Computer-based testing (CBT) is taking hold in nearly every professional sector, and healthcare-related fields are no exception. CBT combines all the necessities of paper and pencil-based testing (PBT) into an electronic format, making test administration more flexible, convenient and secure.
The Certification Board of Nuclear Cardiology (CBNC) recently transitioned its certification exam from paper and pencil to a computerized environment, allowing it to both lengthen the testing window and increase the number of locations it is available to candidates. The paper-based version of the CBNC exam, available once a year and in only one location, limited both the scale and scope of the test. The computer-based version substantially decreases the importance of a candidate's physical location, granting them the convenience and flexibility to test almost anywhere. With regard to testing seat availability, CBT allows the testing window to be more easily extended. In the case of CBNC's exams, once offered on a single day each year, is now offered in a fixed administration of one week per year, increasing both convenience and flexibility to candidates.
An additional, one-off benefit of transitioning to CBT and expanding test availability is that an increased number of candidates can be accommodated at any one time. Occasionally, with high-stakes tests, seats fill up early, and those candidates who wait until the last minute to register for an exam end up scrambling to find an opening. Candidate testing volume, an important measurement in any testing program, often increases as a side-effect of the enhanced availability that comes with CBT.
Another obvious benefit and strength of CBT is the increased security it offers program owners. Paper-based tests must be printed, transported to the testing location and stored in a secure location until the test date, and while PBT remains a secure way to test, CBT offers an enhanced level of protection. CBTs are encrypted and transferred electronically from the test administrator's datacenter directly to the testing center over a secure and private network. Since the encrypted test never actually sees the "light of day" until a candidate brings it up on his or her PC, there is almost complete absence of transport risk.
An additional security risk of any administered test is item exposure and test content security. Various test navigation and presentation strategies, made possible only through CBT, can help mitigate item exposure concerns. Test items can be stored electronically, and either pre-selected by the test sponsor for a given exam or randomly pulled on test day. Additionally, advancements in item management software have made it easier for organizations to maintain an up-to-date item bank, and remove or replace test items easily and at will.
Perhaps the most dynamic aspect of CBT is its ability to more closely replicate the "real life" experiences of people in any profession. Candidate users of computer-based tests often experience colorful high-resolution images or relevant video clips as part of their testing experiences. In the computerized version of the CBNC exams, for example, images and figures similar to those seen as part of physician's actual practice can be replicated to offer a more true-to-life testing experience.
There is most certainly an argument for the computerization of certification exams, especially with those testing programs that require larger-scale, higher stakes or increased flexibility. Computerization and digitization of content is growing more prevalent in every aspect of society, with the medical profession often at the cutting edge. The computerization of tests is critical to ensuring that future doctors, cardiologists and nurses are experiencing the most accurate, secure and "practical" experience possible – ensuring that the rest of us will be well-cared for in the future.
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