BOC Certification: Moving Forward with an Advancing Profession

The O&P profession has been steadily raising the bar as it advances in clinical expertise, education, research, advanced technology, and the application of evidence-based practice for improved patient care and outcomes. As the profession advances, the Board of Certification/Accreditation (BOC) certification programs and processes keep pace. BOC's O&P certifications are recognized by other healthcare professionals, consumers, and payers as indication that practitioners have met the standards necessary to provide quality patient care. Key Findings of an Independent Report [caption id="" align="alignright" width="180"] BOC President and CEO Claudia Zacharias celebrates her fifth year as the agency's leader in 2014.[/caption] Late last year, the Kentucky Board of Prosthetics, Orthotics and Pedorthics was the first licensure board in the nation to commission an independent psychometric evaluation of the BOC and the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) certification exams. Psychometricians specialize in the objective measurement of skills, knowledge, abilities, attitudes, personality traits, and educational/occupational achievement. The psychometric comparison was completed by Michael R. Cunningham, PhD, a psychologist and professor at the University of Louisville, Kentucky. The report evaluated BOC's and ABC's prosthetist, orthotist, pedorthist, and orthotic fitter job task analyses (JTAs) and certification tests and included commendation for aspects of each organization's examinations and processes as well as noted areas for improvements. Key findings in the report include the statement, "this independent review concludes that candidates for certification and licensure in the disciplines of prosthetics and orthotics who have passed all three BOC examinations are likely to possess the preparation and skills for professional practice in those disciplines." (Author's note: For more information on the report, visit www.oandp.com/link/287 ) O&P Educational Standards Consensus [caption id="" align="alignright" width="300"] BOC announced the launch of a new website, which was redesigned to add functionality and improve user experience. Photographs courtesy of BOC.[/caption] In 2008, BOC joined with the four-member Orthotic and Prosthetic Alliance-all national O&P professional and industry organizations-in its efforts to become more unified in advancing the O&P profession. Leaders of the five national organizations representing the profession's clinical, business, and quality improvement aspects forged a consensus agreement, known as the "Historic Agreement," on the required education and training standards that providers and suppliers must satisfy in order to provide custom orthotics and prosthetics. At that time, the O&P Alliance comprised the American Academy of Orthotists and Prosthetists (the Academy); ABC; the American Orthotic & Prosthetic Association (AOPA); and the National Association for the Advancement of Orthotics and Prosthetics (NAAOP). In 2011, BOC accepted an invitation to join the O&P Alliance, adding its support to the alliance's mission and initiatives. Prosthetist and Orthotist Certification Examinations Prerequisites As a result of BOC's commitment to the Historic Agreement, candidates seeking to become a BOC-certified orthotist or prosthetist must provide documentation demonstrating graduation from a prosthetic or orthotic practitioner education program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), and completion of a prosthetic or orthotic residency approved by the National Commission on Orthotic and Prosthetic Education (NCOPE). Candidates may take any or all of the three-part certification exam during their residencies, but certificant status is awarded only after successful completion of their residencies. Test Development Developing and implementing valid certification examinations is a highly complex psychometric process that involves the application of statistical and mathematical techniques. BOC and Applied Measurement Professionals (AMP), Olathe, Kansas, have been partners in test development and implementation for more than 20 years. "Psychometrics in general is the branch of psychology that specializes in measurement," explains Steve Nettles, EdD , AMP program director, psychometrics. "We specialize in licensing and certification testing." [caption id="" align="alignright" width="250"] Donald Dotter, BOCP, BOCO, completes the VPE evaluation form, which will include his comments and feedback on the candidate's performance in the VPE.[/caption] The basis for developing valid certification examinations is the JTA, a detailed study of the job activities of a specified profession, such as were examined for the Kentucky Board of Prosthetics, Orthotics and Pedorthics-commissioned study. JTAs are undertaken every five to seven years by BOC, in accordance with the standards of the Institute for Credentialing Excellence (ICE). Exam Descriptions The three-part exam that BOC O&P certificant candidates must pass includes a multiple-choice examination (MCE), a clinical-simulation examination (CSE), and a video practical examination (VPE). The MCE assesses the knowledge base required for the profession. The three-hour exam is computer-administered and, once completed, the candidate receives results instantly. The CSE lasts three-and-one-half hours and presents eight realistic cases that provide candidates with the opportunity to solve clinical problems. The CSE also is computer-administered with results available instantly after completion. Each orthotist CSE contains eight problems. Three of these problems involve spinal or cervical cases, and five problems involve upper- or lower-limb cases. [caption id="" align="alignright" width="250"] As he watches the video, Wayne Rosen, BOCOP, CPO, CPed, FAAOP, takes notes on the VPE evaluation form. He will rate the candidate's overall performance and interaction with the patient. Rosen has been a BOC VPE reviewer for more than ten years.[/caption] The VPE is a visual demonstration of hands-on skills and craftsmanship in O&P procedures and patient care. Three expert reviewers independently evaluate each video. This process was developed with the candidate in mind, to lower the costs of the examination and provide interrater reliability among the reviewers, according to BOC. Interrater reliability assures consistency in the review process, resulting in an accurate assessment of the candidate's abilities. The MCE and CSE are administered at AMP test centers or at H&R Block offices throughout the country; AMP contracts with H&R Block for facility use. The VPE can be completed from the candidate's own facility or residency site, "saving the candidate time and travel expenses," BOC President and CEO Claudia Zacharias, MBA, CAE, points out. For computer-based exams like BOC's, AMP follows standardized procedures for training proctors and supervisors, administering the exams, and maintaining security. Candidates present identification and are not allowed to bring in cell phones or any other electronic equipment that could be used for cheating. Ceiling-mounted cameras with 360 degree views monitor the test center. Test Scoring Tests are scored pass/fail using a modified Angoff method. "Basically the study determines an absolute standard," Nettles explains. "Unlike the bell curve, it makes no difference to candidates how well other candidates do. If one group is exceptionally able, the group will have a higher pass rate; a less-able group will have a lower pass rate, but everyone has to meet the same standard." [caption id="" align="alignright" width="150"] BOC won two consecutive Stevie Awards for Sales and Customer Service, achieved in 2013 and 2014.[/caption] BOC also provides certification and credentialing exams for pedorthists, orthotic fitters, mastectomy fitters, durable medical equipment (DME) specialists, and facility accreditation for O&P facilities, as well as for mastectomy boutiques, pharmacies, and DME/home medical equipment (HME) suppliers, among others. Improved Avenues to Apply for and Maintain Credentials BOC views improvements in its processes and technology that proffer avenues for certificants to obtain and uphold their credentials as part of its overall commitment to customer service, which has been recognized in two consecutive years with Stevie Awards. Improved services include offering exams throughout the year rather than during brief testing windows and providing the MyBOC web portal. MyBOC was launched in 2011 to provide BOC-credentialed individuals and companies with an easy-to-use portal to apply for and maintain their credentials. In 2013, a new feature was added to MyBOC as a way to provide certificants with a personalized continuing education (CE) experience. After logging into the portal, BOC certificants receive a customized view of educational opportunities within their certification type and geographic area. The site provides an online summary of CE credits earned and highlights the number of credits needed to fulfill requirements for that particular five-year CE cycle. Certificants can complete CE requirements at their own pace during the cycle. [caption id="" align="alignright" width="200"] In celebration of 30 years of credentialing, BOC recognized certificants who have been with them since 1984 with an honorary award.[/caption] "As a dual-credentialed professional, I have a very busy practice," says Shane Hayes, BOCPD, CPed, COF, Shane's Foot Comfort Center, Shoreline, Washington. "BOC helps me stay on track to maintain my certifications and was a tremendous help during the arduous task of facility accreditation. When I have questions, they either have the answers or find the person with the answers. I especially like the ease of navigating BOC's website to find an out-of-state colleague to refer one of my patients or to print the multiple copies of my certifications required by various agencies." Dan White, BOCO, BOCP, comments on the convenience and speed of scheduling his exams. "The exams were relevant to what I do on the job, and it was easy to work them into my schedule. I really enjoy patient care-seeing patients make progress with the help we as prosthetists and orthotists provide." "We have a very dedicated and hardworking team at BOC that includes our board of directors and volunteers, says Zacharias. "Collaboration is a key factor in creating our credentialing programs, supporting our certificants, and delivering outstanding customer service. Miki Fairley is a freelance writer based in southwest Colorado. She can be contacted via e-mail at miki.fairley@gmail.com

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BOC Certification: Moving Forward with an Advancing Profession

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Related posts:

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