Certified Diabetes Educator Exam

From Exampedia
Jump to: navigation, search

Certified Diabetes Educator (CDE)

History

Diabetes educators are health care providers who have specialty training and experiencing in educating patients with diabetes on ways to manage their own health.[1] The diabetes educator has been recognized as a specialized role within the health care system since 1973, when the membership organization the American Association of Diabetes Educators (AADE) was formed.[2] As an independent certification organization, the National Certification Board for Diabetes Educators (NCBDE) maintains sole responsibility for credentialing and maintaining standards for assessing and certifying diabetes educator competence.[3] The NCBDE was established in 1986, when it began administering the Certified Diabetes Educator (CDE) examination. Over 1,200 individuals sat for the first exam.[4] In 2009, the CDE exam became computer-based and testing dates, which were previously available on only two days each year, were expanded to cover two, 2-month periods each year.[5] Today, more than 18,000 professional diabetes educators have been certified by the NCBDE.[6] The exam is not without controversy. Some professionals feel that the NCBDE’s experience requirement is too difficult for some diabetes educators to meet. The AADE, though 60% of its membership ranks are certified, advocated a tiered approach that allowed states to license diabetes educators without certification. Many CDEs did not agree and, in order to protect the reputation of the CDE credential as the gold standard for competence in the field, formed a new organization, the Academy of Certified Diabetes Educators (ACDE) in 2014 as a not-for-profit advocacy group to advance the profession, improve education opportunities for CDEs, and provide a voice for legislative action in support of diabetes education.[7]

Function of the Test

Certified Diabetes Educator Study Guide

The AADE recommends that health care professionals who wish to specialize in the field seek formal certification in order to demonstrate an advanced level of knowledge and skill in counseling and teaching patients to effectively prevent, monitor and manage their diabetes.[8] The CDE is a widely recognized and respected credential within the health care industry.[9] Only qualified, licensed health care professionals are eligible to sit for the CDE exam. Practitioners in the field of medicine (physicians, nurses, and physicians’ assistants), psychology, nutrition/dietetics, physical and occupational therapy, exercise physiology and pharmacy are all eligible, as are those holding an advanced degree in social work.[10] In addition to the appropriate professional licensing, candidates must have at least 2 years’ experience in their profession, and 1,000 or more hours providing diabetes self-management education to patients in a professional capacity.[11] Those with advanced degrees in related health care disciplines who also meet the 2 years’ professional practice requirement plus a 2,000 hour experience requirement may apply using the “Unique Qualifications Pathway.”[12] Currently, half of all CDEs are professional nurses, and another 40% are registered dieticians or nutritionists.[13]

Test Administration

Certified Diabetes Educator Flashcards

The CDE exam is offered over a 2-month period in the spring (May-June) and fall (November-December) each year at Applied Measurement Professionals (AMP) testing sites across the United States. Applications must be received between January 15 and March 15 to take the exam in the spring, and between July 15 and September 15 for the fall exam. The cost to take the exam is $350, which includes a non-refundable $100 processing fee.[14] Applications may be made online or on paper. First-time candidates who are professional social workers or otherwise applying through the “Unique Qualifications Pathway” may not apply online. Those who wish to have a unique identifying number assigned to them in lieu of using social security number must also apply on paper and request an identifier be assigned to them. Applications (both online and paper) are made directly to the testing vendor AMP.[15] Candidates who do not pass the exam may take the exam again as many times as they wish, provided they meet all eligibility requirements at the time of reapplication, and pay the $350 application fee.[16] Special testing accommodations may be made available for candidates with disabilities as defined in the Americans with Disabilities Act (ADA). A “Request for Special Accommodations” form along with written documentation from a professional qualified to describe and assess the limitations imposed by the candidate’s disability must be submitted to AMP along with the application.[17]

Test Format

Sections of the CDE Test
CDE Test Subject Areas # of Questions
Assessment of Diabetes and Prediabetes 60
Interventions for Diabetes and Prediabetes 89
Disease Management 26
Total 175

Test Structure

The Certified Diabetes Educator exam contains 175 questions that have to do with three major topics: Assessment of Diabetes and Prediabetes; Interventions for Diabetes and Prediabetes; Disease Management. There are an additional 25 pretest questions that will be unscored. All 200 questions are multiple-choice. A time limit of four hours is allotted to complete all questions.[18]

Test Environment

The CDE takes place at AMP Assessment Centers. There, candidates are expected to arrive at least fifteen minutes early in order to allow time to check in. Two forms of identification are required, one of which must be a government issued, photo ID, such as a driver's license. The other ID must contain a name and signature, such as a credit card or a social security card. Personal items, such as notes, phones, books, and wallets are not allowed. A locker will be provided to store all personal items. A nonprogrammable calculator is permitted, and scratch paper and pencils will be provided upon check in.

Test Content

What is the first step in the process of diabetes self-management education?

  1. A. Assessment
    B. Goal setting
    C. Diagnosis
    D. Referral
  2. A patient who has identified himself as a visual learner would likely most prefer which method of instruction?
    A. Role-playing a scenario in which he orders a balanced meal at a restaurant
    B. Seeing pictures of food portions followed by booklets on meal planning
    C. A spoken explanation of how to adjust insulin depending on pre-meal glucose
    D. Group discussion on challenges relating to dealing with the stress of diabetes
  3. Which of the following choices would be the most appropriate method for screening for patient numeracy challenges?
    A. Ask the patient about the highest grade he or she completed and how well the patient did in math.
    B. Ask the patient if he or she has any trouble doing math problems.
    C. Give the patient a standardized assessment test to be completed at home and have the patient bring it to the next appointment.
    D. Present applicable hypothetical situations, such as choosing a menu with specified total grams of carbs or calculating a mealtime insulin dose using a correction scale.
  4. Which explanation best describes how steroid use most affects blood glucose?
    A. Steroid use induces insulin resistance and affects glucose metabolism, which is manifested especially in post-prandial glucose levels.
    B. Steroid use decreases the rate of insulin metabolism and therefore increases the risk for hypoglycemia.
    C. Steroid use increases insulin resistance and is specifically manifested in fasting glucose levels.
    D. Steroids suppress the immune system and deactivate a portion of both endogenous and exogenous insulin. Therefore, blood glucose typically rises with steroid use.
  5. Your patient has had type 2 diabetes for the past twelve years. He controls his diabetes with diet, exercise, and oral medication. Similarly, he watches his fat intake because of occasional borderline LDL (currently WNL). His last three HbA1c labs were all less than 7%. He has no apparent co-morbidities. According to the American Diabetes Association Standards of Practice (2013), which of the following screenings is not indicated annually for this patient?
    A. HbA1c
    B. Comprehensive foot exam
    C. Dilated eye exam
    D. Fasting lipid profile
  6. In the last few years, professional diabetes organizations including the ADA have adopted the A1c test as a diagnostic tool. In order for a valid diagnosis to be made using the HbA1c of = 6.5%, which of the following stipulations or qualifiers must also be present?
    A. HbA1c must be accompanied by a fasting glucose test of over 126 mg/dL
    B. The patient must also have symptoms of hyperglycemia
    C. The patient must also have at least one episode of random plasma > 180 mg/dL
    D. HbA1c test must be NGSP-certified and standardized to the Diabetes Complications and Control Trial (DCCT); repeat test is recommended
  7. Which of the following nutrition modifications is not recommended for patients who suffer from gastroparesis?
    A. Increased dietary fiber
    B. Frequent small meals
    C. Decreased dietary fat
    D. Soft (i.e. over-cooked) or liquid foods
  8. Which of the following behavioral goals is measurable?
    A. "Improve diabetes control by managing my portion size"
    B. "Increase cardiovascular endurance by January 1"
    C. "Run 20 minutes at least three times per week"
    D. "Minimize the risk of diabetic eye disease by keeping my ophthalmology appointments"
  9. Which of the following personal characteristics has proven to positively affect behavioral outcomes through healthy coping to one’s diabetes?
    A. Stubbornness
    B. Affluence
    C. Optimism
    D. Consistency

More free Certified Diabetes Educator practice test questions.

Scoring

The exam assesses current job-related knowledge in the field of diabetes education using 200 multiple-choice questions which are based on current practices in the field. Questions are periodically updated using job analysis surveys. The most recent of these surveys was conducted in 2013.[19] 25 of the 200 items on the exam are pretest items included for evaluation only, and are not used to calculate the final score. While taking the test, candidates may skip over questions or mark questions for review and return later to mark or change an answer. Candidates are encouraged to answer all of the questions, if possible, during the 4-hour testing window. Since only correct answers are counted when computing the final score, there is no guessing penalty. Different forms of the exam, containing various combinations of questions from a pool of available questions, are administered, and thus there may be slight variations in difficulty among different forms. Therefore, raw scores are converted using a weighting factor into scaled scores to determine a candidates pass/fail status. The scaled scores range from 0 to 99 points; a scaled score of 70 is required to pass the exam.[20] Pass rates are fairly consistent among first-time candidates. For example, in 2014, 2182 candidates sat for the CDE examination; of these, 1515 were first-time candidates. The pass rate for first-time candidates that year was just over 65%.[21]

Recent/Future Developments

Currently states other than Kentucky do not require licensure for diabetes educators, though some states have proposed legislation to define the requirements and scope of practice for the profession. The NCBDE has created a model act advocating certification as a means of verifying competence for diabetes educators seeking a state license, and has advocated with the states to require competency examinations and to promote inclusion of the CDE credential as an automatic qualification for licensure. These activities are intended to insure that standards for professional competency are enforced via state licensing processes not only to advance the profession, but to protect the public interest.[22]

Answers to Sample Questions

1;A 2;B 3;D 4;A 5;A 6;D 7;A 8;C 9;C

References

  1. ^ About Diabetes Education March 17, 2015
  2. ^ About Us March 19, 2015
  3. ^ NCBDE FAQs March 17, 2015
  4. ^ History and Activity of the American Association of Diabetes Educators March 19, 2015
  5. ^ Summary of the 2009 Certification Examinations and Renewal of Certification by Continuing Education March 21, 2015
  6. ^ About the Academy March 21, 2015
  7. ^ New Academy for Certified Diabetes Educators Butts Up Against AADE March 21, 2015
  8. ^ The Scope of Practice, Standards of Practice, and Standards of Professional Performance for Diabetes Educators March 19, 2015
  9. ^ CDE Certification March 19, 2015
  10. ^ Discipline Requirement March 19, 2015
  11. ^ Professional Practice Experience March 19, 2015
  12. ^ Instructions for Submission of Unique Qualifications (UQ) Pathway* Application March 19, 2015
  13. ^ 2015 Count of CDEs by State and Other Statistics March 21, 2015
  14. ^ Examination Details March 21, 2015
  15. ^ 2015 Certification Examination for Diabetes Educators Handbook March 21, 2015
  16. ^ Post Examination Information March 21, 2015
  17. ^ 2015 Certification Examination for Diabetes Educators Handbook March 21, 2015
  18. ^ CDE Certification Handbook 17 April 2015
  19. ^ Preparing for the Exam March 21, 2015
  20. ^ 2015 Certification Examination for Diabetes Educators Handbook March 21, 2015
  21. ^ Summary of the 2014 Certification Examinations and Renewal of Certification by Continuing Education March 21, 2015
  22. ^ Statement on Kentucky Diabetes Educator Licensure Law March 21, 2015