31May

All Certification Exams Are Basically the Same, Right? How Do You Choose?

By Christopher Damon, JD

The title of this article presupposes that there is in fact a choice of certification bodies for a particular profession. In some allied health professions, there is no real choice. In those professions, there is only one certification entity. For others — which is the case for the allied health credentials conferred by AMT — schools, employers and individuals are confronted with a choice of different certification entities.

Christopher-Damon-JD presents at National Conference on Allied Health EducationHow did we get to this point of multiple certification bodies? How are they different from accreditation bodies? Certification and accreditation do have certain characteristics in common, but the words themselves are sometimes used in confusingly conflicting ways. They both broadly involve publicly recognizing either an institution (accreditation) or an individual (certification) for meeting national standards.

However, they are different in many other ways. One difference is that educational accrediting bodies typically require some form of official approval whether from the U.S. Department of Education or CHEA. Certification bodies, on the other hand, require no approval at all to operate. Literally anyone can set up something called a certification board without approval or authorization from anyone to do so. There are no laws prohibiting someone from calling themselves a certification board, no laws outlawing such entities unless they have certain minimum characteristics.

There is one form of external review: Certification bodies can voluntarily choose to subject themselves to their own form of external accreditation. Two organizations that accredit personnel certifiers are ANSI and NCCA. NCCA (the National Commission for Certifying Agencies) is a component of ICE (the Institute for Credentialing Excellence). ICE is the trade group for certification boards. Mere membership in ICE means nothing in terms of saying something about a certification agency’s quality, but NCCA accreditation does mean something.

My own organization, AMT, is proud to have been NCCA-accredited since NCCA’s inception. We were the first to achieve it in the disciplines we certify. However, it should be noted that accreditation evaluates only the extent to which an exam program adheres to general characteristics of any certification agency, basic principles of certification program administration, and test development and administration. NCCA accreditation does not evaluate the extent to which an exam actually does a good and fair job of testing knowledge, skills and aptitudes in a particular subject matter area. In other words, if NCCA accredits an exam-based certification program for surgical techs, it does not have surgical techs review the exam to see if the questions on the exam makes sense. If NCCA feels that a program’s structure and process and its internal systems are such that it has the apparent capacity to generate an exam that properly addresses the subject matter, that is all NCCA can do and all accreditation means. As to the degree to which an exam actually reflects the subject matter in that field, that typically is a judgment made by the marketplace of users and exam-takers.

That is why reputation and length of service of a certification body has some relevance to judgments on its quality and capabilities. I’ve sometimes been asked, “By what authority does AMT issue credentials?” The truth is that any authority that a certification agency might have rests not on any governmental grant of authority but by its acceptance and reputation in the marketplace. To be sure, many state laws will recognize certification exams, sometimes by name, for purposes of licensure or scope of practice laws, but those laws are not granting the certifying board their basic authority to operate.

Something else has changed over the years. Employers are taking a stronger interest in certification and what it means. Increasingly it is employers who are driving change in the field of credentialing and continued competency. Employers are beginning to understand that not all certifications are created equal, and they are probing what is beneath the surface of that credential.

A 100% guaranteed pass rate, an exam so easy to take you can take it online at home, exam prep materials that practically tell you the answers on the test and recertification requirements that are a snap might be attractive to some schools or students. But they’re not attractive to employers. In fact, a good employer will probably find those kinds of qualities of a credentialing program to be more negative than positive. If an employer determines that a particular credential is conferred in a manner that doesn’t derive from a well-developed, reasonably directed and secure process, they will think less of that credential. The employers are the driving force in this field in the future.

What would a carefully cautious, prudent employer look for in a certification agency? An employer might first look at the overall reputation of the agency in the industry and perhaps how long that organization has been certifying individuals. Is the credential recognized by state and federal agencies and by other health care systems? What has been the experience of hiring employees with these credentials? Are they competent or did the employer need to do extra training to bring them up-to-speed? They may ask if the organization has a goal of improving patient care, instead of looking to make an extra buck. And of course, an employer might want to see how the exams are constructed and administered with an eye toward rigor and integrity.

The stakes are high in the health care market. Why not let quality drive your decision?

Excerpted from a speech given by AMT Executive Director Christopher Damon, JD, at the ABHES Annual Conference at Caesar’s Palace, Las Vegas, on March 1, 2018

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