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Adult Critical Care Specialty Credential​​​​

In 2012, the NBRC launched a new specialty examination for respiratory therapists working in adult critical care settings. We sought input from a variety of organizations representing professionals involved in the arena of adult critical care so we could create a valuable credential that your employer, colleagues and patients will recognize and respect.


This specialty examination program was built on a collaborative effort with other organizations with a vested interest in protecting the public and improving care for adult patients receiving treatment in critical care settings. Because of this effort, this program has wide support from organizations such as:

  • The American Association for Respiratory Care
  • The American College of Chest Physicians
  • The American Society of Anesthesiologists
  • The American Thoracic Society

The Adult Critical Care Specialty Examination program is designed specifically for a respiratory therapist with the RRT credential and experience in the field of adult critical care.


Eligible certificants have already demonstrated advanced knowledge in the field of respiratory care; therefore this examination will focus on competencies unique to therapists practicing in an adult critical care setting and not basic competencies of general respiratory care.


Why should you earn the RRT-ACCS credential? The answer is simple—this specialty examination is unique to your daily tasks as an adult critical care specialist. It goes above and beyond general respiratory care activities so you can demonstrate your enhanced skill level in a fast-growing specialty within the field.


If you are planning to take any of the credentialing examinations offered by the National Board for Respiratory Care, Inc. (NBRC), the Self-Assessment Examination provides an excellent opportunity for you to find out in advance how well you will do. The SAEs are available in web-based format and more information can be found by clicking the Self-Assessment Examination Quick Link.


Admission Requirements

  1. Applicant shall be a Registered Respiratory Therapist (RRT) for at least one year prior to applying for the Adult Critical Care Specialty Examination.

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Free Practice Examination


The web-based NBRC practice examinations are designed to simulate taking an NBRC examination. The software is identical to that which is used for the administration of NBRC examinations. To use this software, you will need a compatible internet browser such as the current version of Internet Explorer, Chrome, Firefox, or Safari. Other browsers may or may not work. Cookies and scripting must be enabled. Pop-up blocking must be disabled.

Clicking the hyperlink below will open the practice examination login page. Please read the following instructions:


  • Login using your e-mail address. Your results will be sent to this address.
  • Use the mouse to select your responses and to maneuver through the examination.
  • To obtain your results, you must take the entire examination in one sitting. Your results are not saved if you exit the examination.
  • When you have completed the examination, click Finish and Display. Your results are displayed onscreen and will be e-mailed to you if you provided your e-mail address on the login page.
  • If you need help using the examination software, click on the Help button in the lower portion of the screen once you begin the examination.
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Adult Critical Care Specialty Credential FAQs

    • ​Can I schedule my examination online?

    Yes. If you are already approved to take an NBRC examination and all fees are paid, you may schedule online from the NBRC website or from the testing agency's website, www.goAMP.com.​
    • What is the application process?​

    You may apply online using the "Submit Application" link located on each examination page or complete and submit a paper application and appropriate fee when the admission requirements are satisfied. If mailing your application, the NBRC recommends using certified mail or a certificate of mailing and keeping your receipt as proof that your application was sent to the NBRC. Ineligible applications submitted to the NBRC will be returned, less a $50.00 processing fee.​
    • When are NBRC examinations administered?​

    NBRC examinations are administered by computer on a daily basis (Monday-Saturday) at over 170 Assessment Centers across the country. A complete list can be found here.​
    • What are the examination fees?​

    The cost for a new applicant is $300. The cost for a repeat applicant is $250.​
    • Why were secondary test specifications included for this examination?​

    There are two sets of secondary test specifications. One set is for items that will engage candidates' thinking about ethics of the situation. The other set is defined by patient condition.

    Addressing content about ethics first, this was a choice that the NBRC made when it decided to develop this specialty examination. Specialists do engage in situations that include ethical elements, so part of producing a relevant examination is mirroring those situations. In contrast to a CRT Examination, which should assess whether a therapist is safe and competent to provide general respiratory care, ethical considerations become a small part of what it means to be recognized as a specialist. To illustrate the difference, consider whether a candidate who incorrectly answered an ethics item should fail to become a CRT and access the gateway to licensure. The NBRC has concluded that the answer to that question is "no" at this point since the focus should be on safety as people enter practice. Conversely, when asked whether someone should fail to achieve a specialty credential because of performances on ethics items, the answer is "yes."

    Because the ACCS Examination is a specialty examination, it is more strongly oriented to clinical situations and oriented less toward the technical elements of respiratory care. Without secondary specification, the NBRC knew there was a risk to standardized testing by unknowingly letting one test form emphasize one type of patient condition too much or differently than another test form. For example, one test form could have five items about patients with congestive heart failure while another form might not include any. Therefore, secondary specifications are critical to aligning examination content with activities of specialists and standardizing test forms among candidates.​
    • When is the application deadline?​

    There are no application deadlines. If you meet the admissions requirements for an examination, you may submit your application and fee at any time. Your application may be submitted online or can be downloaded and printed from this website.​
    • When I earn the RRT-ACCS credential, do I have to recertify?​

    Yes. All credentials earned on or after July 1, 2002 must be recertified. The NBRC strongly supports continued competency for the practitioners it certifies by requiring recertification every five years. The RRT-ACCS certificants will be no different and will be required to demonstrate their continued competence through the NBRC's Continuing Competency Program (CCP).​
    • What information does the confirmation of eligibility notice contain?​

    The confirmation notice contains a website address and toll-free telephone number for you to contact the NBRC to schedule an examination appointment. Appointments may be scheduled a minimum of three days prior to the desired testing date. Note: Examinations will not be offered on nationally recognized holidays.​
    • How long does it take to process my application?​

    If applying and paying by credit card online, your application will be processed immediately. If mailing your application and fee to the NBRC, your application will be processed within approximately two weeks after receipt by the NBRC. A confirmation notice of your eligibility will be sent to you. If your eligibility cannot be confirmed, a letter explaining the information that is still needed will be sent to you.​
    • How did the NBRC determine content for the examination?​

    The NBRC conducted a job analysis study to ensure the examination content would be job related and based on tasks performed by practitioners in this specialty area. We sent several thousand surveys to individuals who are involved in the delivery of care to patients in the adult critical care setting to rate the importance of job tasks.​
    • Why did the NBRC create the Adult Critical Care Specialty Examination program?​

    The American Association for Respiratory Care (AARC) requested that the NBRC determine the desirability and feasibility of developing a specialty examination for respiratory therapists working in the adult critical care arena. After following a long established, five-step process to determine if a new specialty examination for adult critical care specialists was warranted and feasible, we discovered the answer was overwhelmingly yes.​
    • Is a practice test available?​

    A free, 50-item practice examination is available to candidates at no charge to familiarize themselves with the content and types of questions that will be included on the regular exam.​
    • ​What does the examination cover?

    Candidates for this examination have already demonstrated advanced knowledge of general respiratory care competencies. This examination concentrates on those competencies that are unique to the adult critical care setting. It will not include items about general respiratory care.​
    • What if I do not receive a confirmation of eligibility in the mail once my application has been submitted?​

    If you do not receive a confirmation of eligibility or an incomplete notice from the NBRC within four weeks after mailing your application, contact the NBRC. If your application is not on file, you will be asked to send a replacement application form and fee.​
    • How long does the examination last?​

    Candidates will have four hours to complete the 170-item examination.​
    • Where can I find more information on the new examination?​

    Visit www.nbrc.org and click on the 'Examinations' tab. The NBRC constantly updates the website to keep the information current.​
    • Why should I earn the RRT-ACCS credential?​

    The new specialty examination is unique to your daily tasks as an adult critical care specialist. It goes above and beyond general activities so you can demonstrate your acquired skill level in an expanding specialty within the field of respiratory care.​
    • Why is the free practice examination shorter than the live examination?​

    The examination committee recommended and the Board accepted production of a one-third-length practice examination so the committee could move on to developing live test forms sooner.

    The practice examination covers the content domains and cognitive level item types in the same proportions as live examinations cover. The same examination committee developed the practice examination and live examinations.

    If someone is assessing whether he or she is ready for the ACCS Examination and concludes that the free practice examination gives them too little information, then there is a self-assessment examination (SAE) that he or she can purchase by following this link. The ACCS SAE is the same length as live examinations and developed by the examination committee. As with other SAEs that are associated with NBRC examinations, each option is explained.

    The NBRC has no plan to develop a full-length free practice examination at this time given the significant resources that have been necessary to develop ACCS examinations to date and in the future.​

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