It is an immensely satisfying challenge to serve as chair of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Acupuncture and Oriental medicine are rapidly evolving in the United States.Educational programs; school accreditation; national certification; research; publications and increasing opportunities to participate in the practice of "collaborative medicine" are transforming health care, as we know it. The evolution of terms used to describe our place within society is itself an indication of an expanding awareness, a shift in consciousness. We began as "alternative medicine," became "complementary and alternative medicine (CAM)," then "complementary," "integrative," and are now "comprehensive." We are developing new interdisciplinary relationships, and in fact many people are now practicing what I refer to as "collaborative medicine." "Collaborative medicine" is one in which specialists within all health fields participate together in health care delivery, a win-win situation that enriches the experience of both the recipient and health care provider. Without question, it is our national standards of accreditation and certification, which combine to demonstrate our commitment to excellence and public safety, that are helping pave the way towards this collaborative practice environment.
The NCCAOM's mission is to promote nationally recognized standards of competency and safety in acupuncture, Chinese herbology and Asian bodywork therapy (the Oriental Bodywork Therapy Certification Program has recently been renamed the Asian Bodywork Therapy Certification Program). In March 1985, the NCCAOM gave its first examination in acupuncture. This event represented the culmination of a three-year effort to define the safe and effective practice of acupuncture, bringing together the expertise of leading psychometricians and acupuncture practitioners. The development and administration of this exam was a milestone event in the evolution of acupuncture and Oriental medicine (AOM) in the United States.
In 1995, the NCCAOM administered its first examination in Chinese herbology. In 2000, the first examination in Asian bodywork therapy was administered. With respect to all three certification programs, national standards of practice in Oriental medicine were developed in response to the requests of the profession.
The NCCAOM Board consists of nine members, and is currently composed of eight practitioners and one public member. Commissioners create policy and oversee the examination and certification process through regularly scheduled meetings and committees, which include exam development, school equivalency, review and discipline, eligibility, etc. Although many of our board members have non-profit board experience prior to serving the NCCAOM, it is a challenge to become conversant with the business of certification, whose language includes job analysis, role delineation, and the understanding of rubrics.
Revenue collected by the NCCAOM is used to enhance certification programs; improve the quality of examinations; advance certification, research and development; and provide services to its diplomates. The NCCAOM has a website which lists, among other features, all current diplomates by geographic location.
At this point in its history, the NCCAOM is engaged in a long list of significant projects. For example, this year, the Commission will embark on a new job analysis study, a lengthy and expensive process that must be completed at approximately five-year intervals. Once again, psychometric consultants will work with a diverse and expert panel of practitioners to develop a survey that will be mailed to a representative sample of practitioners throughout the United States some time in 2001. The survey will attempt to understand how acupuncture and Chinese herbology are practiced in the United States today. Our future exam development and content will be defined by these role delineation studies.
The NCCAOM has also convened a Task Force on Oriental Medicine, made up of representatives of nine national organizations. Given that our mission is to protect the public welfare, and because our examinations must reflect what is being taught in the schools and practiced in clinics throughout the U.S., the Task Force will provide important guidance as to how Oriental medicine is currently being practiced. The Task Force is also examining whether there is a component of education and practice not currently reflected in our existing certification programs. The Task Force will advise the NCCAOM how it can best certify what is being practiced/taught, and whether it should consider the development of a new Oriental medicine certification program. Specific questions that will be considered are:
- Does OM consist exclusively of acupuncture and Chinese herbology?
- If not, how do we define OM?
- Should we develop a combined certification?
- If so, what will it be called?
- Will it include subjects other than acupuncture and herbal medicine?
The Task Force on Oriental Medicine will reconvene at the end of June for further discussion.
The NCCAOM also convened a blue ribbon task force on recertification last year. Their role is to recommend how the board can modify its current recertification policy so that it will best reflect the current needs within our profession. They are examining issues such as the possibility of developing self-assessment tools; current practice requirements; etc.
Of course, the day-to-day work associated with the administration of three separate examinations in three languages three times each year is, I can assure you, a task that few other certification groups tackle. Thus, this list of special projects, coupled with matters relating to daily operations, makes the NCCAOM a very busy place.
With respect to NCCAOM's policies and procedures, several significant changes have been announced in the past few years. In an effort to share our success and growth with our entire pool of diplomates, the board voted in 1999 to lengthen the recertification cycle from two to four years, thus lowering the cost of recertification by 50%. Although this has resulted in a significant loss of income for the NCCAOM, it was decided that it would be the most equitable way to extend a sort of dividend to all of our stakeholders.
Another new policy was implemented in 1999 so that all commissioners are voted into office by general election. The nominating committee, in seeking appropriate candidates, considers diversity in ethnicity; gender; geographic distribution; professional experience; education; and school of thought within the acupuncture and Oriental medicine (AOM) profession. These selection criteria ultimately assure that the NCCAOM Board of Commissioners is a diverse and representative body.
Indicative of the maturity that our profession has reached, the professional practice route has been eliminated as a route of eligibility for NCCAOM certification as of January 2001. In addition, candidates who began their studies after July 1, 1999, must graduate from an accredited, candidate, or equivalent educational program.
One of our most challenging periods occurred in 1999-2000, when the conversion to computer-based testing was abandoned. Due to a list of unsatisfactory performance issues, the NCCAOM returned to paper-and-pencil formats, with no interruption of scheduled exam administrations. This transition represented an organizational triumph of which both board and staff remain proud.
The Practical Examination of Point Location Skills (PEPLS), which was previously a live-model examination, is now administered on paper and pencil as well. Applied Measurement Professionals (AMP) currently assists the NCCAOM in the administration, scoring and analysis of its exams. AMP is a research and development firm that conducts professional competency assessment and provides examination services for a number of credentialing programs. This partnership guarantees a reliable, valid and fair examination for our candidates. AMP also provides reporting of scores to candidates who sit the examinations.
The NCCAOM is a member of the National Organization for Competency Assurance (NOCA). Our current public member, Benjamin Shimberg, is well-versed in the world of certification, and is an invaluable participant. Indicative of his wealth of experience in the certification world, Ben was honored last year by NOCA by receiving the "Distinguished Service Award" for his "contributions to the advancement of the certification profession."
The National Commission for Certifying Agencies (NCCA) accredits the NCCAOM. The NCCAOM is currently in its second five-year accreditation term, and will begin its third term in 2003. In order to maintain accreditation, we must demonstrate excellence in nine critical areas of certification. The NCCAOM is proud of its record of meeting the needs of our rapidly growing and evolving profession, while maintaining the highest psychometric standards.
The expertise and policies of these three groups - AMP, NOCA, and NCCA - have contributed to NCCAOM's development of a certification process that gives full recognition to the diversity of acupuncture and Oriental medicine in the U.S., while also clearly providing national standards for safe and competent practice. Participation in these organizations strengthens the mark of national certification, and advances the image and understanding of our profession in the national arena.
I believe we will all agree that earning the designation of diplomate from the NCCAOM is a considerable professional achievement. NCCAOM certification demonstrates to employers, patients and peers that you have met national standards for the safe and competent practice in your field as defined by the profession. There has been much discussion lately that the practice of Chinese herbal medicine should be limited to those who have demonstrated competence through national board certification in Chinese herbology. As you are most likely aware, there is a growing concern about public safety and appropriate dispensation of herbal products. Surely national certification is not only an indication of competence; it makes the practice of herbal medicine more legally defensible. Perhaps this will become the standard by which professional practice in the U.S. will be recognized.
In April 2000, Helen Zhang, NCCAOM Commissioner, and I traveled to Beijing on behalf of the Commission. We attended the International Conference on Traditional Medicine sponsored by the Chinese government and the World Health Organization (WHO). I was invited to speak before the full assembly in the Great Hall on Tiananmen Square, which was a great honor. We had the opportunity to meet with the Chinese Minister of Health and the President of Beijing University to discuss international issues of certification and examination. In October, Qian-Zhi Wu, NCCAOM Commissioner, and I attended the Fifth World Conference on Acupuncture in Seoul, Korea on behalf of the NCCAOM. The conference was cosponsored by the World Federation of Acupuncture/Moxibustion Societies and the World Health Organization.
The NCCAOM has recently offered comment to the White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP), which was convened last year. The NCCAOM has also been welcomed as a member of the National Health Council (NHC). NHC is a private, nonprofit association of national organizations whose mission is to promote the health of all people by advancing the voluntary health movement. NCCAOM is the only complementary and alternative medicine organization that is a NHC member. This is an opportunity for our field of medicine to have a voice in an arena dominated by conventional medical groups. Our CEO, Christina Herlihy, was honored recently through her appointment to the NHC Membership Committee.
Look for our attractive new diplomate certificates in the first quarter of 2001. In response to many requests from our diplomates, the NCCAOM will begin awarding a larger, more impressive certificate to all new diplomates (and eventually to all existing diplomates at the point of recertification).
There are numerous challenges ahead for acupuncture and Oriental medicine. It is both educational and rewarding to serve the NCCAOM during this renaissance of medicine, which will lead to new understandings, and eventually, the birth of a new paradigm.
Click here for previous articles by Kabba Anand, DAc, LAc, Dipl. Ac., Dipl. CH.