print the Certification Renewal Application form from
the “Certification Renewal” section of the website.                 • Insert the required address and contact information.
                                                                      Please include your e-mail address(es). An e-mail address
An application for the current year is needed to ensure the           is mandatory, as most communications from the
accuracy of our records.                                              CNA Certification Program will be done via e-mail
To avoid processing delays, or disqualification of                    (e.g., confirmation of eligibility).
your application, please be sure to be accurate in the              • If your contact information changes, it is your responsibility
information you provide. For hard-copy applicants, print              to notify the CNA Certification Program Processing Centre
clearly in pen and make sure the application form and                 directly. You can use the Update Your Information form on
all additional documents are complete before mailing.                 the certification website or e-mail certification@cna-aiic.ca.
Be sure to keep a copy for your records.
                                                                    2. Registration and CNA membership
Completing your application                                         Registered nurse licence/registration
(page 1 of the Certification Renewal
Application form)                                                   We cannot review the eligibility of your application if
                                                                    proof of your RN licence/registration is missing from your
Certification renewal by continuous                                 application form.
learning or by exam
                                                                    • Online applicants: Only your RN licence/registration
• Indicate which option you have chosen for certification             number is required.
  renewal (by continuous learning or by exam).
                                                                    • Hard-copy applicants: Include a copy of your RN status
CNA certification number                                              OR a copy of an e-mail confirming membership in your
                                                                      provincial/territorial nursing association.
• Insert your eight-digit CNA certification number (this
                                                                    • Your surname (family name) indicated on your application
  number is on correspondence you receive from the CNA
                                                                      must correspond with the name indicated on your nursing
  Certification Program and on your certificate). For hard-
                                                                      licence/registration. If there is a discrepancy, please
  copy applicants, please print clearly.
                                                                      provide a copy of documentation (e.g., a marriage licence)
                                                                      indicating your change of name.
Language of correspondence preferred

• Indicate whether you prefer your correspondence and
  documents (e.g., letters, exam information, exam results,
  certificate of achievement) in English or in French.

Nursing specialty/area of nursing practice code

• Indicate the two-letter nursing code for your nursing
  specialty/area of nursing practice. The codes are listed
  on the application form.
• Indicate if you are applying for or renewing certification
  in another nursing specialty/area of nursing practice.
  A separate application is required for each specialty/area.

Canadian Nurses Association getcertified.cna-aiic.ca                                                                             11
The process of obtaining CNA membership is                        CNA membership for Ontario nurses (two options)

      different in Ontario and Quebec than in the
                                                                       Option 1
           other provinces and territories.
                                                                           Membership via the Registered Nurses’ Association
Neither membership in any of the specialty nursing                         of Ontario (RNAO): If you said yes to CNA
  associations nor a CNA certification credential                          membership when you renewed with RNAO for the
              gives you CNA membership.                                    2014-2015 membership year, your RNAO membership
                                                                           number will entitle you to the discounted certification fee:
Are you a CNA member?                                                      • Online applicants: Enter your RNAO membership number
                                                                             only. To be validated as a CNA member, your RNAO
• By being a member of CNA you save over $200 on
                                                                             membership must have been active for two months prior to
  initial certification and over $80 on certification renewal!
                                                                             the application date. If your RNAO number does not give
  Membership, however, is not required to write the exam or
                                                                             you the CNA member exam cost, please contact the CNA
  to renew your credential
                                                                             Certification Processing Centre at certification@cna-aiic.ca.
• RNs registered with the following provincial and territorial
                                                                           • Hard-copy applicants: Attach a copy of your current
  registered nurses’ associations are CNA members:
                                                                             RNAO membership card OR a copy of an e-mail
  College of Registered Nurses of British Columbia (CRNBC)                   confirming membership with RNAO.
  College and Association of Registered Nurses of Alberta              • Under this option, you must be an RNAO member during
  (CARNA)                                                                the 2014-2015 membership year. If you have been an
  Saskatchewan Registered Nurses’ Association (SRNA)                     RNAO member for less than two months, please use a
                                                                         paper application.
  College of Registered Nurses of Manitoba (CRNM)
  Nurses Association of New Brunswick (NANB)                           Option 2
  College of Registered Nurses of Nova Scotia (CRNNS)                      Independent membership in CNA: If you are an Ontario
  Association of Registered Nurses of Prince Edward Island                 RN who is not a member of RNAO, it is possible to
  (ARNPEI)                                                                 be a member of CNA with our new independent RN
                                                                           membership. However, we encourage all RNs to ensure
  Association of Registered Nurses of Newfoundland and
                                                                           membership with both provincial and national professional
  Labrador (ARNNL)
                                                                           associations for the benefit of the profession and our health
  Yukon Registered Nurses Association (YRNA)                               system. Should you choose to only join CNA, our annual
  Registered Nurses Association of the Northwest Territories               membership fee is $54.95 (plus applicable taxes). Register
  and Nunavut (RNANT/NU)                                                   directly at join.cna-aiic.ca. Note: If you are applying for
                                                                           certification online, please wait 24 hours after purchasing
CNA membership for Quebec RNs                                              your CNA membership to complete your application.
                                                                           This will ensure our system is updated and your member
                                                                           discount can be applied.
  Independent membership in CNA: Registered nurses in
  Quebec can be a member of CNA with our new independent
  membership. The annual membership fee is $54.95 (plus                • None of the following gives you CNA membership:
  applicable taxes). Register directly at join.cna-aiic.ca. Note: If     registration with the College of Nurses of Ontario;
  you are applying for certification online, please wait 24 hours        membership in the Ontario Nurses’ Association, other
  after purchasing your CNA membership to complete your                  nursing unions or any of the national nursing associations
  application. This will ensure our system is updated and your           for nursing specialties/areas of nursing practice; or a CNA
  member discount can be applied.                                        certification credential.
• The Ordre des infirmières et infirmiers du Québec (OIIQ)
  is not a member of CNA; therefore, CNA membership is                 
  not possible through OIIQ.

12                          General Application Guide for Certification Renewal by Continuous Learning or by Exam
Completing your application                                                                                • Be specific about the time frame in which you have earned
(page 2 of the Certification                                                                                 your hours of experience in your nursing specialty/area of
Renewal Application form)                                                                                    nursing practice in the past five years. For example, an RN
                                                                                                             in the emergency department works 1,950 hours in each
                                                                                                             year of the five-year period. The total number of hours in
3. Verification of experience in the
                                                                                                             ER nursing from January of year one to December of year
nursing specialty/area of nursing
                                                                                                             five equals 9,750 hours (1,950 x 5 = 9,750). One full-time
practice
                                                                                                             year = 1,950 hours (including vacation and sick time).
All candidates complete carefully                                                                           • Please do not use abbreviations (e.g., Children’s Hospital
Because this part of your application serves to verify your RN                                                of Eastern Ontario should not be referred to as CHEO;
experience in your nursing specialty/area of nursing practice                                                 the Ottawa Hospital should not be TOH).
and determine your eligibility, it is crucial that it be completed                                         • Be specific about the unit/department where you work, to
in full and that all details requested be included.                                                          identify your nursing specialty/area of nursing practice
• Dates of employment in the chosen nursing specialty/area                                                   (e.g., emergency department, outpatient psychiatry).
  of nursing practice must be provided up to and including                                                 • Refer to the Eligibility Criteria section on pages 2-3 of
  the past five years only (the duration of your certification                                               this guide. The hours of experience you list must meet the
  term). Experience and employment in all years before the                                                   minimum in the eligibility criteria you have selected.
  past five years will be considered inapplicable.
• Begin with your most current employment.

                                                                                               *Be specific — It is an important determinant of your eligibility

Example:

                                                                                                                                                       Specialty HOURS
                                                                                                                SUPERVISOR/           DATES OF
                                                                                                                                                        (During your 5-year
                         EMPLOYER                                   POSITION                                    CONSULTANT           EMPLOYMENT          certification term)

               Full Name of Employer / Hospital   Title                                            Name                                                         1,950
               The Ottawa Hospital                RN Staff Nurse full time in-patient              Jane Doe, RN                                                 Hrs/yr
                                                                                                                                           From
                                                  geriatric unit                                                                                        (show number of hours
Most Current

                                                                                                                                      September 2009
               floor/Unit 4 EAST/Gerontology                                                                                                              related to specialty
                                                                                                   Title                                                    if not full time)
               Address 1234 MAIN ST.                                                                                                       TO
                                                  Responsibilities                                 Operations Director                                       2010   1,950
                                                                                                                                         current             2011   1,950
               City OTTAWA                        in-patient geriatric care for clients with       Geriatrics
                                                                                                                                                             2012   1,950
                                                  multiple diagnoses                                                                                         2013   1,950
               Province/Territory ONTARIO                                                                                                                    2014   1,950
                                                                                                                                                                9,750
               Postal Code K0K 1A1
                                                                                                                                                            Total hours

Canadian Nurses Association getcertified.cna-aiic.ca                                                                                                                           13
Here are some important points to remember when you               4. Continuous learning activities
calculate your hours of experience:
                                                                  Tracking list of CL activities
  • You must include dates of employment and hours up to
                                                                  • Online applicants: Document your CL activities (one-at-a
    and including the previous five years only (the duration
                                                                    time) on the electronic form, indicating the CL sponsor/
    of your certification term).
                                                                    provider/institution and the CL activity length, then link
  • You may wish to contact your human resources                    your learning activity with one of the competencies of your
    department to obtain the number of hours you have               nursing specialty/area of nursing practice.
    worked as an RN in your nursing specialty/area of
                                                                  • Hard-copy applicants: Download and print the
    nursing practice.
                                                                    Continuous Learning Activities template from the renewal/
  • The hours you calculate must all be RN experience in            continuous learning section of our website and use it to
    your chosen nursing specialty/area of nursing practice.         create your own record. You can use multiple copies of this
    This experience can be in any of these five areas:              form if there is not enough space to include all of your
    direct patient care, education, research, policy                activities on one. You can also keep an electronic list on
    or administration.                                              your computer for quick reference and easy updating.
  • Hours of RN experience in your nursing specialty/area           If you have done so, please feel free to include it with
    of nursing practice may be earned outside of Canada.            your application.

  • Remember: One full-time year equals 1,950 hours (this         • You can calculate your CL activities hours up to the end of
    is also equal to 162.5 hours/month, or 7.5 hours/day).          your five-year certification term, if necessary (April 2015).
    If only a portion of your nursing experience is in your         Please add the word “projected” in the front of the CL
    nursing specialty/area of nursing practice, please indicate     activity.
    the percentage of work hours that are related to the
    specialty/area. For example, if you are working full time     Guidelines for earning and documenting
    in an intensive care unit and 80 per cent of the patients     CL hours
    receive cardiovascular care, this would be calculated as
                                                                  • Read the guidelines provided on the Continuous Learning
    1,950 x 0.8 = 1,560 hours/year in the cardiovascular
                                                                    Activities form and on pages 4-7 of this guide carefully. This
    specialty. If you work full time on a medical/surgical unit
                                                                    information will assist you as you complete your list of CL
    and 30 per cent of the patients receive gastroenterology
                                                                    for certification renewal.
    care, you will calculate 1,950 x 0.3 = 585 hours/year in
    the gastroenterology specialty. Please be sure to indicate
    the correct percentage of hours for each year.

14                        General Application Guide for Certification Renewal by Continuous Learning or by Exam
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