Undersea and Hyperbaric Medical Society Associates formed a committee to investigate the needs and methods for having a credential for hyperbaric chamber operators. The committee decided that the following were the significant points.

• Clinical hyperbaric chamber operators
• Entry level
• Prerequisites
• Course syllabus
• Testing
• Practicum
• Certification vs. License

A survey of all UHMS Associates was conducted to ascertain recommendations and potential questions for a future test bank. Approximately 500 surveys were mailed, with about 100 returned. The Associates committee recommendations were presented to the Executive committee of the UHMS and approval was given to proceed.

A review of references and literature suggested that the UHMS should not be the certifying agency. Outside organizations, Respiratory Therapy, Emergency Medical Technicians, and Nursing were contacted to have them provide certification coverage. For several reasons none were considered feasible.

The National Association of Diver Medical Technicians (NADMT) was contacted and they offered to provide their experience towards the certification effort.

Two UHMS Associates were voted onto the NADMT Board of Directors and the restructure of the organization lead to a new entity, the National Board of Diving and Hyperbaric Medical Technology (NBDHMT).

The design model settled on was:

• Certification
• Clinical hyperbaric chamber operators
• Generic entry level
• Prerequisites of prior ancillary health care certification ( i.e. EMT, RT, LPN, etc.)
• Completion of approved course (“Grandfather” clause for three years)
• Passing a written examination (70% or better)
• Completion of a recognized “Internship” of 480 clinical hours.

Recommendations for the examination was taken from existing models. The examination would consist of 120 questions drawn from a 600 question test bank. Questions would be true or false, multiple choice or mix and match. Questions would come from only referenced text and must be stated so that only one answer was correct. Questions would be structured with levels of difficulty (requiring 1, 2, or 3 cognitive steps), these would constitute “Weighting”. Correct answers would be algebraic, narrative, or matching choice.

The test bank was drawn from recommendations from the Associates, existing training facilities and referenced text. Questions submitted from Associates and training facilities had to have at least two references for the correct answers. Approximately 1,000 questions were reviewed and from those approximately 500-600 were passed through. The test bank questions were entered into LXR 5.0 testing program, formatted into either true/false, multiple choice or mix/match questions. Survey tests of 80 randomized questions each were distributed to twelve clinical facilities where at twelve staff members would take the exams while proctored. The facilities chosen to participate in the survey examinations were equally divided between monoplace and multiplace operators and included two military facilities. The twelve facilities were spread out through eight states located with at least one in each geographical quadrant of the United States. Gender or racial basis was not factored in.

The survey examinations were reviewed by individual questions. To pass a question had to been answered correctly at least 70% of the time. Each of the questions in the test bank was asked 15-20 times, which rendered a good analytical number set. After this review 480 questions were retained in the test bank. A second survey was constructed, using a randomized set of 80 questions distributed to another ten facilities, 12 tests each. The pass rank per individual was @ 82%. The randomized tests were deleted from the computer and an initial test bank of 480 questions divided into 7 categories was installed on a IBM PC using LXR 5.1 test program.

The test bank was ready for use. During the use of this process each examination was hand-graded and challenges by examinees were reviewed by at least two NBDHMT members. Questions are routinely monitored to assure that they do not drop below a 70% pass rank and replaced if they do. New questions reflecting changes in technologies or regulations have been added routinely, but must pass the two references standard and maintain a 70% pass rank to remain in the test bank.