1. Manager of Exam Administration, NCCPA
NCCPA and
Physician Assistant Certification
One technique that some of our presenters use to get the audience involved early is to “poll the audience.” Ask for a show of hands, i.e., how many are 1st year students? 2nd year students? Has anyone already registered for PANCE? This may provide you an idea of where you may need to spend more/less time as well as anticipate questions.
Jenny Walker, MEd
Manager of Exam Administration, NCCPA

2. Presentation Outline A Brief Overview of NCCPA
Initial Certification and PANCE
Your NCCPA Dashboard
Overview of the Certification Maintenance Process
When Things Go Wrong
Tips for Maintaining your Certification
Resources
Q&A

3. A Brief Overview of NCCPA

4. Celebrating 40 years of certifying PAs!
About NCCPA
NCCPA is the only national certifying body for PAs
We are an independent, not-for-profit organization
NCCPA has been certifying PAs since 1975.
NCCPA is the only national certifying body for physician assistants.
It was founded in 1975, largely thanks to the efforts of the American Medical Association and the National Board of Medical Examiners. From the beginning, NCCPA was governed by a Board made up primarily of appointees from other established medical organizations, which certainly helped the profession and its credential gain such a strong foothold so quickly.
Independent, not-for-profit organization
Headquartered near Atlanta, Georgia
Staff of approximately 50
Celebrating 40 years of certifying PAs!

5. Our Purpose
To provide certification programs that reflect standards for clinical knowledge, clinical reasoning and other medical skills and professional behaviors required upon entry into practice and throughout the careers of physician assistants

6. NCCPA is dedicated to serving the interest of the public.
Our Passion
NCCPA is dedicated to serving the interest of the public.
We so do with a passionate belief that certified PAs are essential members of the health care delivery team who provide millions access to more affordable, high quality health care.

7. Our Board of Directors
The Board includes 10 PAs, 7 physicians and 2 public members, including nominees from...
American Medical Association
American Osteopathic Association
Association of American Medical Colleges
Federation of State Medical Boards
PA Education Association
US Department of Veterans Affairs
American Academies of:
Family Physicians
Pediatrics
Physician Assistants
American Colleges of:
Emergency Physicians
Physicians

8. About Certified PAs 102,848 currently certified PAs
Approximately 7,435 new PAs certified last year
PAs are a young profession; 52% are under the age of 40*
*Based on NCCPA PA Profile data as of February 2015.

9. Initial Certification and PANCE

10. Initial Certification
There are currently:
196 ARC-PA accredited entry level programs
8 ARC-PA accredited clinical postgraduate programs
55 additional “potential” programs may be added by 2018

11. Initial Certification
Graduation from a PA program accredited by ARC-PA (Accreditation Review Commission on Education for the Physician Assistant)
Students must graduate or complete program requirements before taking the exam
Passing Score on the Physician Assistant National Certifying Exam (PANCE)
Students can be certified within 4 weeks of graduation or less in most cases
All students graduating from an accredited PA program must pass the NCCPA’s Physician Assistant National Certifying Exam (PANCE) before they obtain their permanent state license.
All state medical licensing boards require initial certification in order to obtain a license.

12. Examination Content Blueprint
Two dimensions:
Organ systems and the diseases, disorders and medical assessments PAs encounter within those systems
The knowledge and skills PAs should exhibit when confronted with those diseases, disorders and assessments
Highest percentage of content down to lowest

13. Distribution (%) of Content by System

14. Distribution (%) of Content by Knowledge & Skill (Task) Areas
Preparing for PANCE
Randy D. Danielsen, PhD, PA-C, DFAAPA
Distribution (%) of Content by Knowledge & Skill (Task) Areas
2009 AAPA Annual Conference San Diego, California

15. PANCE – What’s It Like?
Computer-based exam administered at Pearson VUE
200+ testing centers (
300 multiple-choice questions that assess general
medical and surgical knowledge
Five-hour exam
15 minute tutorial at beginning of exam
5 blocks of 60 questions, 60 minutes each
45 minutes of break time for the entire day

16. Applying for PANCE
You can apply as soon as your program has entered your expected graduation date but no sooner than 90 days prior to your expected graduation date.
Then hours after you apply, you will receive an Exam Acknowledgement from us.
180-day exam window (starting no earlier than 7 days after your graduation date)
Details about how to schedule your exam
If you need testing accommodations, make sure you indicate that when you apply for the exam.
Cost: $475
Please note that if you wait until after you graduate to apply for your exam, you must wait one full week after your confirmed graduation date to do so.

17. Register at www.nccpa.net
This is the page that students will use to “Register” or log on to their Dashboard for the very first time.
If they have never logged in to our site, they must click on the “First Time? Register” link to set up their user name, password and security questions.

18. First Time Sign In
This is the first page that students will see after they click on “Register”.
By completing this First Time Sign In page, they will be ed a link to set up their username and password.

19. PANCE Application
This is what the Dashboard looks like and where students will go to apply for PANCE for the first time.

20. PANCE Application YOUR ADDRESS
YOUR NAME SHOULD READ AS IT APPEARS ON PRIMARY ID
YOUR ADDRESS
Please make sure that you update your name to read exactly as it does on your Primary and Secondary Forms of Identification that you will be using for entrance into the PANCE.
YOUR ADDRESS
XXX-XXX-XXXX
XXX-XXX-XXXX

21. Identification Information
Primary ID: The primary ID must be a valid (not expired) original document (not a photocopy or fax) and contain a permanently affixed photo of you, your pre-printed name and your signature.
Acceptable examples (as long as they meet the above criteria) are:
Driver's license
Passport
Military ID
Student ID
Naturalization papers
International Driver's License issued by government
Employee ID
State issued ID
Important things to remember about identification:
Make sure that all identification is signed BEFORE arriving at the test center
Make sure ID has not expired – even by 1 day!
More than one difference in a name is not acceptable
The most common difference of a middle name or initial on one and not on the other; or a middle initial on one and a middle name on the other ARE ACCEPTABLE differences

22. Become Certified > About PANCE > Name Changes
Identification Information
Secondary ID: The secondary ID must be a valid (not expired) original document (not a photocopy or fax) and contain the examinee's pre-printed name and their signature.
Acceptable examples (as long as they meet the above criteria) are:
Driver's license
Military ID
Student ID
Employee ID
Credit card
Social Security card
For more information about acceptable ID and name differences, visit and navigate to:
Become Certified > About PANCE > Name Changes

23. PANCE Application
Continue through the application process. As you navigate through the application, you will be asked to do the following:
make any necessary changes to your name one last time
Answer background questions
Request special testing accommodations if needed
Review and accept our PANCE Exam policies ( you MUST scroll through all policies and check that you’ve read and understand them)
Payment page
Exam Application Confirmation page which gives you one last opportunity to preview your PANCE application

24. PANCE Application This is your PANCE Confirmation Page –
the FINAL step in the application process!
Date Applied
This is last part of the application!
Within 24 to 48 hours of completion of application, students will receive their exam acknowledgment (next slide)

25. I AM FULL OF IMPORTANT INFO!
Exam Acknowledgement
Exam Acknowledgement with hyperlinks to Pearson VUE to schedule your exam
PLEASE READ ME!!
I AM FULL OF IMPORTANT INFO!

26. Test Day Tips
Read ALL correspondence for detailed instructions about what to expect on exam day.
Arrive 30 minutes early.
Two forms of valid ID required
If you don’t have the appropriate ID, you won’t be able to test!
If something goes wrong, call NCCPA before you leave the test center! (678)
Pearson VUE will take a photo and a palm vein scan.
View a short video about what to expect on test day at 26

27. Test Day Tips
You won’t be allowed to bring any personal items into the testing room.
Lockers will be provided to store your personal items. 27

28. Test Day Tips
Answer every question. Your score is based on the number of questions you answer correctly; points aren’t deducted for incorrect answers.
You may answer the questions within a block in any order, and you may review and change responses within a block of questions during the time allotted for that section.
Mark those that you’re not sure about, and review them if you have time at the end of the block. The computer assists in review of skipped and marked items.
After you exit a block of test questions or after time expires for that block, you won’t be allowed to review its questions or change your answers.

29. Test Day Tips
Take breaks between exam blocks (scheduled breaks). Keep in mind your total break time is limited to 45 minutes.
Unscheduled breaks do not stop the clock.
Taking long or frequent breaks early may leave you with no break time— even between blocks—later in the day.
Each time you leave, you will be required to sign out and sign back in upon return.
You’ll have LIMITED break time during the day to be used between blocks and for a short lunch break, if you choose. It’s up to you to manage your break time. Taking long or frequent breaks early in the day may leave you with little or no break time later in the day. There is a total of 45 minutes of break time for the entire day. 29

30. After the Exam Do not discuss the test with others.
Sharing exam questions or even general subject matter with others constitutes “irregular behavior” and is considered cheating. It’s just not worth it!
If you had any problems at the testing center, document the situation in writing and contact NCCPA within 3 business days of your exam.
More specifics on Irregular Behavior
NCCPA defines “irregular behavior” as any behavior that undermines or threatens the integrity of the application, assessment or certification processes of NCCPA, whether it occurs before, during or after an exam.
Irregular behavior may include, but is not limited to:
having or seeking access to exam materials before the exam,
impersonating an examinee or engaging someone else to take the exam by proxy,
copying answers from someone else or allowing one's answers to be copied,
making notes during a computer-based exam administration, copying or memorizing and reproducing test items,
altering or misrepresenting scores,
stealing exam materials,
possessing unauthorized materials during a computer-based exam (e.g., recording devices, photographic materials, reference material, etc.)
or other such behavior which may cast doubt on the exam results of that or another person.
It may also include making false representations during the application process or in connection with certification status, altering or falsifying NCCPA certificates or other documents, or making the false representation that one is certified by NCCPA by using the legally-protected marks, PA-C® or Physician Assistant-Certified®.
Anyone who has information or evidence that irregular behavior has occurred should submit a written, signed statement to NCCPA detailing the incident with copies of any supporting evidence or documentation.
If NCCPA determines that allegations of irregular behavior are true, the organization may impose sanctions against the offending individual, which may include
temporary or permanent loss of eligibility for exams or certification,
revocation of an existing certificate,
suspension of certification,
invalidation of scores,
or other sanctions as deemed appropriate.
Such sanctions may include legal action against the offending individual.

31. After the Exam
Did something interfere with your exam or go wrong at the test center?
Report any incident to Pearson VUE staff before leaving.
Submit information to:
Must be submitted within 3 business days
Pearson VUE will give you an incident report number.
No grievance based on your score or on exam content 31

32. Exam Grievance
To read more about filing an exam grievance, go to the following link:

33. After the Exam NCCPA provides score reports online.
When your results are ready (about two weeks after your test date), you will receive instructions for accessing your score report on your Dashboard.
To ensure immediate access, be sure NCCPA has your current address by signing in to your Dashboard and updating your personal information. 33

34. After the Exam
Passing rate for first-time takers: around 94.7%; overall about 87%
If you don’t get that good news after your first attempt, keep in mind two key policies:
You may attempt PANCE up to six times within six years of your program completion.
You are limited to taking PANCE one time in any 90-day period or up to three times in a calendar year, whichever is fewer. 34

35. Preparing for PANCE
Randy D. Danielsen, PhD, PA-C, DFAAPA
Scoring PANCE
Exams are scored in two different systems to ensure accuracy.
Periodically, the passing standard is evaluated.
Standard setting committee includes certified PAs and physicians who have experience working with PAs.
They review questions from the exam and develop a recommended passing standard.
NCCPA Board of Directors makes the final decision.
2009 AAPA Annual Conference San Diego, California

36. X Scoring PANCE PANCE is a criterion-referenced examination.
Preparing for PANCE
Randy D. Danielsen, PhD, PA-C, DFAAPA
Scoring PANCE
PANCE is a criterion-referenced examination. X
2009 AAPA Annual Conference San Diego, California

37. Scoring PANCE Scores are based on the number of correct responses.
Preparing for PANCE
Randy D. Danielsen, PhD, PA-C, DFAAPA
Scoring PANCE
Scores are based on the number of correct responses.
PANCE passing standards are not normative (not scored on a curve).
If 100% of the candidates meet the specified passing criteria, then 100% will pass the examination.
2009 AAPA Annual Conference San Diego, California

38. Your NCCPA Dashboard

39. Date you submitted payment
Dashboard
Date you applied
Please note that the Dashboard will be the page where all things that pertain to you and NCCPA can be found. Please keep your Log in information in a place where you can easily access it!
This will be what your Dashboard looks like when you log back in after you’ve submitted your PANCE application.
Date you submitted payment

40. Dashboard – Professional Profile
Talk to students about the profile and the importance of taking the time to complete it.
Start by clicking on the blue “About Me” link.

41. Dashboard - Payments
Click here to view PDFs of receipts for payments that you have made to NCCPA.
This tab will allow you to make any outstanding payments and view PDFs of all receipts for payments that you have made to NCCPA

42. Dashboard – Exams/Open Applications
Date you applied
The Exam tab is where you will apply for future exams or check to see the status of an exam application.
You will also come here to view your PANCE scores once you have received the letting you know that they have been processed.

43. Dashboard – Exams/View Results
Click here to view PDFs of exam performance reports.
Date that you tested
Date you tested
Pass or
Fail
You will come to this page to view your exam results, Score Report, Performance Interpretation Guidelines, Next Steps

44. About Practice Exams $35 online Practice Exams
120 questions taken from the test item banks
General performance feedback helps inform your exam preparation.
Register online the same way you do for a certification exam.
Register online for a $35 Practice Exam.
The reason for developing the exam is two-fold: 1) To answer the request of PAs for such an assessment tool and 2) To ease concern and apprehension about the exam, which we anticipate will enhance exam security.
The Practice Exam will include 120 multiple choice questions delivered online in two 60-question blocks. PAs will have 60 minutes to complete each block to simulate the time-pressure associated with an exam.
After PA’s register, the Practice Exam will be available in their dashboard for 180 days.
While the Exam won’t provide right or wrong answers to the individual questions, it will provide a report based on the examination content blueprint that shows how you performed in those areas.

45. Format of Practice Exam Feedback
Sample of Performance Feedback.
Let students know that they are the red star. Ideally they want their performance in each of the content areas to fall to the right of the black bar.

46. Dashboard – Practice Exams/Order/Launch
This is where you can come to order practice exams for $35 each.

47. Dashboard – Practice Exams/Exam Results
This is where you can view performance feedback reports for all practice exams that have been taken.
Date ordered
Date Completed
PDF of Practice Exam Feedback
Date ordered
Date Completed

48. Dashboard – Credentialing Info Release
Click here to view Previous Requests
Once students pass their PANCE, they are able to request that their scores are released to any third party (i.e. State Licensing Boards, Employers, etc..) by logging on to the Dashboard and clicking on the Credentialing Info Release Tab.
PAs are also able to view any previous requests that may have been submitted should they ever need to by clicking on the “Previous Requests” tab at the top of the page.

49. Dashboard – My Account/Personal Info.
Your Name
Your Current Address
Your most current address
The “My Account” tab of your Dashboard gives you access to the following:
Make updates to all of your personal information
View any correspondence that has been sent to your address on file
View all Acknowledgements that you have made
View all Policies and Procedures to which you have read and agreed
View any documents that you may have uploaded to your Dashboard
It is extremely important to keep NCCPA informed of updated info., especially address because that is they way that we communicate EVERYTHING!
Home Telephone Number
Cell Phone Number

50. Dashboard – My Account/Correspondence
This is where you can view ALL correspondence that you receive from NCCPA. This comes in handy when you have deleted something from us in your – you can always look here to find a record of that .

51. Dashboard – My Account/Acknowledgements
Date Acknowledged
You will be able to view all acknowledgements that you have made.
These most often occur when you log in to our website and we have important information to convey. We ask you to read and acknowledge that you have read the information.

52. Dashboard – My Account/Agreed-to-Policies
View uploaded documents here
Date You Agreed to Policy
Your Name
Date You Agreed to Policy
Your Name
Under the “Agreed to Policies” tab, you can find a PDF of all of NCCPA’s Policies & Procedures to which you have agreed as well as the date that you agreed to the policy.
Date You Agreed to Policy
Your Name
Date You Agreed to Policy

53. Overview of the Certification Maintenance Process

54. Certification Maintenance Process
Continuing Medical Education (CME)
100 credits every 2 years
at least 50 Category 1
at least 20 self-assessment and/or performance improvement CME credits
$130 certification maintenance fee due December 31 of expiration year
Pass the Physician Assistant National Recertifying Examination (PANRE) every 10 years
IF ASKED: PANRE fee is $350

55. Another Look at CME Requirement
100-Credit CME Requirement (every 2 years)
Category 1 (50 credits)
Category 1 or 2 (50 credits)
This slide shows how the directed CME looks during cycles 1 – 4 (years 1 – 8). Basically, we have defined a system that directs specific Category I requirements for SA and PI.
* Choice Concept:
PA must fulfill either a Self Assessment (SA) or Performance Improvement (PI) requirement during each of their first four cycles (years 1 – 8) as long as a total of at least 40 SA and at least 40 PI requirements are fulfilled during the first four cycles.
During each of the first four cycles, you must complete at least 20 directed Category I CME credits through SA or PI activities, and these credits can be used toward the 50 Category I credits required each cycle.
PI projects completed outside of a PI CME activity – more implementation details to follow on this approach
20 Category 1 credits directed towards self-assessment or performance improvement CME

56. More on Self-Assessment (SA)
Self-assessment is the process of conducting a systematic review of one’s own performance, knowledge base or skill set, usually for the purpose of improving future performance, expanding knowledge or honing skills.
Self-assessment activities often involve a learning experience.
Examples…

57. AAPA’s Learning Central

58. Self-Assessment Activities
Currently:
165+ self-assessment CME activities in many different specialty areas
$0 to $400 depending on the sponsor and the number of credits offered

59. More on Performance Improvement (PI) CME
PI-CME is active learning and the application of learning to improve your practice.
Can be done in partnership with your supervising physician and others in practice
Everyone can work on and get credit for PI-CME together
Three-step process:
Compare some aspect of practice to national benchmarks, performance guidelines or other established evidence-based metric or standard.
Based on the comparison, develop and implement a plan for improvement in that area.
Evaluate the impact of the improvement effort by comparing the results of the original comparison with the new results or outcomes.
PI-CME is active learning and the application of learning to improve your practice. This can be done in partnership with your supervising physician and others in your practice; everyone can work on and get credit for PI-CME together. PI-CME involves a three-step process:
•  Compare some aspect of practice to national benchmarks, performance guidelines or other established evidence-based metric or standard.
•  Based on the comparison, develop and implement a plan for improvement in that area.
•  Evaluate the impact of the improvement effort by comparing the results of the original comparison with the new results or outcomes.

60. PI-CME Activities Currently:
Over 45 approved PI-CME activities in many different specialty areas
Prices range from $0 to $400 depending on the sponsor and the number of credits offered

61. Certification Maintenance Illustrated
1st CME Cycle
2nd CME Cycle
3rd CME Cycle
4th CME Cycle
5th CME Cycle
During each cycle, earn CME credits including 50 Category 1 credits with 20 earned through self-assessment or PI-CME activities.
By the end of your 4th CME cycle, you must have earned at least 40 Category I CME credits through SA activities and at least 40 Category 1 CME credits through PI activities.
Earn 100 CME credits (including 50 Category 1) and pass PANRE
Choice Concept:
PA must fulfill either a Self Assessment (SA) or Performance Improvement (PI) requirement during each of their first four cycles (years 1 – 8) as long as a total of at least 40 SA and at least 40 PI requirements are fulfilled during the first four cycles.
During each of the first four cycles, you must complete at least 20 directed Category I CME credits through SA or PI activities.
AAPA has committed to providing solutions for PAs to fulfill the SA and PI requirements
More implementation discussions will be had on PAs that chose to complete a PI project on their own without going through an organized PI CME activity.

62. When Things Go Wrong

63. The Appeals Process
Were you unable to meet CME requirements or take an exam due to unusual or severe extenuating circumstances?
Are you a military PA on active duty in a combat zone?
Requests for exceptions to policy and exam grievances are reviewed by staff.
Adverse staff decisions may be appealed to the Review Committee.

64. Exception to Policy http://www.nccpa.net/Legal#ExceptionstoPolicy
To read more about filing an exception to policy, go to the following link:

65. Code of Conduct of Certified and Certifying PAs
Focuses on the ethics and professionalism expected from all PAs holding or seeking NCCPA certification
Two sections focus on the responsibility of certified PAs to uphold the integrity of the
Certification and recertification processes
Laws, regulations and standards governing PA practice
Developed as a way to clearly communicate expectations to regulators, employers and patients the standards that almost all certified PAs are already upholding
The Code of Conduct for Certified and Certifying PAs was developed as a way to clearly and proactively communicate the standards of ethics and professionalism NCCPA expects of certified PAs. In addition, the document makes clear what regulators, employers and patients should expect from certified and certifying PAs.
Although not an exhaustive list, PAs in violation of the standards in the Code of Conduct may be subject to disciplinary action based on NCCPA’s disciplinary policy (next slide).

66. NCCPA Disciplinary Policy
Specifies consequences for irregular behavior and falsely representing oneself as certified
Provides for the denial or revocation of certification based on
Loss of licensure due to documented gross incompetence or unethical conduct
Conviction of or pleading no contest to a felony
Court decision that finds a PA mentally incompetent
Irregular behavior includes a variety of actions before, during and after an exam—including leaving an exam and sharing the questions you can remember with others who haven’t taken the test yet.

67. Disciplinary Case Origination
Self-reports from PAs during certification maintenance process; must answer every two years
Adverse licensure actions
Misdemeanors and felonies
Adjudication of mental incompetence
Reports on state board actions provided by the FSMB
Individual state medical boards and/or federal entity reports
Individual complaints

68. Potential Disciplinary Actions
Issue a Letter of Concern
Issue a Letter of Censure
Revocation
of Certification
of Eligibility
Non-reportable Action:
Issue a Letter of Concern – communiqué between NCCPA and the PA
Reportable Actions (reported to interested parties - licensing boards, federal entities, etc.)
Issue a Letter of Censure
Revocation of Certification
Revocation of Eligibility
Take No Action
Other – additional CME, ethics course, fines, etc.

69. Tips for Maintaining Your
Certification

70. Tips for Maintaining Your Certification
Go to NCCPA web site to update any postal or address changes
Read all NCCPA correspondence
Log CME as you earn it
Save your Category 1 CME documentation
Take personal responsibility for your certification, i.e. don’t delegate
Get definitive information about your certification only from the source
If we can’t find you, we can’t remind you about upcoming deadlines or changes in certification maintenance requirements. This item is especially important for you, as students, because many of you will be moving after graduation – make sure you update your address with us. You can make the change online by signing in to your personal certification record at
Your personal certification record tells you everything we know about you. It lets you know when the next step must be completed and allows you to track your certification requirements.
Maintaining your certification is a two-part process. Log CME and pay fees every two years and take a recertification exam every six years.
NCCPA doesn’t send junk. If you receive something from us in the mail, assume it applies to you. If you think it doesn’t, call us. Don’t just ignore it.
You never know what might come up later – where certification is concerned, the sooner you can complete a requirement the better.

71. Tips for Maintaining Your Certification
Log CME as you earn it.
There’s an
app for that!
(Android version coming later this year.)

72. Resources

73. NCCPA Resources Website: www.nccpa.net E-mail: nccpa@nccpa.net
online access to your certification Dashboard
exam application, CME logging, exam results, address changes
Videos and more on how to obtain and maintain certification
Or call: (678)

74. Licensure Resources
Use Credentialing Information Release link from your NCCPA dashboard to request your scores be sent to a particular state board or another third party.
Visit AAPA’s Web site ( for state-by-state information about licensure requirements.

75. Questions?