To align with best practices and to ensure that the program remains current and relevant, the Certification Committee has determined that a job analysis should be conducted every 5 years.

In 2022, the NAWCO began the redevelopment of its Wound Care Certification (WCC) examination. The purpose of this summary is to explain the Test Development Process.


The JTA process included 3 steps.

  1. A job task analysis (JTA) is conducted to identify the essential tasks and related knowledge and skills required of a wound care professional. This was accomplished by convening  a group of subject matter experts (SMEs), selected to represent the field as a whole, who were guided through a research based process to identify this information.
  2. They then worked as a group to translate these essential job tasks, knowledge and skills into content that could be readily measured on the WCC exam. This group also provided input on the relative importance of the various content.
  3. This work was then validated through an online survey distributed to more than 13,000 members of the wound care profession. Respondents included RNs, LPNs, APNs, MDs, PTs and OTs. The input provided by both the group of professionals as well as the respondents became the basis of the WCC exam content, referred to as the blueprint.

The 3 steps to the JTA process yielded valid, practice-based, and thoroughly reviewed recommendations for the WCC exam blueprint.


Once the updated exam blueprint was generated from the JTA, SMEs conducted a formal review of the existing bank of WCC exam items. This was done to ensure the currency and accuracy of the items as well as their relevance to the updated exam blueprint. Some items were kept, others were edited, and yet others were removed from use in the item bank.

Next, SMEs wrote additional WCC items. All SMEs engaged in this activity were given training on item writing, and all new items were then reviewed by a group of SMEs before being approved for use.

Using a combination of new and previously written items, WCC exam forms were assembled to meet the updated WCC exam blueprint. This means that the WCC forms match the content and number of items recommended by the SMEs and survey respondents who participated in the JTA.

The first administration of a WCC exam based on the updated WCC exam blueprint was on November 15, 2023. In order to evaluate the technical characteristics of the new items and forms, scores were not immediately reported. Rather data was collected for the first few weeks of exam administrations and then used for statistical analyses. These analyses included consideration of the difficulty, discrimination and reliability of the items. Adhering to the exam blueprint, items were approved for use in the determination of candidates’ scores. In the future, such analyses will be conducted on a regular basis to monitor the quality of the items and forms as well as to approve new items for use on future WCC exam forms.


Standard setting is the process by which the passing performance, or cut score, is determined on an exam. Standard setting for the WCC exam will be completed by a group of SMEs selected to represent the field of wound care professionals. This group will be guided through a formal process that includes discussing the meaning of passing the exam with regard to the minimum knowledge skills and abilities required of a candidate and then translating that information into performance on the WCC exam. During the standard setting process, the SMEs will be provided with additional information to inform their input including empirical item statistics, impact data based on candidates who took the WCC exam during the winter of 2023. The outcome of standard setting will be a recommended range of cut score from the SMEs that will then be reviewed by the NAWCO Certification Committee who will then select the final cut score that will be applied to the WCC exam.

The standard setting will include two forms of the WCC exam. To apply the cut score to subsequent forms of the exam, a statistical process called equating is then employed. Equating accounts for the differences in items and item difficulties on forms and makes adjustments such that the cut score on each form reflects equivalent performance on the exam. This process of equating is essential to the fairness of the WCC exam program as it provides equivalent expectations of “passing” performance over time and across forms of the exam.


The recent and upcoming efforts to update and maintain the WCC exam were and will be done following best practice and utilizing the expertise of experienced wound care professionals throughout the process. During each step of the process to update the exam, NAWCO has, and will continue to focus on producing a valid and fair exam for candidates and the field.