The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

EXAMINATIONOF THE REGISTRY CREDENTIAL: ARE THE WRITTEN REGISTRY AND CLINICAL SIMULATIONEXAMINATION MEASURING SOMETHING DIFFERENT OR THE SAME THING?

Deborah Cullen EdD,RRT, FAARC,Linda Van Scoder EdD,RRT, Indiana University; KrzysztofPodgorski PhD, Derek Elmerick MS, Purdue University, Indianapolis, Indiana

The Registered RespiratoryTherapist (RRT) credential consists of two examinations; the written registry(WR) multiple choice question (MCQ) examination and the clinical simulationexamination (CSE). The respiratory profession continues to maintain a two-testprocess containing the CSE component although no other allied health professionrequires a CSE or two tests for one credential.1

Background: Currently, theNational Board for Respiratory Care (NBRC) utilizes all content on the certification(CRT) and WR content matrices to produce the CSE. This represents duplicationof testing content. The NBRC asserts that the CSE measures problem-solving abilityas demonstrated by the differences in passrate between the WR and CSE.2A test should be designed to identify minimal knowledge and skills appropriatefor the credential. Since the CRT and WR matrices are utilized for the CSE,the content is duplicative. Moreover, the WR tests 73% of its items at the analysislevel, which simulates problem-solving ability.1 Within this context,we set the purpose of this study to determine whether the WR and CSE measuredifferent attributes. Attenuation is utilized for this type of study becauseit will correct a correlation for its unreliability due to random measurementerror and result in a ?true correlation? as if both tests were perfectly reliable.

Methods: A convenience sampleof 56 advanced-level respiratory therapy students were administered the 1999web-version of the self-assessment examination (SAE) WR form B and CSE formA. These subjects were in their last month of program study and consisted of30.4% baccalaureate and 69.6% associate degree students from 4 different states.Student examinees were monitored by an instructor to assure simulated test conditionsand assist with technical test-taking issues if necessary. Reliability coefficientsfor each exam were determined utilizing Cronbach?s Alpha. Spearman Brown attenuationwas calculated between the WR and CSE to derive the true correlation betweenthe WR test and CSE. Numerical computation and analysis were performed withthe S-Plus statistical software. Institutional board approval was obtained forthis study.

Results: The attenuation calculateda correlation of .857 between the two tests. This result indicated that a strongcorrelation between the two tests exists.

Discussion and Conclusions:The strong correlation between the two tests suggests that the WR and CSE measuresimilar attributes, or at the very least, well correlated content. For our sample,the results demonstrated that the two tests measure the same attributes andthat the CSE may not be necessary. Elimination of the CSE would still permittesting for analysis of material through the WR. However, we caution that theseresults are limited to the SAE WR B and CSE A and may be limited by the studentsample or sample size.

1 Cullen DL & KossJA. The uniqueness of the clinical simulation examination. Respir Care EducationAnnual 1999; 8(1):59-68.

2 Traband MF & GeorgeBF. The clinical simulation examination: fact vs. fiction. NBRC Horizons 1994;20(5);1-5.

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