Certification Candidates Performance on Exams

Larry Fabrey, Ph.D, Senior Vice President, Psychometrics, Applied Measurement Professionals, Inc

Now that a revised detailed content outline for the CIC® examination has been developed, let’s look at the candidates’ performance on the examinations that were based on the previous outline, in effect from July 1, 2007 through June 30, 2010. As a reminder, the purpose of the CIC® certification process is to protect the public by:

  1. Providing standardized measurement of current essential knowledge needed for persons practicing infection control.
  2. Encouraging individual growth and study, thereby promoting professionalism among infection control professionals.
  3. Formally recognizing infection control professionals who fulfill the requirements for certification.

To identify the infection prevention and control professionals who possess the appropriate level of knowledge to be formally recognized as a CIC®, a passing standard (i.e., cut score) must be established. The actual cut score for the examinations is based on the raw score (i.e., number of correct answers) achieved by the candidate, and the raw score required to pass is established through a criterion-related passing point study. Details of the passing point study can be found in CBIC’s Candidate Handbook, but simply stated, the intent of the study is to determine the amount of knowledge that should be displayed to warrant issuance of the credential, by evaluating the difficulty of examination questions. Since question difficulty can vary among different versions of the examination, the cut score could vary slightly. For recent proctored computer-based tests (CBT) administered during this three year period, the cut score has been between 70 to 75 percent correct. That same cut score has been applied to anyone taking the CBT, whether as a first time candidate or someone taking the examination for recertification. During this same period of time, the passing point on the Self-Achievement Recertification Exam (SARE) has been between 75 to 80 percent correct.

The performance of first time and recertification candidates taking the CBT during this three-year period in test centers in the United States is summarized in Table 1. Please note the following key points. First and foremost, the six content categories on the previous outline are similar to, but not the same, as the new outline introduced July 1, 2010. Specifically, some of the category titles have changed slightly; the numbers of items per category have changed; and the order in which the categories are listed is different. However, the overall content of the examinations was similar to the content of the current examinations. Also, when creating examinations, the CBIC Test Committee and the testing agency (Applied Measurement Professionals, Inc., or AMP) are able to control the difficulty of the overall examinations to some extent, so that the cut score remains fairly consistent, but the difficulty of the questions within each of the major categories is not controlled. While every version of the examination has exactly the number of items shown in the second column, the percent correct values in the right columns of Table 1 represent the average percent correct across all versions. While percent correct is not always the best way to describe performance, it provides a consistent scale when comparing performance based on a different number of questions.

Table 1. Examination (CBT) Performance by Candidate Group

Content Category

# of

% Correct by
Candidate Group

First Time


1.  Identification of Infectious Disease Processes




2.  Surveillance and Epidemiologic Investigation




3.  Infection Prevention and Control




4.  Program Management and Communication




5.  Education




6.  Infection Control Aspects of Employee Health




In evaluating the information in the table, what is not known is whether any apparent differences in performance by category represent differences in item difficulty or in candidate ability. However, since the values are aggregated across many versions of the examination, candidate ability (i.e., performance) provides at least a partial explanation. In other words, if the table showed performance based on only one version, the difficulty of the items would likely have a greater influence. It is safe to say that first time candidates perform best on category 2 (Surveillance and Epidemiologic Investigation) and worst on category 6 (Infection Control Aspects of Employee Health).

Education has also been a relatively weaker area, and the other three categories (1, 3, and 4) fell just a bit behind performance on category 2. The patterns are similar for the candidates who took the test for recertification, although recertification candidates showed much more consistency across the content categories. The differences between the performance of first time candidates and recertification candidates is not surprising, for at least two reasons: 1) those in the recertification group have already demonstrated they possessed the knowledge necessary to attain the CIC® credential, and 2) additional experience as an infection prevention and control professional should help increase the depth of their knowledge. Every question on the examination has been unanimously approved by the Test Committee to be appropriate for assessing knowledge that should be possessed by an infection prevention and control professional with two years of experience, but the table suggests that knowledge of Infection Control Aspects of Employee Health increases with more experience.

Regarding overall candidate performance, based on over 1,300 candidates taking the CBT examination for the first time during this three-year period, slightly over 65% have passed. During that same time frame, over 600 candidates have taken the CBT to maintain their certification, and slightly over 90% of these individuals have passed. Similarly, approximately 90 percent of the candidates taking the SARE to maintain their certification have passed.