BCEN Updates

Evolving Excellence: Updating the CEN Exam

February 10, 2026

Evolving Excellence: Updating the CEN Exam

In this edition of Evolving Excellence: Hear from 2025 Certified Emergency Nurse (CEN) role delineation study (RDS) Advisory Committee members Ellie Newton, BSN, RN, CEN, and Shelby Stillwell, BSN, RN, CEN, and get all the need-to-know details about the updated CEN exam and content outline, including:

How does a role delineation ensure fairness in a certification exam?
What was it like helping to define and describe current emergency nursing practice?
What sets Certified Emergency Nurses apart?
When does the new CEN exam content outline go into effect?

How a Role Delineation Study Ensures Fairness

Role delineation studies ensure fairness by grounding test content in the real-world practice of specialty nurses across all types of environments within that specialty. As BCEN’s Amy Grand, MSN, RN, ICE-CCP, explains with respect to the 2025 emergency nursing RDS:

“By surveying emergency nurses with varying years of experience, practice settings, geographic locations, etc., the RDS captures the full range of tasks, responsibilities, and knowledge that are essential to safe and competent emergency nursing practice. Because the RDS collects data from nurses working in diverse settings—urban, suburban, rural, critical access, pediatric, adult, and mixed EDs—it prevents any single environment or experience level from disproportionately shaping the exam content.”

As a result, the CEN exam blueprint is built around the core common competencies that every emergency nurse must have, regardless of where they practice or how long they’ve been in the field.

What Nurses Need to Know About the Updated CEN Exam & Content Outline

The updated CEN exam content outline goes into effect on July 6, 2026. (For complete details, visit the CEN Study and Prepare page.)

Because the exam content outline serves as a useful roadmap for studying for the CEN exam, here are a few notable updates on exam content and content outline organization:

Gastrointestinal is now a separate section and no longer grouped with Genitourinary, Gynecology, and Obstetrical.
Maxillofacial and Ocular Emergencies has been renamed and reorganized as Head, Eye, Ear, Nose, Throat Emergencies.
Professional Issues has been reorganized into two sub-sections: Prioritization (Triage, Mass Casualty, and Patient Throughput) and Legal and ethical issues.

Expert Perspectives: Defining the Emergency Nursing Scope of Practice & What Sets CENs Apart

BCEN asked 2025 Emergency Nursing RDS Advisory Committee members Ellie Newton, BSN, RN, CEN (University Hospitals, Cleveland, Ohio) and Shelby Stillwell, BSN, RN, CEN (Atrium Health Navicent, Macon, Georgia) to share their experiences and perspectives. Here’s what they had to say:

Why is it important for the CEN credential to evolve as the emergency nursing specialty evolves?

Shelby: “The practice of nursing is always evolving, and I believe the practice of emergency nursing is at the forefront of this. We are innovative thinkers and come up with creative solutions to some of life’s most difficult challenges. The CEN credential must evolve with the ever-changing emergency nurse to stay current.”

What did you find interesting or validating about reviewing the knowledge areas and tasks of the emergency nursing specialty?

Ellie: “I found it very interesting to compare my lived, work experience in the ED to those of the other SMEs on the committee. Whether we worked in a large, academic, Level I trauma center or in a small, free-standing community hospital, we could all agree on which tasks and knowledge areas were fundamental in providing safe, life-saving care.

It felt so gratifying to be connected with other high-achieving healthcare professionals who share the same goal: performing at the highest level in order to provide evidence-based, patient-centered, life-saving care.”

Shelby: “What I found the most interesting was that the breadth of required knowledge highlights how emergency nurses must be prepared to manage anything and everything that comes through our doors.”

What do you want nurses and organizations to know about how being a CEN sets RNs apart—and how having CENs on staff sets emergency departments apart?

Ellie: “CENs possess a unique understanding of not only pathophysiology and medical interventions, but of disaster management, triage and throughput, patient safety, ethics, and process improvement. Their knowledge base informs their care, and their leadership skills allow them to educate their team, in turn, making patient care much safer. CENs foster a lifelong love of learning and set the bar for care in their departments high, pushing every member of their team to achieve at an elite level.”

Shelby: “CENs are experts in their field. We are prepared to make rapid and high-consequence decisions. We are able to prioritize interventions and act decisively in unpredictable or time-critical situations.

Having CENs as staff in your ED means they are able to hold your unit to a higher standard of professional accountability. A higher number of CEN-certified nurses shows the ED is equipped with staff who know how to manage high-acuity, high-volume, and complex emergencies with consistency and expertise.”

In your experience, is the importance and impact of earning and maintaining the CEN increasing?

Ellie: “I absolutely believe that the importance of earning and maintaining an emergency nursing specialty certification is increasing. Many EDs have found their staff consists primarily of new graduate nurses. Obtaining certifications allows younger nurses to step into informal leadership roles and positively impact the culture of their departments.

Becoming a CEN sparked my love for professional development and has led me to work on system-wide councils, in patient experience committees, and to start my master’s degree, but most importantly, it has reminded me why I love bedside emergency nursing.”

Meet the 2025 CEN RDS Experts

BCEN is grateful for the time, experience and contributions of the esteemed members of the 2025 CEN Emergency Nursing Role Delineation Study (RDS) Advisory Committee, who hold a variety of roles in adult/mixed and pediatric EDs and in civilian and military settings—including staff nurse, charge nurse, clinical coordinator, unit supervisor, clinical nurse educator, and trauma strategy management leader.

The 13-member 2025 Emergency Nursing RDS Advisory Committee consisted of CEN-certified emergency nursing experts from a variety of U.S. hospitals, university hospitals, and children’s hospitals, plus Navy Medicine Headquarters. Collectively, they brought more than 105 years of nursing experience and more than 100 years of emergency specialty experience to the RDS process.

2025 CEN RDS Advisory Committee

Madison Abshire, Georgetown Community Hospital (Georgetown, KY)
Erin Doppelheuer, University of Utah Hospital (Salt Lake City, UT)
Lorelei Ferre, Penn Medicine Lancaster General Health (Lancaster, PA)
Cassie Gudek, Elliot Hospital (Manchester, NH)
Andrea Nappo, St. Luke’s University Health Network (Stroudsburg, PA)
Ellie Newton, University Hospitals (Cleveland, OH)
Julian Mohammed, WakeMed Children’s Hospital (Raleigh, NC)
Carrie Palomado, Silver Cross Hospital (New Lenox, IL)
Carlton Purvis, Methodist University Hospital (Memphis, TN)
Autumn Riddell, Navy Medicine Headquarters/Bureau of Medicine and Surgery (Washington, DC)
Marcos Sanchez, Oregon Health & Science University (Portland, OR)
Bethany Seiler, Inova Fairfax Medical Center (Fairfax, VA)
Shelby Stillwell, Atrium Health Navicent (Macon, GA)

Thank You RDS Survey Participants!

To every nurse who participated in the RDS survey: Your input is essential and invaluable. Thank you for your commitment and for being a pivotal part of advancing emergency nursing specialty practice!

2026 CEN Exam Scoring Update

As a result of BCEN’s 2025 emergency nursing job analysis, an updated CEN exam content outline will go into effect on July 6, 2026. The exam passing score will also be updated to reflect the latest exam content outline, as determined by the 2026 CEN Passing Point Study (PPS).

Updated CEN Passing Score: 99/150 questions
Effective Date: July 6, 2026

What We Learned from the 2026 CEN Passing Point Study (PPS)

One of the final steps in BCEN’s regular exam maintenance schedule, the passing point study employs the judgment of more volunteer nurse experts to systematically review the new outline and set a standard passing score.

“BCEN uses a criterion-referenced methodology to set a standard. The Angoff procedure’s underlying philosophy is that the passing standard should reflect the performance expected of minimally competent examinees, or those with the requisite capabilities commensurate with the eligibility requirements. This procedure requires judges to assign an expected performance rating to each test item, reflecting the likelihood that a minimally competent examinee would answer correctly,” explained Grand.

Special Thanks to the 2026 Emergency Nursing PPS Volunteer Committee

BCEN thanks the volunteer members of the 2026 CEN PPS committee for contributing their time and expertise to ensure a fair passing score representative of the latest emergency nursing knowledge and competencies.

2026 CEN PPS Advisory Committee

Alexa Aguirre, Froedtert Hospital (Milwaukee, WI)
Ashley Blye, NYU Langone Health (New York, NY)
Vanessa Brinksneader, Norton Brownsboro Hospital (Louisville, KY)
Grishma Budhathoki, Adventist Healthcare (Gaithersburg, MD)
Roger Casey, Kadlec Regional Medical Center (Richland, WA)
Zachary Knuutila, University of Pittsburg Medical Center (Pittsburg, PA)
Sheneeza Misir, Moses Cone Hospital (Greensboro, NC)
Jerven Nalang, St. Bernards Medical Center (Jonesboro, AR)
Lionel Oliver, Naval Medical Center (San Diego, CA)
Rachel Philpott, Oregon Health and Sciences University Hospital (Portland, OR)
Joshua Rice, OSF Healthcare (Peoria, IL)
Susan Ryder, Houston Methodist Hospital (Houston, TX)