Report from the Front Lines
by Cheryl L. Wild, Ph.D., CQA.

Have you heard the buzz about validity? If you haven’t yet, you will. It is the single most important testing concept in certification. The Certification Commission for Healthcare Interpreters (CCHI) has the goal of developing "a national, valid, credible, vendor-neutral certification program for healthcare interpreters." CCHI is doing an outstanding job of creating validity. As a consultant in the certification industry I have seen many certification start ups, but few have focused so effectively on validity and the stakeholders.

Before I explain why I snuck the word stakeholders into the discussion, let me define validity. Validity means your certification test measures what it intends to measure. Validity encompasses the idea of test use as well, i.e. the decisions made based on the test scores need to be consistent with the intended purpose of the test. For example, the Medical College Admission Test (MCAT) is a valid and reliable test for admission to medical college – but it is not valid for admission to private high schools.

How can we assure that the certification program for healthcare interpreters that CCHI is developing is valid?

1. Follow the national standards for developing and maintaining a certification examination.
2. Appropriately involve healthcare interpreters, managers/supervisors of health care interpreters, other medical professionals and consumer representatives (these are the stakeholders) in the development and communication about the certification program.

Most testing experts talk about the "psychometric" steps necessary to develop a test. (I do too – I’ve spent too much time in the field to be able to restrain myself.)

The process that CCHI used to develop the healthcare interpreter certification test is designed specifically to ensure validity. These steps (develop test specifications based on a job task analysis, develop a test using subject matter experts, set cut scores using subject matter experts, evaluate the test using item and test analysis, etc.) are the minimum requirements for a developing a valid test and are included in the NCCA Standards for Certification Programs. The minimum effort to meet these standards isn’t enough to have an excellent certification program.

The secret of developing an excellent certification program, one that is valid and recognized as such by the profession is the active involvement and buy-in to the certification program by the stakeholders – medical interpreters, their supervisors, the hospitals and doctors who employ them, and even accrediting agencies.

To ensure validity a certification body needs to ensure that the development of a certification program involves a wide range of the certification stakeholders and that certification stakeholders contribute to the development of the examinations and the decisions about its use.

Clarence Chaffee discussed defining the profession without bias in the November article on "Cultivating Certification." He said, "As much as we would like to think otherwise, people come with biases, personal motives and prejudices all of which are born out of our individual experiences. … you have to create a process that reduces the impact of individual biases . . You do so by specifically involving representatives from the breadth of the profession and by including as many independent voices as possible."

In order to have the active involvement of a wide range of professionals, the certification body needs to be very deliberate in their efforts to involve the profession. CCHI is actively involved in such efforts – the most recent evidence of this is their job/task analysis survey.

The exciting news is that the first step in the development of a valid certification examination for healthcare interpreters – completion of the job/task analysis survey – was a resounding success. CCHI went well beyond the minimal requirements in conducting this survey. Nearly 2,500 of your colleagues participated in the survey. (In my experience few organizations have as large a sample in their job/task analysis.)

What are the implications of this participation? Close to 2,500 professionals will have contributed to defining the content of the healthcare interpreters certification test!  The results of the survey formed the foundation for the test blueprint, or the content outline of the test.  From the blueprint, test items were written, test forms were created and pilot tested, and CCHI's exams will launch nationally in January 2011.

Of course, the job analysis survey is not the only way that CCHI is encouraging involvement in the development of stakeholders in this certification program. One of the first steps to involve stakeholders was to create a web site (www.healthcareinterpretercertification.org) and invite interested parties to sign up for monthly updates.

We hope that you will return to this website to keep updated on our progress and send us any comments and/or suggestions. Thank you for your participation.