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CBIC Town Hall Session: An Evidence-based Approach to Assessing the Competence of Infection Preventionists

Fran Feltovich, RN, MBA, CIC, CPHQ, CBIC PresidentJames P. Henderson, Ph.D, CASTLE Worldwide, Inc.Terrie Lee, RN, MS, MPH, CIC, CBIC President-elect

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Contrasting Missions

• APIC: improve health and patient safety by reducing risks of infection and other adverse outcomes. Purpose: serve the needs and aims common to all disciplines united by infection control and epidemiology activities.

• CBIC: protect the public by raising the standard of the infection prevention profession through the development, administration, and promotion of an accredited certification process

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• National Organization for Competency Assurance• Practices and Requirements of Renewal Programs in• Professional Licensure and Certification• November 11, 2008• James P. Henderson, Ph.D

CASTLE Worldwide Inc.

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Practices and Requirements of Renewal Programs in

Professional Licensure and Certification

  November 11, 2008

James P. Henderson, Ph.DCASTLE Worldwide Inc.Research Sponsored Jointly by the National Organization for Competency Assurance, National Board on Certification and Recertification of Nurse Anesthetists, and Oncology Nursing Certification Corporation

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Lessons from the Literature Related to Public Confidence

• Initial licensure and certification are not sufficient

• Renewal of licensure and certification is not sufficient

• Reliance on only continuing education is waning

• Issues are complex and finding answers is a struggle

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Start by Defining Continuing Competence

Philosophy• Why is CC important: protection of

the public, professional growth?• What about variations in career

paths?• Is the objective to maintain entry-

level competence or to enhance competence?

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Program Components: Continuing Education

• Ubiquitous• No substantial evidence that

continuing education is sufficient• Consistency in the quality and nature

of continuing education courses and assessments is needed and difficult to ensure

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Program Components: Assessments

Almost universal in initial licensure and certification

Increasingly used for renewal: ABMS, nursing specialties• Use entry-level assessment for renewal?• Require a more advanced assessment for

renewal of licensure or recertification?• Account for specialization? Or not?• Multiple choice? Practical? Simulation?

Oral?• Commitment to psychometric quality for

the renewal assessment?8

Trends in Recertification

• It is important to define what continuing competence means, given stakeholder interests

• Sole reliance on continuing education is seen as not sufficient

• A variety of tools are being used to measure continuing competence. Use of these tools should be consistent with the definition of continuing competence.

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Certification Test Development

• Practice Analysis• Content Outline• Test Specifications

Types of items (questions)RecallApplicationAnalysis

• Item Development10

Item Development

• Each item referencedAPIC TextOther APIC reference materialsControl of Communicable Diseases

ManualFormal guidelines and recommendations

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• Bank of test items electronically stored

• Pool conversion to match content outline following practice analysis

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• Test StatisticsEach itemEach responseReliabilityValidity of examEquating exams

• Legally Defensible Exam Process

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• Exam DevelopmentNew Computer Based Test (CBT) coming

in July 2010150 items on each exam (135 scored)15 pretest itemsExam released this July is based on

references published prior to exam

• SARE produced every two years

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• CBTProctored, timed examWritten for IP with two years experienceOnly option for initial certificationAlso an option for recertificationScore report given at time of exam

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• Self- Achievement Recertification Exam (SARE)Written for an IP with seven years

experienceOn-line exam accessed multiple timesOnce answers submitted, score report is

generated

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• History of SAREWas paper & pencil formatAnswers and explanations for each question

were mailed to certificants with score reportExam questions and answers were readily

shared among many groups of IPs CE Credit was given for examWas seen as an “educational experience”

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• Failing recertifiers –Certification extended throughout the

yearMust pass exam during that time

If failed CBT, can take CBT or SAREIf failed SARE, must take CBT

Upon passing exam, certification extended for four years

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Thank You!

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