LAUSR

Objective The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) conducted a study to determine whether use of resources and method of test administration for the Continued Professional Certification Assessment (CPCA) impacts performance, testing experience, and fidelity of the examination. Methods A total of 1,500 certified registered nurse anesthetists (CRNAs) were randomized into one of six groups based on method of proctoring (in person or live online remote) and use of resources (closed book, open book with NBCRNA-provided resources [e-books], or open book with use of a choice of two of nine approved hard copy resources). Participants completed a baseline survey, the CPCA, and a post-CPCA survey. Results A total of 1,217 participants were included in the analyses. Scores on the CPCA were 5 points higher in the resources groups than in the closed-book groups (p = .0005), but examination times were twice as long (p = .0005). Performance standard rates were similar (p = .26). In the resources groups, 84.2% of participants used resources to confirm an answer. In the e-books groups, approximately 40% of participants' comments indicated problems with the e-books. Participants in remote proctoring groups had a moderate number of problems with remote proctoring; thus, scores were lower than expected. However, 55% to 73% of participants indicated remote proctoring would reduce their anxiety on future examinations. Half of all participants strongly agreed or agreed that the CPCA accurately reflected core knowledge all CRNAs should know. Conclusion It is recommended that the CPCA be delivered as a closed-book examination with choice of in-person or remote proctoring that does not require live online proctors.