The “What” and “How” of Certification Exams

The following is an excerpt from Wound Care Certification Study Guide 2nd Edition, editors Jayesh B. Shah, Paul J. Sheffield, and Caroline E. Fife, explaining the “Whats” and “Hows” of wound care certification exams.

This chapter is designed to help you determine which certification exam best fits your situation and provides ten “pearls” to help pass the certification exam.

I. Wound care certification (certificate of added qualification)

  1. Physicians should be aware that neither the American Board of Medical Specialties (ABMS) nor its osteopathic counterpart, the Bureau of Osteopathic Specialists (BOS), recognizes wound care as a specialty or subspecialty; thus, none of the certification options can be considered an actual board certification. Wound care certification is perhaps better described as a certificate of added qualification. Certification identifies a standard of knowledge essential for developing a comprehensive wound management background; advances cooperation and resource exchange among the various disciplines and organizations involved in treatment of patients with chronic wounds; encourages continued professional growth and development of individuals and the field of wound management; and establishes a code of ethics, responsibility, and high professional standards by all certified individuals.
  2. The wound care certification testing agencies and their corresponding certifications listed in this chapter reflect a compilation of information about the exams available to the authors at the time of this writing. It is highly recommend that all prospective applicants do their own research at the individual certification exam websites, which are provided in the following table. In addition to the degree/license requirement, there is an application fee for each of the exams. Some exams require annual maintenance fees and/or have practice requirements. Prospective candidates are advised to contact the individual organizations for further details.
  3. Table 1.1 summarizes the credentials in wound care that are currently available.

Table 1.1: Wound care credentials

II. Hyperbaric medicine certification (board certification and certificate of added qualification, or CAQ)

  1. Increasing numbers of wound care practices are adding hyperbaric oxygen therapy as a treatment option for difficult wounds. A list of accepted indications for hyperbaric oxygen is available on the Undersea and Hyperbaric Medical Society (UHMS) website at www.uhms.org.
  2. Wound care specialists are often asked to supervise HBOT treatments. Many Medicare Administrative Carriers (MACs) and private payers have begun to specify the physician training required for reimbursement of physician-supervised HBOT. Physicians are encouraged to read their Local Carrier Determinations (LCDs) as requirements vary, though most require ACLS certification and at least a recognized 40-hour introductory course. Some payers require that a minimum number of treatments or hours of HBOT be precepted by a credentialed physician and/or that the physician obtains a CAQ in hyperbaric medicine to be reimbursed for the supervision of HBOT.
  3. The American Board of Medical Specialties (ABMS) recognizes subspecialty board certification in undersea and hyperbaric medicine (UHM) that is offered by both the American Board of Preventive Medicine (ABPM) and the American Board of Emergency Medicine (ABEM). UHM subspecialty board certification is now only possible for physicians who complete a one-year Accreditation Council for Graduate Medical Education (ACGME) approved fellowship in UHM and thus is unlikely to be an option for most physicians.
  4. Physician CAQs in hyperbaric medicine are available from the UHMS, the American Osteopathic Board of Preventive Medicine (AOBPM), and the American Board of Wound Healing (ABWH).
  5. Hyperbaric nurse and hyperbaric technologist certification is available from the National Board of Diving and Hyperbaric Technology (NBDHMT). The American Board of Wound Healing (ABWH) offers a certified hyperbaric and wound specialist certificate.
  6. Table 1.2 summarizes the credentials in hyperbaric medicine that are currently available.

Table 1.2: Hyperbaric credentials

III. Test-taking strategies

Test pass rates vary, but about 15-20% of applicants fail their certification exam. There are three important factors that affect one’s test performance: studying the right material, managing stress/test anxiety, and practical experience. Studying the reference materials on which the exam is based is the most important factor. The certification agencies want to know you understand the “textbook answer” to their questions. Managing test anxiety is the second most important factor. Even the most intelligent and studious individuals may do poorly on exams if they are overwhelmed by test anxiety. The best way to overcome test anxiety is to practice taking tests. Practice exams, like the one found in Chapter 33, are your best weapon against test anxiety. Practical experience, while a prerequisite to some wound care certifications, may actually impair test performance. It may be counterintuitive to think your experience can harm you, but it is important to recognize that the exam is not based on the wound care knowledge that has proven successful for you, unless that knowledge also happens to be the textbook answer to the question at hand. It is imperative you know the textbook answers, not the common practice in your facility.

The following is a list of suggestions for proper study techniques and general preparation considerations.

  1. At least two months before the exam:
    1. Carefully follow all the test registration procedures.
    2. Know the test instructions, duration, topics, question types, and number of questions.
    3. Familiarize yourself with the testing facility protocol. Do they allow any personal effects, e.g., phones, calculators, ear plugs into the testing environment? If not, will they provide you with a location to store these items? What happens if you have to go to the bathroom in the middle of the test?
    4. Set up a flexible study schedule and stick to it.
    5. Study during the time of day you are most alert, relaxed, and stress free. Most test applicants work, so no more than one or two hours a day should be set aside for studying.
    6. Focus on your weakest knowledge base. Do not study the material you are familiar with; study the topics you don’t know or don’t frequently use.
    7. Find a study partner for reviewing and clarifying questions.
    8. Practice, practice, practice.
  2. The day before the exam:
    1. Get a good night’s sleep. Do not try to cram the night before the test.
    2. Know the exact physical location of the testing site. Drive the route to the site prior to the test day.
    3. Keep your cool—play with your kids or go out for an evening walk.
    4. Select and set aside what you need to take to the testing center.
  3. The day of the exam:
    1. Consider taking ear plugs; the testing center could be noisy.
    2. Eat a well-balanced meal, but don’t overeat.
    3. Wear comfortable, loose-fitting, layered clothing; the examination room may be cold or hot.
    4. Take along the required documents to the testing center. This may include forms of identification or a document showing your reservation.
    5. Arrive early, be prepared to wait, and be patient.
    6. Stay positive.
  4. Ten “pearls” to ace the test:
    1. Read the entire question carefully. Scan all the answers, and read the question again. Make sure that you did not misread the question.
    2. Once you have selected your answer, always go back and check it against the question. Make sure your choice answers the question— all answers may be correct statements, but the correct choice is the one that directly answers the question.
    3. Do not disregard any information in the question. Information in the question is there for a reason; it is not there to throw you off.
    4. If you only know the answer to part of the question, the best action is to eliminate the choices you know to be incorrect and make a best educated guess from the remaining answers.
    5. If you’ve read the question and don’t know the answer, skip over the question and return to it later, if you have that option. Reading the remainder of the test may jog your memory or allow the answer to pop into your head when you aren’t stressing over it. If skipping the question is not an option, as with some electronic tests, don’t waste time on it. Pick an answer and move on to the next question.
    6. Don’t read too much into the question. Test writers are not writing questions to throw you off. Be practical and understand that the question is there to test a specific objective. Try to imagine what the test writer had in mind and was actually trying to ask. Don’t overcomplicate the problem by creating theoretical relationships or explanations that will warp time or space. These are normal problems rooted in reality. The applicable relationship or explanation may not be readily apparent, and you may have to figure it out. Use common sense to interpret anything that isn’t clear.
    7. Avoid answer choices that have definitive words like “exactly,” “always,” and “never.” These extreme statements do not leave room for exception. In medicine, almost everything has an exception. Avoid any answer choices with slang.
    8. Time management is crucial: don’t spend too much time on any one question. Pace yourself and check the clock every 30 minutes to make sure that you are on target with your time.
    9. Don’t panic: if you don’t know the answer to a question, it is not the end of the world. You do not have to know all the answers to pass the test.
    10. Finally:
      1. Prepare early—do not procrastinate!
      2. Study multiple books.
      3. Find a good source of practice tests and try to simulate the exam three weeks before the test.
      4. Concentrate on your weakest areas.
      5. About 80-85% of the test-takers pass their exam. You are more likely to pass than to fail.

IV. Wound care resources

  1. Krasner DL, Rodeheaver GT, Sibbald RG. Chronic Wound Care: A Clinical Sourcebook for Healthcare Professionals. 4th ed. Wayne: HMP Communications; 2007.
  2. Armstrong D, Lavery L, editors. Clinical Care of the Diabetic Foot. Alexandria: American Diabetes Association; 2005.
  3. Hess C. Clinical Guide: Skin and Wound Care. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2004.
  4. Veves A, Giurini JM, LoGerfo FW, editors. The Diabetic Foot. 2nd ed. Totowa: Humana Press; 2006.
  5. Joseph WS. Handbook of Lower Extremity Infections. 2nd ed. New York: Churchill Livingstone; 2002.
  6. Campbell DR, Kozak GP, Frykberg RG. Management of Diabetic Foot Problems. 2nd ed. Philadelphia: W.B. Saunders Company; 1995.
  7. Baranoski S, Ayello E. Wound Care Essentials: Practice Principles. Philadelphia: Lippincott Williams & Wilkins; 2003.
  8. Baranoski S, Ayello E. Wound Care Essentials: Practice Principles. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008.
  9. Falabella A, Kirsner R, editors. Wound Healing. New York: Informa Healthcare; 2005.
  10. Sheffield PJ, Fife CE, Smith APS, editors. Wound Care Practice. North Palm Beach: Best Publishing Company; 2004.
  11. Sheffield PJ, Fife CE, editors. Wound Care Practice. 2nd ed. North Palm Beach: Best Publishing Company; 2007.
  12. Masturzo A, Beltz WR, Cook R, et al. Wound care certification: the grin without a cat. Wound Healing Society Education Committee Chair Commentary. Wound Rep Reg. 2013; 21:494-7.
  13. American Board of Wound Management (CWS) Exam. http://www.abwmcertified.org/abwm-certified/cws/cws-how-to-prepare.
  14. American Board of Wound Management (CWCA) Exam. http://www.abwmcertified.org/abwm-certified/cwca/cwca-how-to-prepare.
  15. American Board of Wound Management (CWSP) Exam. http://www.abwmcertified.org/abwm-certified/cwsp/cwsp-how-to-prepare.
  16. American Board of Wound Management Foundation CWCA, CWS, CWSP practice exams (registration fee is required): http://www.abwmfoundation.org/practice-exams/.
  17. Certified Wound and Ostomy Care Nurse (CWOCN) Exam. https://www.wocncb.org/certification/wound-ostomy-continence/eligibility. http://www.wocncb.org/certification/foot-care-certification/eligibility. https://www.wocncb.org/certification/advance-practice-certification/eligibility.
  18. WOCNCB Examination Handbook. http://www.wocncb.org/pdf/WOCNCB_handbook.pdf.
  19. Council for Medical Education & Testing (CMET) Physicians Wound Care Certification Exam: https://www.councilmet.org/index.php/exam-overview.html.
  20. National Alliance of Wound Care and Ostomy (NAWCO) Wound Care Certified (WCC) Exam: http://www.nawccb.org/wound-care-certification.

V. Hyperbaric resources

  1. Kindwall EP, Whelan HT. Hyperbaric Medicine Practice. 3rd ed. North Palm Beach: Best Publishing Company; 2008.
  2. Kindwall EP, Niezgoda JA. Hyperbaric Medicine Procedure: The Kindwall HBO Handbook. 9th ed. Aurora Health Care; 2006. American College of Hyperbaric Medicine (www.ACHM.org).
  3. Larson-Lohr V, Norvell H, Josefsen L, Wilcox J, editors. Hyperbaric Nursing and Wound Care. North Palm Beach: Best Publishing Company; 2011.
  4. Neuman TS, Thom SR. Physiology and Medicine of Hyperbaric Oxygen Therapy. Philadelphia: Saunders Elsevier; 2008.
  5. Sheffield DA, Sheffield RB. CHT and CHRN Certification Exam Review Course. 2nd ed. San Antonio: International ATMO; 2013.
  6. Workman WT, editor. Hyperbaric Facility Safety: A Practical Guide. North Palm Beach: Best Publishing Company; 2000.

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