HPCC Announces Multiyear Diversity, Equity, Inclusion, and Belonging (DEIB) Strategic Initiatives
According to the article “Diversity in Nursing and Challenges with the NCLEX-RN” in Nursing Outlook, standardized testing has historically impeded education and career attainment for members of underrepresented groups. The Hospice and Palliative Credentialing Center (HPCC) understands the importance of evaluating our data to explore possible variances associated with race, ethnicity, and gender. To accomplish this, the organization recently launched a performance analysis of its certification exams. The organization was purposeful in seeking data that compared pass rates across genders, ethnicities, and racial groups over the past three years to detect potential disparities. This work resulted in a comprehensive report on pass rates produced by HPCC’s testing vendor, PSI. The report included overall exam pass rates for the largest certification programs by volume and selected demographic areas, including race, ethnicity, gender, academic level, and years in the profession.
“HPCC has gained valuable insights into its stakeholder population, candidate performance, and program statistics by initiating and completing this important study,” said HPCC Senior Vice President Chad Reilly, MBA, CAE. “We look forward to continuing to analyze the data from the report and using the information to build upon HPCC’s strategic initiatives.”
The initial findings indicate a racial, gender, and ethnic gap in exam pass rates, and HPCC is committed to focusing on initiatives to reduce pass rate disparities across these groups. Although there are few immediate solutions for this complex challenge, HPCC is committed to allowing all stakeholders to participate fully in the certification process and develop a strong sense of community. Throughout 2023, HPCC has undertaken the following strategic initiatives to further these efforts.
Formation of a Diversity, Equity, Inclusion (DEIB Task Force)
In early 2023, HPCC established a DEIB Task Force comprised of individuals passionate about developing a culture and processes prioritizing DEIB. The task force is currently assisting and advising the HPCC Board of Directors in identifying internal and external barriers to achieving certification and providing opportunities to alleviate disparities and remove systematic biases. DEIB Task Force Roster.
Differential Item Functioning (DIF) Analysis of the CHPN® Certification Exam
In June 2023, the HPCC Board of Directors initiated a DIF analysis of data from the Certified Hospice and Palliative Nurse (CHPN®) program, which has the largest number of certificants, allowing for the review and analysis of statistically significant data. One of the goals of the DIF analysis is to identify potential bias in exam questions. The analysis, using Item Response Theory (IRT), also includes the identification of DIF. An item is identified as having DIF if candidates of different demographic groups (race, gender, etc.) who had the same overall test performance differed in their probability of answering a specific exam item correctly.
The HPCC staff is working with PSI to remove exam questions identified through the analysis as having DIF, either positive or negative, from current exams and to allow the DEIB Task Force and other stakeholder groups to review the items for future viability.
Advocating for Diversity on HPCC Committees
HPCC advocates for DEIB in our volunteer opportunities. Invitations for all volunteer opportunities are sent to current certificants, and the staff takes great care in reviewing applications to include volunteers from various demographic and geographic backgrounds. Additionally, targeted outreach to underrepresented certificant and stakeholder populations continues to be a focus area of the organization.
Exam Item Development Focused on Inclusive Language and Regular Reviews
Members of the HPCC Examination Development Committees (EDCs) regularly review pretest and exam questions for inclusive language to ensure they are free from stereotypes, overt and subtle discrimination, and negative messages. The HPCC DEIB Task Force is in the process of developing a DEIB Style Guide that EDC members will use for inclusive language, which includes avoiding the use of gender-specific pronouns and other non-inclusive language. Ongoing review of language included in exam items enables HPCC to offer examinations that are culturally aware and inclusive. This work continues to be a focus for HPCC’s EDCs and will be prioritized during future exam development efforts.
HPCC Looks Forward to the Future
HPCC acknowledges that there is significant work ahead and is committed to continued growth of the DEIB Task Force, evaluation of comprehensive differential analysis, efforts to advocate for diversity within HPCC’s volunteer committees, and transparent exam development processes. Fully completing these initiatives will take time, but HPCC is confident that the results will help the entire organization move forward into a more inclusive future. The Board of Directors and staff look forward to continued growth in these areas as we strive to be the premier national credentialing organization that advances expert care in serious illness.
Contact: Ashley Farrington, Marketing Specialist