Reflections From The ABSM Information Session At SLEEP 2011

By Cindy Altman, RPSGT, R.EEG/EP T.
President-Elect, BRPT

(originally published 06/22/2011 at brpt.org)

I recently attended an American Board of Sleep Medicine (ABSM) technologist examination information session at the American Association of Sleep Technologists (AAST) program in Minneapolis. Most technologists went to lunch, but a hundred or so were present.

Dr. Richard Rosenberg gave the presentation. Dr. Nathaniel Watson was also there. He was introduced as president of the ABSM and he sat next to Dr. Rosenberg on the stage but really didn’t say much.

Dr. Rosenberg is a full-time American Academy of Sleep Medicine (AASM) employee, and Dr. Watson is on the AASM board of directors. How can the ABSM be “an independent, nonprofit, self-designated board” separate from undue influence by the AASM? The relationship between the two groups is not transparent.

On several occasions Dr. Rosenberg let the audience know that he trained in sleep with Dr. Rechtschaffen, and he serves on the Committee for Accreditation of Polysomnographic Technologists Education (CoA PSG). He talked of all the good the AASM has done for sleep technologists and education. He forgot to mention the role that the AAST and the Board of Registered Polysomnographic Technologists (BRPT) played in advancing technologists’ professional status, or in the formation and continued support of the CoA PSG.

Dr. Rosenberg said there was absolutely no financial motivation, as rumors implied, behind the development of the new technologist exam. He said the ABSM simply wants to offer a technologist examination that is relevant for all “stakeholders.” And they want a pass rate that is higher than the RPSGT exam... for the good of the profession. In other words, for the good of the physicians who employ the techs who are unable to pass the RPSGT exam. After all, he implies, the problem in passing the RPSGT exam is with the exam itself, and not the individuals or educational pathways.

To them, it doesn’t matter that the BRPT works with a well-respected professional testing company, or that the BRPT uses best practices for developing, maintaining, reviewing, delivering, and scoring the RPSGT examination. Or that it uses a geographically and professionally diverse group of Subject Matter Experts. Or that at every step along the way, the RPSGT examination is checked for validity and relevance not only by the professionals in the field, but by professionals in the testing community. What matters is that the ABSM believes it has produced a better technologist exam that will result in a higher pass rate. After all, the ABSM knows “some psychometricians” who help with the exam. What matters is that the ABSM will do what the AASM asks.

Dr. Rosenberg said the ABSM would apply for NCCA accreditation for the technologist examination. He fumbled with the terms and relationship between the Institute for Credentialing Excellence (ICE), the National Commission for Certifying Agencies (NCCA), and the National Organization for Competency Assurance (NOCA), which is now ICE. I hope he gets these organizations straight for his next presentation.

Dr. Rosenberg blamed the RPSGT exam pass rate on “stifling” the development of formal sleep technology education programs across the country. He based this on a conversation with a dean at a school in the Chicago area. Dr. Rosenberg talked about the dissatisfaction physicians have with the RPSGT credential, yet he has no data to support that. The AASM is certainly capable of surveying a large number of people and institutions to determine the extent of this dissatisfaction... if they were interested.

Dr. Rosenberg repeatedly referred to outdated RPSGT exam pass rates and did not discuss the difference in pass rates based on educational pathway or over time, or compare the pass rates of similar examinations with multiple pathways. When program directors from two different schools challenged the assertion that the exam was too difficult for CAAHEP students, Dr. Rosenberg indicated their schools were the exception, not the norm.

Dr. Rosenberg told us that the RPSGT requirement for AASM sleep center accreditation would still stand. Yet when asked if he would put that statement in writing, he let the audience know it wouldn’t have any weight. When asked if the new examination should be viewed as a mid-level credential, with the CPSGT on the lowest level and the RPSGT on the highest level, he made it clear that the new credential was to be on equal terms with the RPSGT.

Dr. Rosenberg reminded the audience that the AAST supports the new exam. He let us know AAST’s immediate past president and current president have been involved in the development of the ABSM technologist exam. The audience was already aware of AAST’s position to support “all” technologist examinations—even those not yet developed or evaluated—but it was surprising that AAST leaders were actually assisting in the exam development. This was news to current AAST board members as well. Did Dr. Rosenberg let the cat out of the bag?

When it was time for questions and comments at the end of the presentation, not one person stood up to voice support for the new exam. However, many stood in line to question or comment on the purpose of it. At times those in attendance clapped enthusiastically in support of the techs or physicians who challenged the ABSM. Suffice it to say, the new ABSM technologist examination was not well received.

So why, exactly, is the ABSM getting involved in technologist credentialing? Could it be that the BRPT is truly an independent organization adhering to best practices in credentialing, and the AASM does not like that?

The RPSGT is the Gold Standard. Don’t let grandfathering into the new credential confuse you. While it is “only $25” and you may think that you have nothing to lose, you do. You risk losing the professional identity that technologists have worked for over 32 years to achieve. As technologists we can stand united to keep the RPSGT credential strong. Don’t let the AASM divide and conquer. That is really what this is all about.