In this quarterly letter, I often use familiar systems and everyday experiences to frame discussions about credentialing and competence. These analogies help make credentialing more accessible while highlighting how often unseen credentialing infrastructures support professional practice, workforce stability, and patient outcomes. There was a time when watching a movie at home meant rewinding a Video Home System (VHS) tape and hoping it had been returned in good condition. Then came Digital Versatile Discs (DVDs), offering improved quality, easier access, and more reliable delivery of content compared with a tape that could be damaged when viewed in VHS format. Today, streaming platforms require no physical equipment beyond a television and internet access, delivering content instantly, often tailored to individual preferences and continuously updated. Each transition improved how we accessed and experienced media, but each also required something from us. We had to adapt, learn new systems, and accept that staying with an older format eventually meant losing access to what came next. Professional practice follows a similar trajectory. Health care continues to evolve at a pace that is difficult to overstate, shaped by advances in technology, shifting care models, increasing patient complexity, and growing system pressures. The expectations placed on professionals today are not the same as they were even a few years ago, and they will continue to change as the environment in which care is delivered continues to evolve. Competence does not become outdated all at once; it drifts gradually when not actively maintained. Unlike consumer technologies that update automatically, professional competence depends on deliberate systems and intentional engagement. Remaining aligned with current practice requires structure, ongoing learning, and a shared commitment to keeping pace with evolving standards rather than relying solely on past preparation. As highlighted in this issue’s discussion of the TRUST Leadership Framework,1 sustained change in health care depends on more than innovation alone. It requires environments that support learning, adaptation, and shared accountability. Credential maintenance is one way this responsibility is operationalized at the individual level, translating evolving expectations into concrete mechanisms that support competence over time. The notion that earning a credential is a milestone, achieved at a specific point in time, is just the first part of a certificant’s responsibilities when they add those letters after their name. The real value of a credential is reflected in what happens in the experience that follows. Certification maintenance requirements are not just administrative; they help keep competence aligned with current practice, evolving standards, and the realities of the environments in which professionals work.Many health care professionals may recognize this process by a different name. Terms such as “recertification” are commonly used to describe the periodic requirements associated with keeping a credential active. While terminology varies across professions, the underlying purpose remains the same. These processes ensure continued alignment with current practice, ethical standards, and public expectations. Credentialing professionals often use the term “maintenance” to refer to recertification cycles and to reflect that competence is not reaffirmed at a single point in time but sustained through ongoing engagement with practice. Behind the scenes, credentialing organizations continuously evaluate what competence looks like in practice. Subject matter experts who are actively practicing in the profession, combined with data and input from stakeholders across the field, play a central role in these decisions. Together, they examine how work is performed, how quickly roles are changing, and what risks exist if competence is not periodically reverified. One outcome of this work is the determination of maintenance cycles. Across professions, these cycles may span 2, 3, 4, 5, or more years. The core question guiding these decisions is not convenience but how rapidly the practice of the profession is evolving. Maintenance cycles are designed as purposeful check-ins with the credentialing organization to reverify current practice, attest to adherence to ethical standards, and confirm continued alignment with professional expectations. As job roles and practice environments change more rapidly across many industries, there is increasing attention to whether shorter maintenance cycles are needed to uphold the primary goal of credentialing, which is public protection. More frequent verification may be necessary in professions where knowledge, technology, or scope of practice evolves over relatively short periods of time. Equally important is how the substance of credential maintenance is determined. Here again, subject matter experts guide the process. Some professions require earning nursing continuing professional development contact hours throughout the maintenance cycle. Others incorporate ongoing assessment, such as periodic knowledge checks or performance-based evaluations. In some cases, an additional examination is required as part of the recertification process. These decisions are not uniform because they are intentionally tailored to what activities best support competence and public safety within a specific profession. These processes exist for a reason. A credential without meaningful maintenance is no longer a signal of current competence; it becomes a historical artifact, reflecting what was once true rather than what is required now. The intent of maintenance is to prevent that drift and ensure that a credential continues to represent something real, relevant, and trusted by professionals, employers, and the public. Just as importantly, credentials are intended to reflect active practice. Maintaining a credential makes sense when the knowledge and skills it represents are being used, reinforced, and updated through real-world application. As professionals move into new roles or step away from certain areas of practice, there may come a point when maintaining a particular credential is no longer aligned with what they do in their day-to-day work. Choosing to let a credential lapse in those circumstances is not a failure; it is an acknowledgment of how competence works. When professionals later choose to return to that area of practice, reentry appropriately requires additional education, training, and assessment to ensure they are current in the requisite knowledge and skills. In a field evolving as rapidly as health care, that reengagement can feel demanding, but it remains essential to maintaining trust and safety. How professionals participate in certification maintenance activities is also critically important. As we all know, not all nursing continuing professional development activities are equally meaningful, and the value of professional development is not found in the number of hours completed alone. What matters is how well the learning aligns with the individual’s everyday work, supports evolving responsibilities, and reinforces safe and effective practice. This requires a clear understanding of one’s scope of competence. In complex and evolving environments, professionals may be asked to step into unfamiliar areas or expand beyond their typical responsibilities. Recognizing when additional learning, support, or collaboration is needed is not a limitation, but a critical component of ethical and safe practice. This kind of professional awareness of scope and growth is strengthened through connection with the professional community. Engagement with professional associations, participation in conferences, collaboration with colleagues, and contributions to the broader professional community all support competence. These activities are not separate from practice; they are part of it and often reinforce the same standards and expectations that credential maintenance is designed and intended to support. In many cases, the activities that support professional growth also support credential maintenance. Volunteering with a certification organization, contributing to examination development, or participating in research and education initiatives strengthens both the credentialing system and individual understanding of the profession. It is a reciprocal relationship in which the profession evolves because professionals engage with it. A credential earns trust with our stakeholders when those individuals practicing with that credential remain current in best practices. For employers, that trust supports confidence in hiring and workforce development decisions. For patients, it provides assurance that those delivering care are prepared to meet current expectations. For professionals, it reinforces a commitment to growth, adaptability, and excellence in practice. Returning to the opening analogy, keeping a credential without maintaining the requisite competencies is much like holding on to that VHS player and expecting to be able to watch newly released movies with it. When professionals step away from learning or practice for years, they cannot simply pick up where they left off. Reengagement requires identifying what has been missed, actively getting up to date on what has changed, developing new skills, and reconnecting with current standards. This is why it is so important to ensure that your personal maintenance plan includes staying connected to your profession. In health care, the impact of that commitment extends far beyond the individual, shaping the quality, safety, and outcomes of care for every patient we serve. Respectfully submitted, Melissa R. Nosik, PhD, BCBA-D, CAE, ICE-CCP, SHRM-SCP Chief Executive Officer, Competency & Credentialing Institute Conflicts of interest statement The author has no conflicts of interest to declare. Funding source None.
Melissa R. Nosik (Fri,) studied this question.