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Examination Construction

Examination construction begins with the preparation of a draft examination that is based on a form of the examination about to be retired from use;

  • The examination consultants (consultants) review the test and item level statistical data for the examination being retired and based on classical item analysis statistics remove items that are too easy (i.e., approx. p>.90), too difficult (i.e. approx. p<.40) and/or poor discriminators (i.e. approx. rpb>.10),
  • Every five years following the release of the new task analysis, a Standard Setting Study is conducted using methods that objectively facilitate the criterion-referenced nature of credentialing decisions, based on a method described by Angoff (1971). The study results are used to guide selection of a passing standard. The form used for standard setting is used as the base form for the creation of subsequent forms of the examination, to be made parallel and equivalent using statistical pre-administration equating and adherence to the content allocation requirements of the exam content outline.
  • The consultants review the test specifications and produce a table indicating the number of items in each content area needed as replacements;
  • The examination committee members (committee) perform an item-by-item review of the draft prepared by the consultants and take any of the following actions: 1) retain item; 2) delete item from the exam; and 3) select items to replace those removed by the consultants in their preparation of the draft and those removed by the committee in its itemby-item review; and 4) revise items (i.e., pre-test items only).
  • Replacement items are selected according the content areas that need replacements so the examination conforms to the test specifications. The replacement items must also have acceptable item analysis statistics as described above.
  • The committee also selects items for pre-testing. Each examination includes 50 pre-test items and the 50 pre-test items are selected to approximate the test specifications.
  • The consultants execute the committee’s item revisions and replacements, and submit the next draft of the examination to the committee for review;
  • The committee performs a review of the second draft of the examination prepared by the consultants and takes any of the following actions: 1) retain item; 2) delete item; 3) select items to replace those removed by the committee in its item-by-item review; or 4) revise pre-test items.
  • The consultants execute the changes made by the committee and prepare a third draft of the examination. Draft three is submitted to the committee chairperson for finalization by her and selected members of the committee; and
  • The consultants execute the changes made in the finalization process and produce the examination in a form suitable for submission to the computer-based testing vendor.


Examination Review Guidelines
  • Items will be reviewed for clarity, accuracy, and relevance to the test specifications and to entry-level midwifery practice;
  • Every item approved by the committee will have a current or classic reference;
  • At each committee meeting, items selected for use in an exam will be evaluated by committee members to ensure that the items continue to reflect current, best practice;
  • References for items previously used will be reviewed to ensure they comply with having been published within the last 5 years;
  • Staff will provide the committee with a library of references/resource materials for use during meetings;
  • Committee members may bring and use personal references/resources for use during meetings; and
  • Committee members review the item’s content codes to ensure that they are aligned to the appropriate content category and task statement.


AMCB Committee Description for Examination Process


Examination Committee
The Examination Committee is responsible for the development, final review and approval of the examinations. The committee is comprised of a diverse group of subject matter experts (CMs & CNMs) who represent midwives of different races/ethnicities, genders, practice settings, locations, etc. as much as possible. The committee typically meets 2 to 3 times per year to develop a new version of the examination. They review new questions developed by the Item Writing Committee and select new questions or revised questions for pretesting. They review the content of each test question and associated statistical properties (i.e., item analysis data). At each meeting, the committee reviews the performance of the examinations (i.e., quarterly exam performance reports), and all candidates’ comments about test questions. The committee receives orientation and training by a psychometrician on how to review and validate examinations.

Item Writing Committee
The Item Writing Committee is a diverse group of subject matter experts (CMs & CNMs) who represent midwives of different races/ethnicities, genders, practice settings, locations, etc. as much as possible. The committee is responsible for developing new test questions based on requirements set forth by the Examination Committee. New questions are developed annually. The new items are drafted in an item development software that is password protected. The committee receives orientation and training by a psychometrician on how to develop test questions and how to enter the questions into the item development software. New questions are then passed on to the Examination Committee for review and the questions that are approved by the Examination Committee undergo a psychometric review and are entered into the question bank for future use.

Passing Score Committee
The Passing Score Committee is a diverse group of subject matter experts (CMs & CNMs) who represent midwives of different races/ethnicities, genders, practice settings, locations, etc. as much as possible. The committee is responsible for participating on a passing score study on a new base form of the examination. The passing score meeting is facilitated by a psychometrician who provides orientation and training on the passing score methodology. A modified Angoff method is used to establish the proposed passing score for the examination. The modified Angoff method focuses on defining the “examinee with basic competence” and obtaining judgments from subject matter experts regarding the expected performance of such examinees on the test questions comprising an examination (Angoff, 1971). The Passing Score Committee meets once every five (5) years following the development of a new base form examination that conforms to test specifications resulting from the most recent task analysis study.

Task Analysis Committee (aka Research Committee)
The Task Analysis Committee is a diverse group of subject matter experts (CMs & CNMs) who represent midwives of different races/ethnicities, genders, practice settings, locations, etc. as much as possible. The committee is responsible for conducting a task analysis study once every five (5) years. A psychometrician provides consultation and conducts analysis of the data collected for the study. The data resulting from the study are used to develop the test content outline (i.e., major domains of practice and associated tasks) and test specifications for the examination (i.e., the number of test questions by major domain of practice). The test content outline and test specifications are used to develop new forms of the examination.



If you have any questions about AMCB Certification, please contact:

Morgan Saul
Certification Coordinator
Phone: 410-694-9424 ext. 7017