Medical specialty certification exams studied according to the Ottawa Quality Criteria: a systematic review.

BACKGROUND: Medical specialty certification exams are high-stakes summative assessments used to determine which doctors have the necessary skills, knowledge, and attitudes to treat patients independently. Such exams are crucial for patient safety, candidates' career progression and accountability to the public, yet vary significantly among medical specialties and countries. It is therefore of paramount importance that the quality of specialty certification exams is studied in the scientific literature. METHODS: In this systematic literature review we used the PICOS framework and searched for papers concerning medical specialty certification exams published in English between 2000 and 2020 in seven databases using a diverse set of search term variations. Papers were screened by two researchers independently and scored regarding their methodological quality and relevance to this review. Finally, they were categorized by country, medical specialty and the following seven Ottawa Criteria of good assessment: validity, reliability, equivalence, feasibility, acceptability, catalytic and educational effect. RESULTS: After removal of duplicates, 2852 papers were screened for inclusion, of which 66 met all relevant criteria. Over 43 different exams and more than 28 different specialties from 18 jurisdictions were studied. Around 77% of all eligible papers were based in English-speaking countries, with 55% of publications centered on just the UK and USA. General Practice was the most frequently studied specialty among certification exams with the UK General Practice exam having been particularly broadly analyzed. Papers received an average of 4.2/6 points on the quality score. Eligible studies analyzed 2.1/7 Ottawa Criteria on average, with the most frequently studied criteria being reliability, validity, and acceptability. CONCLUSIONS: The present systematic review shows a growing number of studies analyzing medical specialty certification exams over time, encompassing a wider range of medical specialties, countries, and Ottawa Criteria. Due to their reliance on multiple assessment methods and data-points, aspects of programmatic assessment suggest a promising way forward in the development of medical specialty certification exams which fulfill all seven Ottawa Criteria. Further research is needed to confirm these results, particularly analyses of examinations held outside the Anglosphere as well as studies analyzing entire certification exams or comparing multiple examination methods.

Addressing Current Issues in Vision Rehabilitation as a Specialty Practice of Occupational Therapy.

The purpose of this paper was to examine the low number of occupational therapy practitioners in the United States that possessed specialty or advanced certification in low vision. The discussion explores possible reasons for this finding, including insufficient educational accreditation standards to prepare occupational therapy students to work with people with visual conditions, lack of clarity on the definition of low vision leading to misalignment with the profession's scope of practice, inconsistent requirements for advanced certification, scarcity of post-professional preparation programs, and other issues. We propose several solutions to prepare occupational therapy practitioners to meet the challenges and needs of people of all ages with visual impairments.

The Effect of Peer-to-Peer Education about the Significance of Specialty Certification on Empowering Nurses Working in Dialysis.

Specialty certification demonstrates knowledge and expertise in an area of nursing practice resulting in significant benefits to nurses, patients, public, and hiring organizations, empowering professional practice, and improving nurse retention and patient outcomes. However, a large majority of nurses working in dialysis have never validated their knowledge and skills through specialty certification. A one-group pre- and post-intervention study was conducted, with a sample group of registered nurses working in dialysis, using an asynchronous peer-to-peer education regarding empowering practice through specialty certification. The effect on psychological empowerment was measured using a 2-tailed t test with a comparison of enrollments in pre-certification courses. Results showed a 25% increase in course enrollments, but no statistical significance in psychological empowerment. Future study is needed on how nephrology nursing certification impacts patient outcomes, empowerment, workplace environment, and staff retention in nephrology.

Simulation's Use Across the Clinical Landscape.

Across the healthcare continuum simulation is routinely integrated into the curriculum for nurses and other professionals. The amount of simulation experienced at different points in the clinical setting highly depends on the specialty and organizational investment. The use of simulation in nursing can be divided into five specific use cases. Required and specialty certification courses include the following: Nurse Onboarding, Nurse Continuing Education, Regulatory & Joint Commission, and Interprofessional Education. Although common elements exist for each of the abovementioned use cases, there are distinct advantages, disadvantages, and implementation challenges with each that need to be considered.

The association between advanced orthopedic certification and confidence and engagement in prescription opioid medication misuse management practices: a cross-sectional study.

In the United States, attaining the orthopedic certified specialist (OCS) credential or the orthopedic subspecialty credential of Fellow of the American Academy of Orthopedic Manual Physical Therapists (FAAOMPT), may lead to a higher level of orthopedic practice. It is unknown whether attaining these credentials influences physical therapist confidence in and frequency of engagement in prescription opioid medication misuse (POMM) management practices. A national cross-sectional web-based survey of PTs identified whether respondents had an OCS or FAAOMPT credential. Self-report confidence in POMM-related management practices and the frequency of engaging in these practices were assessed. Logistic regression evaluated association between credential status and confidence in, and frequency of, engagement in POMM-related management practices. The analysis included 402 respondents with a mean age of 41.0 (SD = 11.2) and 203 (50.4%) females. There were 91 (22.6%) PTs with a FAAOMPT credential, 143 (35.6%) with an OCS but with no FAAOMPT credential and 168 (41.8%) had neither credential. Compared to those with an OCS credential, FAAOMPTs reported greater confidence in, and greater frequency of engagement in, POMM-related management practices (p< .05). Compared to those without an OCS or FAAOMPT credential and compared to those with an FAAOMPT credential, those with an OCS did not report greater confidence or greater engagement in any POMM-related management practice (p≥ .05). Obtain the FAAOMPT credential may increase PTs' confidence in some POMM-related management practices. Research is needed to determine why FAAOMPTs report greater confidence and engagement in POMM-related management practices.

Turning a Crisis Into an Opportunity: Promoting Professional Development Among Perioperative Personnel During a Pandemic.

The perioperative setting is a complex, high-risk working environment. Ensuring adequate staffing with highly competent nurses remains a top priority to sustain safe patient care. However, there are barriers to individual professional advancement in hospitals, including costs and lack of support or time, which can lead to decreased nurse satisfaction. After the mandated cancellation of elective surgery in March 2020 resulting from the coronavirus disease 2019 pandemic, leaders at a medical center decided to turn this difficult situation into an opportunity to re-engage their perioperative personnel in professional development. More than 70 staff members participated in activities related to certification, continuing education, clinical advancement, and cross-training. Elective surgery has since resumed, and as a result of the pursuit of professional development opportunities, staff member turnover did not increase throughout the transition at the medical center. Interest in professional growth has been reignited and staff members are excited about future development opportunities.

Nurses' decision making in heart failure management based on heart failure certification status.

BACKGROUND: Research findings on the value of nurse certification were based on subjective perceptions or biased by correlations of certification status and global clinical factors. In heart failure, the value of certification is unknown. OBJECTIVES: Examine the value of certification based nurses' decision-making. METHODS: Cross-sectional study of nurses who completed heart failure clinical vignettes that reflected decision-making in clinical heart failure scenarios. Statistical tests included multivariable linear, logistic and proportional odds logistic regression models. RESULTS: Of nurses (N = 605), 29.1% were heart failure certified, 35.0% were certified in another specialty/job role and 35.9% were not certified. In multivariable modeling, nurses certified in heart failure (versus not heart failure certified) had higher clinical vignette scores (p = 0.002), reflecting higher evidence-based decision making; nurses with another specialty/role certification (versus no certification) did not (p = 0.62). CONCLUSIONS: Heart failure certification, but not in other specialty/job roles was associated with decisions that reflected delivery of high-quality care.

The current status and development of a skill examination for the Korean speciality certification examination

The Specialty Certification Examination is an important part of the assessment of medical education. However, the step 2 skill examinations of 26 medical specialties in Korea are insufficient with respect to achieving the objective of practical examinations that evaluate clinical skill and competence. Among the current step 2 skill examination methods, picture testing using slides or reading of pathology slides/radiologic images is more suitable for testing cognition and knowledge than for testing performance. The oral examination has low reliability because of its relatively short testing period and absence of scoring criteria. In addition, the Specialty Certification Examination is a high-stakes test and the performance during the training course is not reflected in the skill examination. We have reviewed the various skill examinations including clinical practice examinations, objective structured clinical examinations of the United States and Canada, and work-based assessments of the United Kingdom. Based on the review, we suggest some plans for improving the Korean Specialty Certification Examination.