Introduction
An important career milestone of allied ophthalmic personnel (AOP) is achieving certification which demonstrates a professional commitment to ophthalmic assisting and patient care. Important benefits of certification are the standardization of the knowledge and skills needed in the profession that ensures consistent patient care, validation that the individual meets the knowledge criteria of ophthalmic care, competency assurance in ophthalmic clinical skills and knowledge, as well as certificants achieving increased confidence and self-esteem.
This chapter provides an overview of the certification standards and examinations for AOP.
Knowledge-based examinations
The International Joint Commission on Allied Health Personnel in Ophthalmology’s (IJCAHPO) mission is to develop certification examinations that are based on fundamental principles. These principles include validity, reliability, objectivity, and security.
Validity ensures that the test content measures the know-ledge, skills, and tasks required for the certification level. Based on a worldwide job task analysis (JTA) conducted by IJCAHPO every 5 years, the content domains ( Table 51.1 ) provide the foundation for the examination length, the number of test questions, and the amount of time allowed for candidate testing.
| Content areas | Certified ophthalmic assistant | Certified ophthalmic technician | Certified ophthalmic medical technologist |
|---|---|---|---|
| Number of Examination Questions | 200 | 200 | 190 |
| Examination Length | 180 minutes | 180 minutes | 180 minutes |
| Examination content areas | Percent of examination | ||
| Patient Evaluation | |||
| History and Documentation | 5% | 3% | 3% |
| Visual Assessment | 6% | 7% | 3% |
| Visual Field Testing | 4% | 3% | 6% |
| Pupil Assessment | 3% | 4% | 3% |
| Tonometry | 4% | 4% | 2% |
| Keratometry | 2% | 3% | 2% |
| Ocular Motility Testing | 4% | 6% | 12% |
| Lensometry | 3% | 3% | 4% |
| Refraction, Retinoscopy, and Refinement | 5% | 5% | 6% |
| Biometry | 3% | 5% | 3% |
| Supplemental Testing | 3% | 2% | 6% |
| Assisting with interventions and procedures | |||
| Microbiology | 3% | 3% | 2% |
| Pharmacology | 3% | 3% | 4% |
| Surgical Assisting | 4% | 6% | 4% |
| Ophthalmic Patient Services and Education | 14% | 12% | 8% |
| General Medical Knowledge | 14% | 5% | 4% |
| Corrective lenses | |||
| Optics and Spectacles | 2% | 5% | 2% |
| Contact Lenses | 2% | 5% | 7% |
| Imaging | |||
| Ophthalmic Imaging | 5% | 7% | 9% |
| Photography and Videography | 5% | 6% | 8% |
| Office and clinical skills | |||
| Equipment Maintenance and Repair | 2% | 1% | 1% |
| Medical Ethics, Legal and Regulatory Issues | 4% | 2% | 1% |
Examination reliability demonstrates test scores are consistent, precise, and reproducible. Objectivity ensures that the examinations are carefully designed to test relevant core knowledge of job incumbents without bias or unfair questions.
Security procedures require that the examination be kept in a secured location and accessed by staff with proper authority. IJCAHPO examinations are given in a proctored environment that is supervised by an approved, neutral person (a proctor) who ensures the candidate’s identity and the testing environment. Security protects the integrity of the examination, the test data, and the certifying agency, as well as protecting test results and examinee privacy.
Examination format and administration
Certification examinations and certificates of completion are administered using open-book, paper and pencil, computer-based, or online examination formats that may be proctored through a video camera. Use of the computerized format allows the examination to be administered in multiple locations (testing centers) with flexible dates and times. Online examinations offer candidates the ability to sit for examinations on their personal computer, anywhere and anytime.
Online virtual proctoring is a technology advancement that will become more common and standardized.
IJCAHPO certification examinations test content-specific and most often in a multiple-choice format ( Fig. 51.1 ). Practice examinations provide candidates the opportunity to become familiar with computer testing and the examination. Upon test completion, many certification agencies provide immediate performance feedback with unofficial pass/fail test results with automated scoring. Box 51.1 gives sample certified ophthalmic assistant (COA) examination test items (answers are in Box 51.2 ).
