Developing, Administering, and Scoring the Healthcare Ethics Consultant Certification Examination

Abstract

In November 2018, the practice of health care ethics consultation crossed a major threshold when 138 candidates took the inaugural Healthcare Ethics Consultant Certification Examination. This accomplishment, long in the making, has had and continues to have both advocates and critics. The Healthcare Ethics Consultant Certification Commission, a functionally autonomous body created and funded by the American Society for Bioethics and Humanities, was charged with overseeing creation of the certification process, developing the exam, and formulating certification standards and policies to assess candidates’ qualifications. In this essay, as members of the commission, we describe the process of developing, administering, and scoring the certification examination as well as the historical context and the outlook for certification. By detailing the decisions and actions of the commission, we aim to provide a transparent account of the commission's efforts to develop a psychometrically sound, reliable, and secure examination through a deliberative, fair, and data‐driven process.

The Healthcare Ethics Consultant-Certified Program: Fair, Feasible, and Defensible, But Neither Definitive Nor Finished

“…There is a relative paucity of evidence regarding any potential associations between HCECs' characteristics, such as the consultants' degree or number of degrees, or their volume of consultative experience, and the quality of their healthcare ethics consultations (Bliss et al, 2016;Magnus 2015). In order to better understand actual practice, in 2016-2017 the American Society for Bioethics and Humanities (ASBH) conducted a HCEC workforce survey (Bruce et al 2019). The survey found that the majority of respondents had bachelor's, but not higher, degrees.…”

“…HCECs subsequently rated the domains in terms of importance and frequency of occurrence. The number of questions addressing a specific domain are in proportion to that domain's combined importance and frequency (Bruce et al 2019).…”

“…Individual questions were written and underwent review and validation by multiple subject matter experts. The testing company performed a psychometric review of all questions regarding "best practices" for standardized test questions, such as assuring that incorrect answers were similar in length, complexity, vocabulary, and grammatical construction compared to correct answers (Bruce et al 2019).…”

“…Content experts reviewed poorly performing questions (questions that people who otherwise answered most questions correctly answered incorrectly). The content experts decided whether to maintain the question unaltered (because there is a clear correct answer), discard the question (because the question is ambiguous), or (if two answers are, in retrospect, deemed correct) add an additional correct answer (Bruce et al 2019). The Commission has heard complaints regarding questions posed in a particular "what would you do first" format (Horner et al 2020).…”

What Factors Contribute to Moral Problems in Patient Care? A Scoping Review and Case Series of Ethics Consultations at a Somatic and a Psychiatric University Hospital in Switzerland

“…CEC is also increasingly implemented in hospitals in European countries such as Germany, the UK and Switzerland (2)(3)(4). To increase prevalence and quality of CEC, recommendations by medical associations (5,6), professional standards (7)(8)(9), training guides and courses (10)(11)(12), certi cation and accreditation programmes (13)(14)(15)(16)) and tools to evaluate CEC (17)(18)(19)) have been developed. There is also now some A total of 664 records were found in the search, 541 without duplicates.…”