October 6, 2015

All about the CWS Exam

Before you take the Certified Wound Specialist (CWS) exam developed by the American Academy of Wound Management (AAWM), you will want to spend some time becoming as familiar as possible with what it contains. This is not as difficult to do as you may think. The AAWM has written and published a Handbook for Candidates that provides you with a great deal of information. It includes the code of ethics, the rules and regulations for taking the exams, all of the details about applying to take the exam, as well as detailed information about what the exam contains and sample questions. You should plan to read this handbook (available as a pdf on the AAWM website) before you begin the study process.

CWS Exam Structure and Content

A team of nurses, doctors, specialists, and other healthcare providers who specialize in wound care develop the content of the exam. This team meets two to three times a year to review the exam and make sure it is up to date and valid for wound care professionals. The Professional Testing Corporation administers the exam, and this company also performs a statistical analysis of the exam on a yearly basis to validate the effectiveness of the test structure and format. The test is composed of 150 questions, and you’ll be given 3 hours and 30 minutes to complete it. Here are the topic areas the exam covers, what percentage of the exam each section represents, and more details of what the section contains.

  1. Wound Healing Environment : This section represents 19 percent of the total exam questions, and covers subjects such as anatomy and physiology and wound healing.
  2. Assessment and Diagnosis: This section represents 22 percent of the exam. It includes topics such as history, physical examination, wound and skin assessment, pain assessment, risk assessment, functional assessment, laborator/imaging, and nutrition.
  3. Patient Management: The patient management portion of the CWS exam, making up 26 percent of the exam, is concerned with issues such as wound bed preparation/debridement, dressings, skin substitutes, topical agents, complications in repair, nutrition, biophysical technologies, compression therapy, negative pressure wound therapy, oxygen therapy, and pressure redistribution.
  4. Etiological Considerations: This section represents 23 percent of total exam questions. Topics covered in this section include nueropathy, diabetes, venous insufficiency, ischemia, pressure ulcers, lymphedema, trauma, surgical complications, atypical wounds, dermatological, infectious, and burns.
  5. Professional Issues: Ten percent of the total exam questions tests your knowledge of professional issues as it relates to wound care management. This includes documentation, patient adherence, legal concepts, reimbursement and medical economics, medical ethics, multidisciplinary teams, epidemiology, evidence based practice and research.

Many of these items are also covered on the certified wound care specialist (CWCS) exam, but the CWS exam covers the items in more depth, and from a doctor’s or equivalent health care role rather than a person who provides immediate stabilization for the patient until the doctor examines and diagnoses him or her.

Differences between CWCA and CWS

The goal of the American Academy of Wound Management (AAWM) is to ensure that there are healthcare professionals across the country who specialize in wound care management. The healthcare community has recognized that there is a growing need for health care providers to understand in a more in-depth way how to care for patients with wounds. This need is increasing for several reasons. First, there is a growing population of elderly patients, as the Baby Boom generation ages. Additionally, people are living longer. Elderly patients often have limited mobility and are prone to frequent falls, resulting in chronic wounds. There are also an increasing number of patients with diabetes and similar diseases that also are prone to chronic wounds. This has led to the development of several different designations for the healthcare industry, including the certified wound care associate (CWCA) and the certified wound specialist (CWS). So what are the differences between the two, and which one should you pursue?

Primary differences

The main difference between the CWCA and the CWS is in their eligibility requirements. The CWCA designation is for healthcare providers who have at least three years of direct patient care/wound care experience, and who also have a high school diploma. College-level education is not required of these professionals. This means registered nurses (RNs), licensed practical nurses (LPNs), and nurse aids that have the three years of experience can earn this certification. The CWS certification is offered to professionals that have a bachelor’s degree in a life science field, have three years of direct care/wound care experience or have completed a one-year fellowship under the supervision of a current CWS, and is licensed or certified to practice as a medical doctor, registered nurse, physician’s assistant, physical therapist, or similar medical position. The complete list of professions that are eligible to apply for the CWS designation is available in the CWS Handbook for Candidates published by the AAWM.
So you can see that the primary difference between the two certifications is the level of education and training that are required. Registered nurses that have earned their bachelor degree will have the option of wither becoming the CWCA or the CWS.
Another very big difference between the CWCA and the CWS is the scope and depth of the material covered. The CWCA test assumes that the caregiver is providing immediate, first responder care in advance of a medical doctor taking over to provide a diagnosis and treatment. The CWCA therefore covers the basic signs and symptoms associated with wound care and how to stabilize the patient until medical care is available. The CWS assumes that the examinee is a medical doctor or has more in-depth medical training and experience. Therefore the exam covers very different information. The CWS spends a great deal more time on pathophysiology, etiology, diagnosis, and recommended therapeutics for various wounds that the healthcare provider may encounter in his or her practice. There is also a lot less focus on the administrative aspect of patient care than there is in the CWCA exam.
Registered nurses or LPNs with a bachelor’s degree will need to weigh the pros and cons of each designation and decide which is most appropriate for his or her current and future career goals. For some of these professionals, the CWS will be a much weightier designation than what is needed. However, if the caregiver is planning to further his or her education and become a nurse practitioner or similar service provider, than gaining this certification can be a good start toward achieving these goals. It could mean, however, that this professional will need to spend more time studying in order to pass the exam.

Why Become a Certified Wound Specialist


The American Academy of Wound Management’s (AAWM) mission is to ensure that there is high quality wound care available to patients across the Unites States. How it seeks to fulfill this mission is by developing ethical standards and as well as care standards that are incorporated into its certificate programs. It offers these certificates to healthcare professionals in several different practice areas as well as different levels of education and experience. The Academy takes an interdisciplinary approach, knowing that it takes knowledgeable and skilled practitioners at all levels to provide the best care for this patient population. For example, the certified wound care associate (CWCA) is usually a caregiver who has a high school diploma, but at least three years of experience in direct wound care. This person may be working as a registered nurse, nurse aid, or licensed professional nurse. The certified wound specialist (CWA) must also have at least three years of wound care experience, have at least a bachelor’s degree, and be a practicing MD, DO, RN, or similar practitioner. A complete list of the types of medical practitioners who are eligible to take the CWS exam are available in the Handbook for Candidates for CWS published by the AAWM.

The Need for Wound Care Specialists

The AAWM has developed its programs in response to a growing need for highly skilled wound care specialists. This need is due to the fact that there is an increasing elderly population that is prone to falls. This population also often becomes diabetic, and diabetics can also be prone to falls and other chronic wounds. Wounds encompass presentations such as broken bones, cuts, contusions, subsequent infections, etc. Healthcare providers need to be fully trained on all aspects of wound management to ensure that this growing population receives the care they need.

Who Should Become a Wound Specialist and Why

Any registered nurse or medical doctor that is eligible (see the Handbook for the list of practice areas that are eligible) and who provides care for patients that are prone to chronic or frequent wounds should consider becoming a wound care specialist. Examples include RNs or doctors who work in emergency rooms, urgent care facilities, nursing homes, rehabilitation facilities, or similar care settings. Also, RNs or doctors who work in the military and may need to care for wounded soldiers should also consider earning the wound specialist certification.
The primary reason to earn the wound specialist designation is to gain the knowledge and skills that are required to earn certification. After you’re certified you’ll be required to maintain your certification through taking continuing education classes, which means you’ll always be up to date when it comes to skills and knowledge. This means you’ll be able to provide optimum care for your patients.
Another important reason to consider obtaining your CWS certification is that it shows employers and patients that you’re committed to this area of patient care, and that you are highly skilled and have in-depth knowledge of wound care. The CWS designation is considered a master-level certification. This could lead to career advancements, opportunities for you to train others in wound care management, or other potential opportunities.

Who Benefits from the CWS Certification

The primary beneficiaries of the CWS certification are the patients of these would care specialists, who will receive high quality wound care management. The employers of these specialists also benefit from having these highly trained caregivers on their staff. Finally, the specialists themselves can benefit, not only from the potential career advancements the CWS can provide, but also through the added confidence they will have in their abilities to provide excellent care to their patients.

Requirements for taking the CWS exam

The certified wound specialist (CWS) exam developed and offered by the American Academy of Wound Management (AAWM) is designed to ensure that medical professionals who care for populations that are prone to chronic wounds possess the basic knowledge and skills required to provide effective care. Once the professional takes and passes the exam, he or she will be a certified wound specialist.
This designation is for healthcare professionals that have more extensive education, training, and experience in the medical field. For professionals who work on a more basic or entry level, there is a separate designation available, the certified wound care associate (CWCA).

Eligibility requirements

The AAWM provides all of the details that you need for the entire CWS application and exam process in a document the organization developed and published called the Handbook for Candidates. This handbook explains what the certification is, how you go about earning it, and the exam information such as what it covers and practice questions. Plan to visit the AAWM website to download and read this handbook.

In general, however, to be eligible to sit for the CWS exam, the healthcare professional must have a bachelor’s degree in a life science field, and have at least three years of clinical experience in wound care. If you don’t have three years in wound care, you have another option, which is to complete a fellowship of at least one year that is certified by a credentialing organization. Once the fellowship has been completed, you will need to supply a letter of recommendation from the fellowship program director and a CWS that was actively involved in your wound care training.

The AAWM also requires that CWS candidates be licensed or certified to practice in a medical profession, such as a medical doctor, registered nurse, physician’s assistant, physical therapist, or similar occupation. See the AAWM Handbook for Candidates for a complete list of professions.

Once you’ve determined you’re eligible to take the exam, you’ll need to provide the following information/forms in your application package:

  1. Provide a completed application to take the exam with all fields filled in with biographical information, including your social security number.
  2. You will need to provide an up-to-date or recent professional resume or curriculum vitae.
  3. Provide a detailed description of at least three years of clinical wound care experience and direct patient care.
  4. Copies of the professional licenses and board certifications you possess.
  5. Provide three letters from professional references sealed in original envelopes. Make sure these letters discuss your experience in wound care management, your knowledge, skills, and expertise throughout the entire three years or more. If you have chosen the one-year fellowship alternative, two of the three letters of recommendation need to be from the fellowship program director an the CWS who supervised or was involved in your training (in a direct way).
  6. Read the AAWM code of ethics. Afterwards, there is a statement in the handbook that you’ll need to sign verifying that you’ve read the code and agree to adhere to it.
  7. Complete the professional testing center application, which is also found in the Handbook. This application will schedule the exam.
  8. Include the payment for the required application fee. If you are able to send in your application package by the early registration deadline, the fee is $575. If you send it in after the early registration deadline but before the registration deadline, the fee is $625. All late applicants are charged a $50 fee.
  9. There is also a checklist in the Handbook that you are required to use to ensure you’ve met all of the application requirements. Make sure to fill it out and include it in your package.
  10. All application materials must be sent in one envelope or package and arrive at the AAWM in that manner.

Study Guides, Practice Tests, and Other Study Material Available

The certified wound specialist (CWS) exam developed by the American Academy of Wound Management (AAWM) is a three and a half hour, 150-question exam that covers many different aspects of wound care. No matter how much education and experience you may have, you should plan to study for the exam before you take it. Even the most seasoned medical professionals don’t encounter every aspect of wound care, so there may be some areas that you are less familiar with. In fact you should plan to study for several weeks prior to taking the exam.

Practice Exams

One of the primary study tools you should plan to use as you prepare for the CWS exam is one or two different practice tests. As a medical professional, it is likely you’ve already prepared for and taken at least a few exams similar to the CWS exam in order to obtain licensing. So you know that using practice exams provides many benefits, such as helping you become familiar with the format and scope of the test, and giving you a good idea of what areas are your strengths and what areas you need to study. The AAWM developed a practice exam that is available for you to purchase and take online. It is an abbreviated version of the CWS exam, and you will have two hours to complete it. This practice exam will give you a good indication of the areas that you need to focus on. The AAWM stresses to its candidates that taking the practice exam is not an indication of how you will do on the actual CWS exam. It should be used only as a study tool.
There are also other practice exams available through educational publishing companies online. These exams can have a broader range of topic areas and questions and take longer to complete. They may also be more expensive. Before you purchase any test, you should read reviews or check with other healthcare professionals who have used them to make sure they will give you the benefits you’re looking for. You should plan to take at least two different practice tests as part of your study plan.

Study Guides and Other Tools

In addition to practice tests, there are many study guides available you can use. Study guides present the material that appears on the CWS exam in detail, so that you don’t have to study a variety of text books or develop your own material to study from. Some study guides are more comprehensive and widely used than others. Before purchasing a study guide, find out as much as you can about the company that produces it. Also ask other professionals who have taken the exam which study guides they used. Remember, everyone learns differently so what works for one person might not work for you. That’s why it’s important to take some time to investigate your study guide options before purchasing.
In addition to practice exams and study guides, there are other study systems you might want to invest in, such as flashcard systems. While the CWS tests your knowledge and skills in a practical way, there is a lot of information that needs to be memorized. Flashcard systems can help you remember important terms, definitions, equations, lab values, and similar items you will need to be able to recall in order to successfully complete the exam.
Overall, it’s important to develop a realistic study plan that includes a combination of two or more of the study tools available today. It does mean more expense, but using these tools can make taking and passing the exam a much less difficult task to accomplish.

Maintaining your CWS Certification


Maintaining your CWS CertificationOnce you’ve earned your certified wound specialist (CWS) designation, there won’t be a lot of time to rest on your laurels. Since the goal of the American Academy of Wound Management (AAWM) is to ensure that healthcare providers are able to provide effective wound care to their patients, you will need to put forth some time, effort, and expense in maintaining your certification, including taking continuing education credits. This assures the AAWM that you are up to date on the latest information and methods in wound care management, and that you are continuing to provide optimum care to your patients.

Renewal of your CWS Certification

While many certifications only require you to recertify on a regular basis (usually every two, three, or five years), the AAWM requires its certificate holders to renew their certifications on a yearly basis. All CWSs must renew at the same time every year, before the end of January. In order to renew, you will need to complete at least six continuing education units related to wound care and pay the renewal fee of $150.00. The CEUs must be completed in the calendar year prior to your renewing. The application for CWS renewal includes providing proof of your CEUs. You can consult the Handbook for Candidates supplied by the AAWM or contact the organization if you have questions about what validation is needed for CEUs.
Since other certifications require CEUs to be completed before the recertification date, this gives certificate holders the ability to wait until the third year or later to take their classes. The AAWM requirements makes it mandatory to take your continuing education classes every year, keeping wound care top of mind and up to date.

CWS Recertification

However, just because you are completing your CEUs and renewing your certification every year doesn’t mean that you don’t need to also become recertified. However, you will only need to complete the recertification process every ten years. The process is simpler than other certification renewals, since you have been taking and verifying your continuing education units on a yearly basis. However, you will need to sit for the CWS exam again. Just as it was the first time you took the exam, it is offered twice a year in April and October. The Professional Testing Corporation will notify you of your status, whether you passed the exam or not, within six weeks of taking it. You will pay the full fee of $275 to take the exam again. If you are late registering, you will be charged $50.

Notification of Recertification

The AAWM does send out a recertification notice to all certificate holders six months prior to your expiration date. It then sends out multiple notices (up to four) prior to the expiration date if you haven’t contacted the organization to begin the recertification process. If you move during your ten-year certification process you should make sure to notify the AAWM of your new address. This can be done at the time of your yearly renewal. If you let your certification lapse, whether during the yearly renewal or the ten-year recertification, you should contact AAWM to become reinstated. During a yearly renewal period you can still supply your CEU information and the $150 fee to become certified again. If the lapse occurs in the tenth year, you will need to sit for the exam again.
After going to the expense, time, and effort of becoming a certified wound specialist, it makes sense to maintain that certification through the renewal and recertification process. It is up to you to make sure that you follow through and renew and recertify in a timely manner.