The specialty councils make the determination on the content areas to be covered on the examination and the number of items in each area, based on the results of a practice analysis. This practice analysis, also referred to as a job analysis, is a systematic plan to study professional practice behaviors and knowledge that comprise the practice of the specialist. The practice analysis is described in detail in the Description of Advanced Clinical Practice (DACP)/Description of Specialty Practice (DSP) for each specialty area. The practice analysis is a description, based on survey data and expert judgments, of the task and roles as well as the expected knowledge, skills, and abilities of physical therapists who possess advanced clinical skills in the area of specialty practice.
The specialty council uses the results of the practice analysis to write or revise a set of test specifications for the examination. The test specifications, also referred to as the content outline or examination blueprint, provide an outline of the content of the exam and consist of the percentage of questions representing each competency on the examination. The blueprint also helps to guide the development of an appropriate number of items for each area included in the examination blueprint.
Although the specialty councils are responsible for examination construction, ABPTS oversees all item-writing activities and evaluates the item-writing process. Questions or exam items are written to reflect the test specifications by content-area experts currently practicing in the specialty area, including practitioners and academicians, representing the full range of practice settings in all regions of the country. Item writers attend workshops and receive instruction to enable them to write high-quality, practice-related test items. Test items undergo extensive editing and review by subject-matter experts and professional test editors before the council approves them to be placed on an examination.
The specialty councils construct the examinations in conjunction with NBME staff, including professional test editors. Each specialty council meets annually with testing agency staff to review new and existing items in the test item bank, which is stored and managed by NBME. Shortly after the item review meeting, a specialty examination of approximately 200 items is constructed. The questions are designed to test synthesis and analysis levels of cognitive skills as well as content knowledge. The examination is composed of objective multiple-choice questions with four answer choices. The questions either stand alone or are part of a series that relates to a presented case study.
The National Board of Medical Examiners administers the specialist certification examinations through Prometric, a division of Thompson Learning, Inc. The examinations are administered by computer under proctored conditions at multiple sites across the US that meet high standards of equipment, comfort, and security. Following each administration, examinee responses are electronically transmitted to NBME.