Perceived Value of Certification for Nurses and Nurse Managers: Updated 2026 White Paper

Since the first orthopaedic nurse certification (ONC) examination in 1988, more than 16,000 nurses have earned the ONC credential, with nearly 5000 currently certified in orthopaedic nursing, advanced practice, or nurse navigation roles. Certification validates expertise in musculoskeletal care and supports improved clinical practice, professional identity, and organizational performance.

The Orthopaedic Nurses Certification Board survey included a representative sample of over 300 orthopaedic-certified nurses. Survey items were based on the Perceived Value of Certification Tool, a validated instrument measuring intrinsic and extrinsic value. Data were collected anonymously to ensure unbiased responses and allow comparison between 2020 and 2025 survey responses. Orthopaedic-certified nurses were offered the opportunity to provide personal quotes highlighting their opinions and lived experiences as a specialty-certified nurse. Quotes represent the opinions of those individuals specifically.

Survey results consistently demonstrated high perceived value of certification, including increased confidence, enhanced professional identity, greater autonomy, professional growth, lifelong learning, improved competence, commitment to excellence, increased marketability, additional opportunities for career advancement, and improved recognition from peers, leaders, and patients, versus the experiences of respondents before they were certified. The data collected is explained in context, as well as in comparison to the data collected in 2020 using the same survey and tool.

Published research was reviewed as a part of this work. Evidence demonstrates that hospitals with higher proportions of certified nurses' experience lower healthcare-associated infections and patient fall rates, improved patient safety metrics, and reduced mortality and failure-to-rescue rates.

Based on available evidence and data gathered through surveys, the role of the specialty certified nurse is discussed in context and comparison. Certification strengthens competency, accountability, and evidence-based practice adoption. Manager perspectives continue to support certified nurses as preferred hires, and health systems increasingly invest in certification support and incentives.

Nursing specialty certification delivers measurable benefits to nurses, healthcare organizations, and patients. Continued support for certification advancement promotes excellence in care delivery, workforce expertise, and patient safety.