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National Competency Exam

Provider
National Board for Certification in Hearing Instrument Sciences (NBC-HIS); scheduled through Kryterion Webassessor at testing centers
Format
Computer-based multiple-choice board certification examination for holders of a current dispensing license or certificate of registration (where applicable); items from the five competency areas are randomly distributed and scored as a single exam, each item correct or incorrect with no partial credit
Exam questions
100 scored multiple-choice items, sometimes with as many as 30 additional non-scored beta items
Time limit
105 minutes for the 100-question exam; adjusted automatically when beta questions are added
Passing score
Criterion-referenced passing standard set by a modified Angoff methodology; pass or fail reported for the entire exam
Exam fee
$225 (USD) for United States & Canada or $250 (USD) for International, per exam sitting
Examination outline
  • DOMAIN 1: Assess patient presenting problem and needs (25%) (25%)
    • 1) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes a family history of hearing loss.
    • 2) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes childhood hearing-related illnesses.
    • 3) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes hearing loss duration, dizziness, loss of balance, and/or tinnitus.
    • 4) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes hearing loss duration, trauma and/or discomfort.
    • 5) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes past and/or current health conditions and/or medication/drug history.
    • 6) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario that includes occupations or recreational activities that include exposure to noise and acoustic trauma.
    • 7) Identify the most likely type/degree/slope of hearing loss or potential impact to hearing given a patient scenario including history of ear surgeries, diseases and treatments.
    • 8) Identify the potential impact on patient's lifestyle (e.g., family, work, social activities) given a patient scenario of hearing loss type (e.g., SNHL).
    • 9) Identify which patient scenario would most likely require a medical referral based on given symptoms (e.g., impacted cerumen, asymmetric hearing loss, sudden onset hearing loss).
    • 10) Identify the most appropriate type of preventative hearing protection given a patient scenario involving noise exposure.
    • 11) Differentiate between scenarios that indicate a hearing loss vs. lack of understanding (e.g., cognitive decline, retrocochlear).
  • DOMAIN 2: Test and analyze patient hearing (25%) (25%)
    • 1) Identify irregularities/obstructions during an otoscopic examination.
    • 2) Identify when the patient would benefit from cerumen management, removal, and/or precautions in cerumen management.
    • 3) Identify the degree and type of hearing loss based on the pure-tone air and bone-conduction given audiometric results (e.g., mixed hearing loss, SNHL).
    • 4) Identify condition(s) that would cause the tympanogram and/or reflex configuration given tympanogram and/or reflex results.
    • 5) Identify potential methods for managing tinnitus.
    • 6) Identify when to conduct speech awareness vs. speech reception threshold test.
    • 7) Identify how speech discrimination test results would impact the patient's outcome, most appropriate treatment option, or additional testing.
    • 8) Determine whether this was over masked, under masked, effectively masked, masking was not necessary, or a masking anomaly (e.g., interaural attenuation) given audiometric test results showing air- and/or bone-conduction testing and masking levels.
    • 9) Identify the potential impact on fitting given a patient scenario involving Speech Reception Threshold (SRT), Most Comfortable Listening Level (MCL), and/or Uncomfortable Loudness Level (UCL) (e.g., recruitment).
    • 10) Interpret Speech in Noise (SIN) results and impact on treatment plan.
    • 11) Identify signs of irregular test results and/or the potential causes of irregular test results (e.g., malingering, user error, equipment failure).
    • 12) Identify the results that indicate recommendation for medical referral given otological or hearing test results (e.g., binaural interference, PTA vs. SRT discrepancy, air-bone gap).
    • 13) Identify when a client is a possible candidate for a surgical solution (e.g., cochlear implant, Bone-anchored Hearing Aid (BAHA), PE tubes).
    • 14) Select the best audiometric transducer given physical considerations of the patient (e.g., supra-aural vs. insert earphones).
  • DOMAIN 3: Prescribe and analyze hearing instruments (25%) (25%)
    • 1) Identify the appropriate hearing instrument (e.g., style, configuration, matrix, rechargeable vs. battery) given a patient scenario that includes physical and/or cognitive limitations.
    • 2) Identify which telephone use options are most appropriate given a patient scenario including physical/cognitive limitations or knowledge of technology.
    • 3) Identify which Assistive Listening Devices (ALDs) are most appropriate given a patient scenario that includes lifestyle, physical/cognitive limitations and/or knowledge of technology.
    • 4) Identify the contraindications for Invisible-in-Canal (IIC) hearing instruments given a patient's ear canal, size, hearing loss and lifestyle (i.e., extended or daily wear use).
    • 5) Identify the most appropriate modification to the procedures and/or materials during an ear impression (e.g., gun vs. syringe, otoblock size/type, mastoid and/or piercings, unusual/missing pinna).
    • 6) Identify the most appropriate tube, tube length, dome size, earmold, or receiver power for over-the-ear (OTE) hearing instruments.
    • 7) Identify the most appropriate wire, wire length, dome size, earmold, or receiver power for receiver-in-canal (RIC) hearing instruments.
    • 8) Identify the most appropriate tube, tube length, dome size, earmold, or receiver power for behind-the-ear (BTE) hearing instruments.
    • 9) Identify advantages and disadvantages of custom hearing instruments versus OTE, RIC, and BTE given a patient scenario.
    • 10) Identify advantages and disadvantages of custom hearing instruments given a patient scenario.
    • 11) Identify possible treatment options for asymmetrical and single-sided deafness (SSD) (e.g., CROS/BICROS).
    • 12) Determine the most appropriate hearing instrument given a patient scenario that includes lifestyle, history, test results, and ear canal characteristics.
  • DOMAIN 4: Fit, adjust, program, and service hearing instruments and equipment (15%) (15%)
    • 1) Identify the appropriate adjustment given objective verification outcome results (e.g., sound field aided/unaided discrimination, sound field aided/unaided warble tones or narrow band noise).
    • 2) Identify potential causes of problems or identify the appropriate modification given results from real ear or speech mapping.
    • 3) Identify the appropriate methodologies for modifying the physical fit of earmolds, custom shells, OTE, BTE, and/or RIC instruments given a patient complaint.
    • 4) Identify the appropriate adjustments given subjective validation of results (e.g., COSI, IOI-HA, APHAB, verbal feedback).
    • 5) Troubleshoot and adjust/modify programming of hearing instrument given a patient complaint.
    • 6) Identify or resolve potential hearing instrument problems caused by obstructions, moisture, or battery performance.
    • 7) Troubleshoot pairing and wireless connectivity between hearing-related devices.
  • DOMAIN 5: Counseling and rehabilitation (10%) (10%)
    • 1) Identify the most appropriate patient explanation given results of otoscopic examination and audiometric examination.
    • 2) Identify potential limitations and benefits of amplification.
    • 3) Identify the most appropriate counseling based on subjective validation results.
    • 4) Identify helpful strategies and information for improved hearing and communication in various situations or environments.
    • 5) Identify appropriate manual hearing instrument adjustments that patients, family members, or caregivers can make.
Examination sources

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This examination may be required or accepted as an alternative, depending on the license and application pathway.