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Certification in Infection Certification in Infection ControlControl

Why bother????Why bother????

Sharon Krystofiak, Sharon Krystofiak, MS, MS, MT, CICMS, MS, MT, CICInfection Infection PreventionistPreventionist

UPMC Presbyterian, Pittsburgh, PAUPMC Presbyterian, Pittsburgh, PAPresident 2009, CBICPresident 2009, CBIC

On a personal noteOn a personal note……

►►I am saddened by the low percentage of I am saddened by the low percentage of certified IC professionals.certified IC professionals.

►►I thought some of the exam questions I thought some of the exam questions were flawed, outdated and entirely too were flawed, outdated and entirely too picky. I still do.picky. I still do.

►►I wish 100% of qualified candidates would I wish 100% of qualified candidates would pass the test.pass the test.

I know what information you really want I know what information you really want me to discuss, howeverme to discuss, however……

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CBIC Mission StatementCBIC Mission Statement

►►To improve the quality of healthcare by To improve the quality of healthcare by increasing the number of professionals increasing the number of professionals whose knowledge mastery in infection whose knowledge mastery in infection control and applied epidemiology has been control and applied epidemiology has been demonstrated by certification. demonstrated by certification.

CBIC endorses the concept of certification for all professionals meeting the educational and practice

requirements. We

►believe certification is in the best interest of the public and the profession.

►adhere to the highest standards of certification.

►are customer focused.►are fiscally and ethically responsible and

accountable.►value our partnerships.►are responsive to the external environment.►accept change and support excellence.

The CBIC Board of DirectorsThe CBIC Board of Directors

►► Voluntary, autonomous, multidisciplinary board Voluntary, autonomous, multidisciplinary board ►► Comprised of Comprised of

nurses from various settings, nurses from various settings, a physician, a physician, a Medical Technologist/clinical microbiologist a Medical Technologist/clinical microbiologist a Canadian, a Canadian, an educator, an educator, a consumer membera consumer membera representative from the APIC Board*a representative from the APIC Board*the CHICAthe CHICA--Canada President *Canada President *

►► All members must be currently certified, including the MDAll members must be currently certified, including the MD

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Applied Measurement Applied Measurement Professionals Inc.Professionals Inc.

►►““provides certification organizations, provides certification organizations, governmental agencies, professional governmental agencies, professional associations and private industry with associations and private industry with innovative assessment and management innovative assessment and management solutions that focus on the appropriate solutions that focus on the appropriate application of technology and personal application of technology and personal customer service.customer service.””

►►Provide management services, assessment, Provide management services, assessment, delivery, finance, meeting planning.delivery, finance, meeting planning.

Applied Measurement Professionals, Applied Measurement Professionals, Inc. (AMP)Inc. (AMP)

►►Different groups within the company Different groups within the company provide our testing and association provide our testing and association management services management services

►►Psychometric staff analyze our questionsPsychometric staff analyze our questions►►Located in KansasLocated in Kansas►►http://www.goamp.com/http://www.goamp.com/

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The CBIC HandbookThe CBIC Handbook

A goldmine of informationA goldmine of information

Download it from websiteDownload it from websitewww.cbic.orgwww.cbic.org

Available in hard copy Available in hard copy format at this conference format at this conference

Read it carefullyRead it carefully

Two ExamsTwo Exams

►►Both are comprehensive, objective examsBoth are comprehensive, objective exams►►150 multiple choice questions150 multiple choice questions►►Developed from a job analysis sent to IPs in Developed from a job analysis sent to IPs in

the U.S. and Canadathe U.S. and Canada►►Initial testing must be using the Proctored Initial testing must be using the Proctored

Computer Based Test (PComputer Based Test (P--CBT)CBT)►►This exam is accredited by the NCCA This exam is accredited by the NCCA

(National Commission for Certifying (National Commission for Certifying Agencies).Agencies).

Major changesMajor changes

►►Elimination of the 2 year practice Elimination of the 2 year practice requirementrequirement

►►All exams are computer basedAll exams are computer based►►New Practice AnalysisNew Practice Analysis►►Will be creating a new Content Outline for Will be creating a new Content Outline for

use in 2010.use in 2010.►►PrePre--auditing of candidates auditing of candidates

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In the beginningIn the beginning……

The Practice Analysis

The Practice Analysis

►► 8080--100 questions asking about what job tasks 100 questions asking about what job tasks are performed and how important those tasks are performed and how important those tasks are to the profession.are to the profession.

►► Answers determine the content of the examsAnswers determine the content of the exams►► 9,590 email surveys sent out in 20059,590 email surveys sent out in 2005►► Received 1304 responses (21.8%)Received 1304 responses (21.8%)

►►In 2009, ~15,000 survey invitations were In 2009, ~15,000 survey invitations were sent, 3771 responses were usable, sent, 3771 responses were usable, resulting in a 27.5% response rate. resulting in a 27.5% response rate.

The results werenThe results weren’’t surprisingt surprising►► Very few changes in practiceVery few changes in practice►► Only questions on research tasks Only questions on research tasks

were removedwere removed►► Employee Health was streamlinedEmployee Health was streamlined► Bioterrorism, patient safety and

focus on infection prevention questions were added

►► By this time, all nationBy this time, all nation--specific specific references had been removedreferences had been removed

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The 2006 Content OutlineThe 2006 Content Outline►►Identification of Infectious Disease Identification of Infectious Disease

ProcessesProcesses►►Surveillance & Epidemiological Surveillance & Epidemiological

InvestigationInvestigation►►Preventing/Controlling the Transmission of Preventing/Controlling the Transmission of

Infectious AgentsInfectious Agents►►Program Management and CommunicationProgram Management and Communication►►Education & ResearchEducation & Research►►IC Aspects of Employee HealthIC Aspects of Employee Health

2009 Practice Analysis2009 Practice Analysis

changes have made the previous PA nearly changes have made the previous PA nearly obsoleteobsoleteInternet accessInternet accessInformaticsInformaticsPublic ReportingPublic ReportingNHSNNHSNPatient Safety initiativesPatient Safety initiatives

Content Outline will change for 2010Content Outline will change for 2010

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Exam GoalsExam Goals--CompetencyCompetencyWhat is important to test?What is important to test?

►► Knowledge alone does not necessarily imply Knowledge alone does not necessarily imply competent practice, or successful performance on competent practice, or successful performance on the job the job

►► Need to incorporate performance of several Need to incorporate performance of several related tasksrelated tasks

►► Requires the use of a variety of knowledge Requires the use of a variety of knowledge domains/cognitive levelsdomains/cognitive levels

Eligibility CriteriaEligibility Criteria

►► A current license or registration as a medical A current license or registration as a medical technologist, physician, or technologist, physician, or registered nurse;registered nurse;

OROR

►► A minimum of a baccalaureate degree. A minimum of a baccalaureate degree. ►► Candidates who are selfCandidates who are self--employed or employed or who work in who work in

nonnon--traditional settings must submit additional traditional settings must submit additional documentation documentation ((SeeSee Candidate HandbookCandidate Handbook for for detailsdetails))

►► Candidates with lapsed certification also must Candidates with lapsed certification also must meet the practice requirementsmeet the practice requirements

The Minimally Competent IPThe Minimally Competent IP

►►Licensure assures minimal competency to Licensure assures minimal competency to practice in a field, practice in a field,

►►Certification indicates mastery of a defined Certification indicates mastery of a defined body of knowledgebody of knowledge

►►CBIC does not believe that continuing CBIC does not believe that continuing education credits measure competencyeducation credits measure competency

Too subjectiveToo subjectiveToo electiveToo elective

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Cognitive LevelsCognitive Levels

1.1. Declarative/Recall Declarative/Recall -- retention of retention of basic knowledgebasic knowledge-- assesses static assesses static conceptsconcepts

►► The answers will not change The answers will not change –– you either you either know it or you donknow it or you don’’tt

►► The ability to The ability to useuse knowledge on the job knowledge on the job is is notnot assessedassessed

►► ExampleExample-- Who was the Queen of Who was the Queen of England in 2008?England in 2008?

Cognitive LevelsCognitive Levels

2. 2. ApplicationApplication –– dynamic or variable conceptsdynamic or variable concepts

►► Evaluates the ability to describe the performance Evaluates the ability to describe the performance of given activities under certain conditionsof given activities under certain conditions

IfIf……then situationsthen situations

►► A patient is admitted with a postA patient is admitted with a post--operative operative wound infection. MRSA is cultured from the wound infection. MRSA is cultured from the wound. What type of precautions are required wound. What type of precautions are required for this patient?for this patient?

Cognitive LevelsCognitive Levels

►►Analysis/PerformanceAnalysis/Performance-- Ramps it up a Ramps it up a notchnotch

►►best for measuring competence best for measuring competence --measures performance factorsmeasures performance factors

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AnalysisAnalysis

►► An ICP is conducting a An ICP is conducting a ““best practicebest practice”” quality quality improvement project in improvement project in a LTC unit and is a LTC unit and is reviewing the reviewing the occurrence of occurrence of conjunctivitis over a 4 conjunctivitis over a 4 year period. year period.

Conjunctivitis 2004 -2007

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10

20

Year

Num

ber o

f in

fect

ions

Number 5 4 16 12

04 05 06 07

What is the best What is the best interpretation of this interpretation of this data?data?

A. A. Analysis of absolute numbers of infections Analysis of absolute numbers of infections is misleading.is misleading.

B. There is a problem as the number of cases B. There is a problem as the number of cases increased in two out of four years.increased in two out of four years.

C. Literature indicates that there is no issue C. Literature indicates that there is no issue with this number of cases.with this number of cases.

D. Eye infections are uncommon in the D. Eye infections are uncommon in the elderly.elderly.

Conjunctivitis 2004 -2007

0

10

20

Year

Num

ber o

f

infe

ctions

Number 5 4 16 12

04 05 06 07

Creation of QuestionsCreation of Questions

►►All questions created must fit into a All questions created must fit into a category on the Content Outlinecategory on the Content Outline

►►All questions must be validated before they All questions must be validated before they can be scoredcan be scored

15 15 ““Pretest itemsPretest items”” on each examon each examThere is no indication which questions are not There is no indication which questions are not counted for the final scorecounted for the final scoreIf questions perform poorly, they are revised If questions perform poorly, they are revised and reand re--tested or deleted.tested or deleted.

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The ideal questionsThe ideal questions►► Have 4 plausible answersHave 4 plausible answers►► Candidates have selected all of the various Candidates have selected all of the various

answers in appropriate percentagesanswers in appropriate percentages►► Math calculations must be possibleMath calculations must be possible►► Answers are about the same length and formatAnswers are about the same length and format►► No negative wording, exclusionary words (all, No negative wording, exclusionary words (all,

nevernever……) or multiple ) or multiple multiplemultiple answers (A+B, answers (A+B, A+C, A+B+C, B+D)A+C, A+B+C, B+D)

Validity of the ExamsValidity of the Exams

►► The examinations are developed under the The examinations are developed under the guidance of Applied guidance of Applied Measurement Professionals Measurement Professionals (AMP), an independent testing agency. AMP also (AMP), an independent testing agency. AMP also oversees scoring of the examination.oversees scoring of the examination.

►► Each test item undergoes both expert Each test item undergoes both expert and and statistical scrutiny before use.statistical scrutiny before use.

►► Passing scores are calculated to Passing scores are calculated to compensate for compensate for item difficulty and differences between item difficulty and differences between examinationsexaminations

►► Acknowledged by JCAHO as an element of an Acknowledged by JCAHO as an element of an effective infection control programeffective infection control program

The proctored computer based The proctored computer based exam (Pexam (P--CBT)CBT)

►► The initial exam is always the higher security The initial exam is always the higher security computer based exam.computer based exam.

►► No practice requirement (time spent on the job) No practice requirement (time spent on the job) mandated effective in 2009.mandated effective in 2009.

►► The recertification exam (SARE) is now computerThe recertification exam (SARE) is now computer--based also but remains an based also but remains an ““openopen--book testbook test””

►► Technology to score a paper based exam has Technology to score a paper based exam has become obsoletebecome obsolete

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Initial PInitial P--CBTCBT

►►Administered at Assessment Centers Administered at Assessment Centers throughout the Canada and the United throughout the Canada and the United StatesStates

►► Sites are listed on the AMP web site,Sites are listed on the AMP web site,wwwww.goamp.comw.goamp.com

►►Can be used for both initial certification and Can be used for both initial certification and rere--certification purposescertification purposes

If you wanted to take the Exam in If you wanted to take the Exam in the U.S.the U.S.

Exam SecurityExam Security►►Current, permanent identification card Current, permanent identification card

issued by a governmental agency, issued by a governmental agency, which includes both signature and which includes both signature and photograph requiredphotograph required

►►You must bring your registration letter You must bring your registration letter with youwith you

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Taking the testTaking the test

►►Arrive in plenty of timeArrive in plenty of time►►Late comers will be turned away if more Late comers will be turned away if more

than 15 minutes past the time of the than 15 minutes past the time of the appointmentappointment

►►No paper is allowed. Scrap paper will be No paper is allowed. Scrap paper will be provided and must be returned at the end provided and must be returned at the end of the examof the exam

►►NonNon--programmable calculator is allowedprogrammable calculator is allowed►►You will be given some practice time with You will be given some practice time with

the mouse and computerthe mouse and computer

Taking the testTaking the test

►► 3 hours to complete the 3 hours to complete the computerized examcomputerized exam

►► Exams taken in the U.S. Exams taken in the U.S. give you a give you a ““passpass”” or or ““failfail””notice when the exam is notice when the exam is finished.finished.

How many testing sites?How many testing sites?

►►140 Assessment 140 Assessment Centers in US and Centers in US and CanadaCanada

►►Exam available in Exam available in 30 countries 30 countries including USincluding US

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QuestionsQuestions

Question number

QuestionsQuestions

Option to make a comment

QuestionsQuestions

Go to the next question

Go to whatever question you want

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QuestionsQuestions

I’m finished

CommentsComments

►►Make sure you are comfortable with the Make sure you are comfortable with the computer before beginning the timed computer before beginning the timed portion of the examportion of the exam

►►Please tell proctor about any issues Please tell proctor about any issues encounteredencountered

►►Anyone with disabilities may request a Anyone with disabilities may request a time allowancetime allowance-- but this must be but this must be documented before arriving for the exam.documented before arriving for the exam.

We just did an online survey of IPsWe just did an online survey of IPs

►►Why they are CIC:Why they are CIC:Personal satisfactionPersonal satisfactionRecognitionRecognitionRequirementRequirementAdvancementAdvancementOtherOtherMoneyMoney

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We just did an online survey of IPsWe just did an online survey of IPs

►►Why they are NOT CIC:Why they are NOT CIC:Certification not supportedCertification not supportedIC not viewed as significantIC not viewed as significantHave to pay for it myselfHave to pay for it myselfNot convenientNot convenientExam too hardExam too hardDonDon’’t know enough about itt know enough about it

Certification & RecertificationCertification & Recertification

CBIC believes that:CBIC believes that:

Continuing education does NOT Continuing education does NOT demonstrate competencedemonstrate competence

Demonstrating competence is anDemonstrating competence is anongoing process requiring repeatongoing process requiring repeatmeasurementmeasurement

Why Why II think Certification is think Certification is importantimportant

►►Recognition and marketabilityRecognition and marketability►►Provides an objective measure of Provides an objective measure of

competence to employers and the competence to employers and the publicpublic

►►Professional developmentProfessional development►►Personal satisfactionPersonal satisfaction

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In closing, please rememberIn closing, please remember……

►►We would like all competent candidates We would like all competent candidates to be able to successfully pass the to be able to successfully pass the examsexams-- there is no intention to create there is no intention to create trick questions.trick questions.

►►There is a practice requirement.There is a practice requirement.►►There is a training requirement.There is a training requirement.►►Earning the CIC credential says Earning the CIC credential says

something about the professional. something about the professional.

To Contact CBICTo Contact CBIC

►►Website: Website: www.CBIC.orgwww.CBIC.org

Please be advised that CBIC does not produce or Please be advised that CBIC does not produce or endorse educational offerings such as study endorse educational offerings such as study courses, study guides or "flashcards.courses, study guides or "flashcards.““

►► We take no credit or responsibility for the contents We take no credit or responsibility for the contents thereof .thereof .

Thank you!!!Thank you!!!