At its April 9, 2022, meeting, the NBRC Board of Trustees voted to make a significant change to the examination system for the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) credentials which will be implemented in January 2027. The NBRC is transitioning to a single examination to further minimize barriers to graduates as they enter the profession while maintaining the standards of excellence associated with the CRT and RRT credentials. As you may recall, the Board of Trustees made an important transition in 2015 by removing the second multiple-choice examination that candidates had to take to earn the RRT credential, so this is a continuation of those efforts.

We will shift to a single multiple-choice examination, eliminating the Clinical Simulation Examination, designed to cover the breadth of knowledge and depth of clinical judgement needed to document the competencies of respiratory therapists who achieve CRT and RRT credentials in the future. The new examination will be called the Respiratory Therapy Examination. The examination will have two cut scores that determine whether passing candidates receive credentials as a CRT or as an RRT. Individuals achieving the low cut score earn the CRT credential and those who achieve the high cut score earn the RRT credential.

The Respiratory Therapy Examination will be assembled in two sections, one to assess candidates’ breadth of knowledge and one to assess their depth of clinical judgment. The breadth of knowledge section will be organized around the same content domains and cognitive levels that have guided development of the Therapist Multiple-Choice Examination. The depth of clinical judgment section will be organized around the following elements of the current simulation examination:

• Patient types (e.g., chronic airways disease, trauma, cardiac)
• Settings (in-hospital, out-of-hospital)
• Patient ages (neonate, pediatric, adult)
• Clinical activities (information gathering, decision making)

The entire examination will be assembled from independent, multiple-choice items resulting in one overall CRT passing standard and one overall RRT passing standard. Details about elements within both sections will be shared after a job analysis study defines them in 2024.

The Board intends to maintain standards for achieving CRT and RRT credentials in the future rather than make it easier or more difficult. Starting in 2027, those who earn the CRT credential must select enough correct responses in the clinical judgment portion of the examination to pass overall, whereas they have been able to bypass a deep clinical judgment assessment by avoiding the simulation examination. Those who earn the RRT must at least equal the high standard that has been associated with this credential since it began in 1961.

More information about the new single examination is below.

Q: What is the name of the new exam?

A:  The Respiratory Therapy Examination

Q: How many questions are on the Respiratory Therapy Examination?

A: The Respiratory Therapy Examination consists of 185 multiple-choice items (160 scored items and 25 pretest items).

Q: What are the examination fees?

A: The Respiratory Therapy Examination costs $360 for new applicants and $300 for repeat applicants.

Q: What is the time limit for the examination?

A: The examination time limit will be 4 hours.

Q: How will the CRT and RRT credentials be awarded to passing candidates?

A: The examination will have two cut scores that determine whether passing candidates receive credentials as a CRT or as an RRT. Individuals achieving the low cut score earn the CRT credential and those who achieve the high cut score earn the RRT credential.

Q: What if I pass the Therapist Multiple-Choice Examination at the high cut score and don’t successfully complete the Clinical Simulation Examination before December 31, 2026?

A: The CSE will be available through December 31, 2027, for those individuals who pass the TMC at the high cut score prior to December 31, 2026. Alternatively, individuals may also take the new exam and pass at the high cut score to earn the RRT credential after January 1, 2027.

As we work towards implementation in 2027, we will keep you updated with new information posted on our website and social media outlets. We look forward to these exciting changes coming to the respiratory care credentialing system!

For questions, please email us at info@nbrc.org, or call 913.895.4900.