Fourth Quarter 2014
V. 40 / N. 4
HORIZONS CREDENTIALING FOR THE RESPIRATORY CARE PROFESSION
Reminder of Upcoming Examination Changes 3
METHODS AND RESULTS FROM THE JOB ANALYSIS OF PULMONARY FUNCTION TECHNOLOGISTS Robert C. Shaw, Jr., PhD, Asst. Executive Director and Psychometrician for NBRC Programs
INTRODUCTION 23rd Annual State Licensure Liaison Group Meeting Held in Kansas City 4 30, Ja 1–Sept pt Jan 2013 Jan 1–Se 30, 2012
ation
n 1–Sept 2014
30,
76.0 %
min 70.0 % ates : 13.2 % Gradu 67.1% Level 16.3 % Entry s didate 16.2 % an C New s 83.3 % didate t Can : 82.4% Repea duates 27.1% vel Gra 82.3 % ced Le .0 % 27 an dv A tes 27.8 % andida New C s te 69.9 % dida t Can 70.0 % Repea ion 35.2 % xaminat E 67.9 % en % tt .3 34 R R T Wri didates 33.3 % an C ew N s 63.9 % didate t Can 64.0 % Repea 50.1% ation 64.5% E xamin s 50.6 % SE C T R R didate 52.4% an C s New 77.1% didate t Can 68.8 % Repea 47.8 % 74.3 % ination % m .1 xa 57 E T CPF tes 32.3 % andida New C s te 61.8 % dida t Can 54.5% Repea 52.0 % ion .5% at 86 in m % .0 50 R PF T E xa didates 33.3 % an C ew N s 68.8 % didate ination % t Can lt y E xam 72.7 Repea ic Specia 67.6% 46.6 % /Pediatr .6 % al 48 at n Neo tes 43.5% andida New C s te n 94.4% dida inatio t Can 87.9 % Repea lt y E xam % 57.1% rs Specia 87.2 de % or .0 is D 75 Sleep tes 25.0 % andida New C s 84.2 % didate ination .1% t Can lt y E xam 88 Repea re Specia 47.6 % 83.7% itical Ca s 51.9 % Adult Cr te andida New C s te da di t Can Repea
CR T E xa
Examination Statistics Through the Third Quarter of 2014 6
Annual Renewal Annoucement 7
N /A
Executive Office Holiday Hours
7
A job analysis study of pulmonary function technologists was conducted in 2013. Compared to studies of the past, this study was affected by the decision that the board of trustees had made about assessing candidates for the CPFT and RPFT credentials over the same body of content. In the past, a pair of studies had been done to support the content of separate examinations that were developed for each credential. Going forward, achieving the CPFT or RPFT credential will be respectively differentiated by earning a score high enough to equal a low cut score or a high cut score. The plan is to begin the new examination on June 17, 2015.
METHODS A task inventory approach was applied for this study. A list of 275 task statements was developed by an 8-person advisory committee. Each task described the behavior of a technologist. The advisory committee organized the task list around three major domains each of which was divided into three minor
domains, which yielded a total of nine content domains. Respondents were asked to assess the importance of each task that was performed within their facilities by a general pulmonary function technologist without differentiating whether the technologist had the responsibilities of an entry level or an advanced level person. This was a new method compared to past studies when task ratings were separately collected in the context of entry level and advanced level personnel. A scale gave each respondent four points to indicate how important he or she perceived each task to be plus a zero point to indicate when a task was not among the responsibilities of a technologist. Respondents were identified by soliciting the entire population (n=6,561) of credentialed pulmonary function technologists from the NBRC database who had an email address. The American Association for Respiratory Care membership organization supported the study by blasting emails that contained survey access information to the populations of its members who belonged to
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HORIZONS
Fourth Quarter 2014
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CLINICAL SIMULATION… º CONTINUED FROM PAGE 1 the (1) Diagnostics specialty section (n=895) and the (2) Management specialty section (n=1,762). In total, 9,218 contacts were attempted. However, we knew that some people existed in more than one of the three groups and we knew that there would be some inactive email addresses. The survey was opened for responses on July 9, 2013. A reminder message was sent on July 30, 2013. Access to the survey was closed on August 12, 2013. Tasks from the inventory could be excluded based on (1) extent-in-practice results from those who selected the zero point on the rating scale, (2) average importance results based on rating scale responses of 1, 2, 3, or 4 from the whole sample, and (3) average importance results after subgroups had been formed from responses to background information items within the survey. A total of 14 sets of subgroup task analyses were used to mitigate any potential overrepresentation or underrepresentation of subgroups within the population. The mitigation method involved giving each group an equal opportunity to exclude a task regardless of subgroup size.
A plot of sample sizes and expected error in observations indicated that additional respondents would not have produced a practical reduction in error within observed results. Coefficient alpha values as indicators of consistency within each major domain were no lower than .948. Intraclass correlation values as indicators of the likelihood of observing the same data from other samples from the population were no lower than .998. Most (95.5%) of respondents found no gaps in the content expressed by the task list when asked to assess the adequacy of the list. Advisory committee members’ comparisons of observed demographic characteristics of the sample to what they knew about the population of technologists revealed no surprises, which would have suggested that the sample was different in important ways from the population. As described in the Methods section, the advisory committee used 14 sets of subgroup task analyses to mitigate against being misled by the results from the whole sample in case any subgroups had been disproportionately represented in the sample as compared to the population. After 62 tasks were excluded from examination content based on observed extent-in-practice results, no additional tasks were excluded by the remaining exclusion rules.
RESULTS Just more than 1,000 email addresses proved invalid and just less than 100 people opted out of study. There were 1,224 sets of valid survey responses received.
CONTINUED ON PAGE 3 » Published Quarterly by the NATIONAL BOARD FOR RESPIRATORY CARE, INC. 18000 W. 105th St. Olathe, Kansas 66061-7543 (913) 895-4900 Fax: (913) 895-4650 Email: nbrc-info@nbrc.org Website: www.nbrc.org NBRC Horizons is published quarterly to communicate information about the admission policies and procedures, the day-to-day activities, and the short-term and long-range plans of the National Board for Respiratory Care, the national certifying board for the respiratory care profession. The NBRC is sponsored by the American Association for Respiratory Care, the American Society of Anesthesiologists, the American Thoracic Society and the American College of Chest Physicians. Subscriptions to NBRC Horizons are free for active credentialed practitioners and $24 for inactive practitioners and others. Subscription forms can be obtained by contacting the NBRC Executive Office.
MEMBERS OF THE BOARD Doreen J. Addrizzo-Harris, MD, FCCP (ATS) Sherry L. Barnhart, RRT, RRT-NPS, FAARC (AARC) Todd G. Bocklage, MPA, RRT (AARC) Suzanne Bollig, RRT, RRT-SDS, RPSGT, R. EEG T., FAARC (AARC) William W. Burgin, Jr., MD, FCCP (ATS) Brian W. Carlin, MD, FCCP, FAARC (ACCP) Robin J. Elwood, MD, FAAP (ASA) Katherine L. Fedor, RRT, RRT-NPS, CPFT (AARC) Hyacinth M. Johnson, RN, BSN, MPA, RRT (AARC) David A. Kaminsky, MD, FCCP (ACCP) Carl A. Kaplan, MD, FCCP (ACCP) David C. Levin, MD, FCCP (ATS) Robert A. May, MD, FCCP (ACCP) Omid G. Moayed, MD, MBA (ASA) Carl D. Mottram, BA, RRT, RPFT, FAARC (AARC) Theodora K. Nicholau, MD, PhD (ASA) Donald S. Prough, MD, FCCP (ASA) Gregg L. Ruppel, MEd, RRT, RPFT, FAARC (AARC) Robert A. Sinkin, MD, MPH, FAAP (ATS) Mark S. Siobal, BS, RRT, FAARC (AARC) David L. Vines, MHS, RRT, FAARC (AARC) Teresa A. Volsko, MHHS, RRT, FAARC (AARC)
Copyright © 2014. The National Board for Respiratory Care, Inc. Permission must be secured in writing to reprint any portion of this issue. State societies for respiratory care, respiratory care education programs and state licensure agencies may reprint any portion of this publication in their newsletter provided they mention the source. EXECUTIVE COMMITTEE Carl F. Haas, MLS, RRT, RRT-ACCS, CPFT, FAARC (AARC), President Alan L. Plummer, MD, FCCP, FAARC (ATS), Vice President Linda A. Napoli, MBA, RRT, RRT-NPS, RPFT (AARC), Secretary Robert A. Balk, MD, FCCP (ACCP), Treasurer Kerry E. George, MEd, RRT, RRT-ACCS, FAARC (AARC), Past President PUBLIC ADVISOR John R. Garrison, MPA MEMBERS-AT-LARGE Susan B. Blonshine, BS, RRT, RPFT, AE-C, FAARC (AARC) Robert L. Joyner, Jr., PhD, RRT, RRT-ACCS, FAARC (AARC) Stephen A. Stayer, MD (ASA)
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TRUSTEE EMERITUS H. F. Helmholz Jr., MD, FAARC Robert M. Lawrence, MD Theodore Oslick, MD, FCCP, FAARC CHAIRMAN OF NBRC PUBLIC RELATIONS AND PUBLICATIONS COMMITTEE Carl Mottram, BA, RRT, RPFT, FAARC (AARC) STAFF Gary A. Smith, RRT (Hon), FAARC, Chief Executive Officer and Executive Director Lori M. Tinkler, MBA, Chief Operating Officer and Associate Executive Director Chelsea Earhart, MBA, Assistant Executive Director Robert C. Shaw Jr., PhD, RRT, FAARC, Assistant Executive Director Homer Rodriguez, RRT, Director, International Affairs Ami Bishop, Administrative Support Specialist Scott M. Hermansen, CPA, Chief Financial Officer Glenda Hocker, Executive Assistant Nancy Sachen, Administrative Assistant
HORIZONS
Fourth Quarter 2014
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REMINDER OF UPCOMING EXAMINATION CHANGES As of January 2015, there will only be one multiple-choice examination called the Therapist MultipleChoice Examination (TMC). There will be two different cut scores. If a candidate achieves the lower cut score, they will earn the CRT credential. If a candidate achieves the higher cut score, they will earn the CRT credential AND become eligible for the Clinical Simulation Examination (provided that those eligibility requirements are met and the candidate is eligible to earn the RRT credential). Until that time, candidates wanting to earn the CRT and RRT credentials must take and pass the CRT Examination, Written Registry Examination, and Clinical Simulation Examination to earn both credentials. Candidates wanting to attempt the current CRT, Written Registry, and/or Clinical Simulation Examinations between the dates of November 1, 2014 and December 31, 2014, will need to complete the special application acknowledging that they will not receive a full 90-day eligibility window. The special application and all of the information regarding the upcoming changes are available on the NBRC website at www.nbrc.org. The application can be faxed to 913.895.4650 or mailed to 18000 W 105th St, Olathe, KS 66061. m
METHODS AND RESULTS… º CONTINUED FROM PAGE 2
SUMMARY
Therefore, examination content will be developed around 213 tasks. Specifications for the examination will involve 100 multiple-choice items, each of which presents four options to candidates. Items on each examination will be divided among 9 content domains and 3 levels of cognitive complexity. The decisions of the advisory committee about content domain weights were influenced by results from a survey item that had asked respondents to indicate their preferences, if the decision had been theirs to make. Decisions about cognitive level weights were based on a consensus among members of the advisory committee. After observing results of a survey item about the percentages of pediatric and adult cases who were tested in pulmonary function labs, the advisory committee decided to designate 90% of examination items for general or adult patients while 10% of the examination will involve pediatric patients. The endpoint of the decisions about examination content and specifications that were made by the advisory committee can be observed within the detailed content outline document, which can be viewed from the NBRC’s website (www.nbrc.org).
The NBRC conducted a job analysis study in 2013 to inform the content of, and the design specifications for, the pulmonary function examination. Examination results will be used to confer CPFT and RPFT credentials to candidates starting on June 17, 2015. The two credentials will be associated with a low cut score and a high cut score that will be compared to total scores from the examination. After starting with a list of 275 tasks, study methods directed the advisory committee to base examination content on 213 tasks that were observed to be critical. Criticality was associated with being extensively performed and being highly important as indicated by responses from 1,224 technologists. Specifications for the examination will involve 100 multiple-choice items, which will be divided among 9 content domains, 3 cognitive levels, and either general (90 items) or pediatric (10 items) patients. m
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HORIZONS
Fourth Quarter 2014
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23RD ANNUAL STATE LICENSURE LIAISON GROUP MEETING HELD IN KANSAS CITY
T
he State Licensure Liaison Group (SLLG), sponsored by the NBRC and the American Association for Respiratory Care (AARC), met September 12-13 in Kansas City for the 23rd year in a row. Twenty-two representatives from 22 state and territory agencies, including Puerto Rico, attended this significant function. The State Licensure Liaison Group was formed to facilitate communication between the NBRC, AARC, and state regulatory officials and this year’s meeting continued to fulfill this purpose. The program began on the evening of September 12th with a welcome reception and dinner for all representatives. NBRC President Carl F. Haas, MLS, RRT, RRTACCS, CPFT, FAARC began the September 13th session by welcoming the attendees and emphasizing the NBRC’s continued desire to maintain an excellent relationship with states regarding the profession of respiratory care. Mr. Haas introduced the NBRC’s panel of speakers, NBRC Trustee and Licensure Liaison Committee Chairman, Suzanne M. Bollig, RRT, RRT-SDS, RPSGT, R. EEG T., FAARC, Lori M. Tinkler, MBA, NBRC Associate Executive Director, and NBRC Assistant Executive Director, Robert C. Shaw, Jr., PhD, RRT, FAARC. He also welcomed special guests and speakers: AARC Chief Executive Officer, Thomas Kallstrom, MBA, RRT, FAARC; AARC Director of Government Affairs, Cheryl West, MHA; and CoARC Executive Director Tom Smalling, PhD, RRT, RPFT, RPSGT, FAARC. AARC Director of Government Affairs, Cheryl West, was first to take the podium and delivered a presentation that updated the group on current federal legislative and regulatory issues. She spoke about the 16th Annual RT Capitol Hill Advocacy Day, in which the goal was to educate lawmakers and healthcare staff about HR 2619–The Medicare Respiratory Therapist Access Act. She also reviewed the regulations concerning hospital readmissions and proposed regulation of tobacco products such as e-cigarettes and vaporizing devices. Ms. West also presented information on the expansion of other disciplines and the potential effects that
NBRC ASSOCIATE EXECUTIVE DIRECTOR, LORI TINKLER, PRESENTS TO THE GROUP
may have on the respiratory care field. She also spoke in detail about the current efforts to de-license respiratory therapy in states such as Texas. She explained the consequences that may follow de-licensing, and emphasized the importance of continued communications and when appropriate, joint efforts between RT State Societies and the RT Licensure Boards/Councils/Committees. Cheryl concluded her presentation by providing valuable information on the new changes in legislation for the respiratory therapy profession that had taken place in 2014 and explained their impact on the profession. Next, Tom Smalling presented an update of his organization’s Board, and the current number of accredited respiratory therapy programs in operation. He reviewed the role of the Commission on Accreditation for Respiratory Care as the agency that supports the process for accrediting respiratory care education programs. Dr. Smalling gave an update on the changes to accreditation policies that will go into effect starting June 1, 2015. He also updated the group on the proposal to develop Advanced Practice Respiratory Therapist (APRT) programs. Dr. Smalling concluded his presentation by discussing various accreditation issues that are of interest to state respiratory care licensure agencies. These issues included topics such as the regulation of out-of-state programs, State and Institution-mandated credit limits for degrees, and the Higher Education Reauthorization Act and Federal Government Agenda.
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HORIZONS
Fourth Quarter 2014
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23RD ANNUAL STATE LICENSURE… º CONTINUED FROM PAGE 4 Next, Thomas Kallstrom provided the group with an update about AARC activities in 2014. He shared about recent collaborations with other associations and the mounting support from other agencies for HR 2619–The Medicare Respiratory Therapist Access Act. Mr. Kallstrom then discussed the Affordable Care Act policy for hospital readmissions of COPD patients and the potential impact this will have on hospitals, individuals, and the profession. He also addressed the potential opportunities and examples of hospitals that had successfully implemented the changes. Tom concluded his presentation by highlighting the upcoming launch of new programs and features, including the AARC Virtual Museum accessible through the AARC website. Next, Lori Tinkler and Robert Shaw presented information on the upcoming changes to the credentialing system in January of 2015. Ms. Tinkler began the presentation by giving an overview of the administrative and operational side of the changes, including the Therapist Multiple-Choice, Clinical Simulation, and Pulmonary Function Technologist Examinations. She also discussed in detail the Continuing Competency Program and the NBRC Disciplinary Database. Lori concluded her presentation with a question and answer session, which allowed further explanation of the discussion topics. Dr. Shaw then took over the presentation to discuss the technical aspects of the new examination programs
coming in January 2015. He compared and contrasted the CRT and Therapist Multiple-Choice Examinations identifying factors that will stay the same and factors that will change. Similarly, Rob explained the differences between the current and future Clinical Simulation Examinations. In addition, he explained why the cut score policy change matters, and concluded by answering questions from the audience regarding the upcoming examination and scoring changes. The meeting adjourned after a roundtable discussion on topics and issues at the forefront of importance to state licensure. Licensure Liaison Committee Chairman, Suzanne M. Bollig, spearheaded the discussion, which allowed the attendees to provide immediate feedback and advice to the group on a peer-to-peer basis. The 2014 meeting proved to be yet another successful session for the State Licensure Liaison Group. Attendees indicated that the group continues to serve a vital role in ensuring effective communication between the states, the NBRC and the AARC. The NBRC and AARC maintain their commitment to annual sponsorship of this program as part of national efforts to provide uniform licensure examinations for all states regulating the practice of respiratory care and to ensure that the national credentials awarded by the NBRC continue to be recognized by all state entities. m
2014 SLLG PRESENTERS FROM LEFT TO RIGHT: TOM SMALLING, SUZANNE BOLLIG, ROBERT SHAW, LORI TINKLER, CHERYL WEST, CARL HAAS, AND THOMAS KALLSTROM
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HORIZONS
Fourth Quarter 2014
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EXAMINATION STATISTICS THROUGH THE THIRD QUARTER OF 2014
T
he NBRC administered 32,620 credentialing examinations from January 1, 2014 through September 30, 2014. A total of 13,725 new CRT, RRT, CPFT, RPFT, Neonatal/Pediatric Specialist, Sleep Disorders Specialist, and Adult Critical Care Specialist credentials were issued. Relevant statistics for each NBRC examination are shown in the following paragraphs, along with the 2012 through 2014 pass rate information.
CRT Examination A total of 10,345 CRT Examinations were given through the third quarter of 2014. A total of 6,819 individuals have earned the CRT credential so far this year.
RRT Examinations The Written Registry and Clinical Simulation Examinations (CSE) make up the two part RRT Examination System. By the end of September 2014, 10,510 Written Registry Examinations had been administered, while 9,964 CSE Examinations have been given. Through the first nine months of 2014, 5,651 practitioners have been awarded the RRT credential by successfully passing both portions of the RRT Examination.
Pulmonary Function Technologist Examinations Two hundred seventy-nine (279) CPFT Examinations have been given as of September 30, 2014. The entry-level pulmonary function technologist credential, CPFT, has been awarded to 195 individuals during this time period. Eighty (80) RPFT Examinations were administered and 47 CPFTs have achieved the advanced-level RPFT credential through the first nine months of the year.
Neonatal/Pediatric Specialty Examination The Neonatal/Pediatric Examination was administered to 862 CRTs and/or RRTs during the first three quarters of 2014. Five hundred forty-four (544) practitioners earned the RRT-NPS or CRTNPS designation.
Sleep Disorders Specialty Examination Sixty-one (61) candidates attempted the Sleep Disorders Specialty Examination during the first three quarters of 2014. Fifty-five (55) CRTs and/or RRTs earned the CRT-SDS or RRT-SDS designation.
Adult Critical Care Specialty Examination Five hundred nineteen (519) candidates attempted the Adult Critical Care Specialty Examination during the first three quarters of 2014. Four hundred fourteen (414) practitioners earned the RRTACCS credential. The Board of Trustees extends congratulations to the respiratory care professionals earning the 13,725 new credentials awarded by the NBRC during the first nine months of 2014. The NBRC has now awarded 402,595 credentials since its formation in 1960. m
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PASS RATES COMPARED Below are the passing percentages for NBRC credentialing examinations given in the first three quarters of 2012, 2013 and 2014. Jan 1–Sept 30, Jan 1–Sept 30, Jan 1–Sept 30, 2012 2013 2014
CRT Examination Entry Level Graduates: New Candidates
67.1%
70.0%
76.0%
Repeat Candidates
16.2%
16.3%
13.2%
Advanced Level Graduates: New Candidates
82.3%
82.4%
83.3%
Repeat Candidates
27.8%
27.0%
27.1%
New Candidates
67.9%
70.0%
69.9%
Repeat Candidates
33.3%
34.3%
35.2%
New Candidates
64.5%
64.0%
63.9%
Repeat Candidates
52.4%
50.6%
50.1%
New Candidates
74.3%
68.8%
77.1%
Repeat Candidates
32.3%
57.1%
47.8%
New Candidates
86.5%
54.5%
61.8%
Repeat Candidates
33.3%
50.0%
52.0%
RRT Written Examination
RRT CSE Examination
CPFT Examination
RPFT Examination
Neonatal/Pediatric Specialty Examination New Candidates
67.6%
72.7%
68.8%
Repeat Candidates
43.5%
48.6%
46.6%
Sleep Disorders Specialty Examination New Candidates
87.2%
87.9%
94.4%
Repeat Candidates
25.0%
75.0%
57.1%
83.7%
88.1%
84.2%
N/A
51.9%
47.6%
Adult Critical Care Specialty Examination New Candidates Repeat Candidates
HORIZONS
Fourth Quarter 2014
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ANNUAL RENEWAL ANNOUCEMENT Have you completed your 2015 annual renewal? Be sure to renew early in order to receive the benefits all year long! Being an active member in the national groups of practitioners credentialed by the NBRC means you care about protecting your professional future. The renewal cycle is based on a calendar year, from January 1 through December 31 each year. The Board provides an annual gift of appreciation to those who support the NBRC through the annual renewal process. The 2015 gift will be mailed out approximately 4-6 weeks after your renewal is processed. If you have not maintained active status in the past, please reconsider activating your status to demonstrate support for your credentialing organization and to help ensure that your NBRC credentials continue to have value and meaning. Part of being a professional is to continue to recognize the value of your national credentials and support the organization that stands behind them. Your support will be greatly appreciated and used by the NBRC to accomplish our mission for years to come. You can renew online at www.nbrc.org under the ‘Credentialed Practitioners’ tab. m
Happy Holidays!
from the NBRC and AMP!
The offices of the NBRC and its subsidiary, Applied Measurement Professionals, Inc. (AMP), will be closed Thursday, November 27 and Friday, November 28 for the Thanksgiving Holiday.
SUNDAY
NOV. 23
MONDAY
NOV. 24
TUESDAY
NOV. 25
WEDNESDAY
NOV. 26
THURSDAY
NOV. 27
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FRIDAY
NOV. 28
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SATURDAY
NOV. 29
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In addition, the Executive Offices will be closed December 24-26 in observance of Christmas. The offices will be closed again December 31-January 2 to celebrate the beginning of the New Year. The Board of Trustees of the NBRC, Board of Directors of AMP and the NBRC/AMP Staff extend our best wishes to all for a happy holiday season, as well as a joyous and successful 2015.
SUNDAY
DEC. 21
MONDAY
DEC. 22
TUESDAY
DEC. 23
WEDNESDAY THURSDAY DEC. 24 DEC. 25 SED
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DEC. 28
DEC. 29
DEC. 30
DEC. 31
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JAN. 1
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FRIDAY
DEC. 26
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SATURDAY
DEC. 27
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JAN. 2
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The NBRC/AMP offices will be open December 29-30 to schedule examination appointments and answer questions. The Executive Office will reopen Monday, January 5, 2015 with regular operating hours to respond to your credentialing needs. 7