Exam Development & Scoring

Exam Development 

All NCCPA exams are built to the specifications outlined in their respective content blueprint. The content blueprint is a set of specifications that describes the relative proportion of questions from each content category and task area that should be included on a test form. The blueprint is the output of a practice analysis, which is an analysis of the various diseases and disorders PAs encounter and the skills they use in practice.

NCCPA’s exam questions are developed by committees of PAs and physicians selected for both their item writing skills, experience, and demographic characteristics (i.e., practice specialty, geographic region, practice setting, etc.). The test committee members each independently write a certain number of test questions (items), and each item then goes through an intense review by content experts and medical editors. Only items that make it through this robust review are eligible for pre-testing. Proctored NCCPA exams (i.e., PANCE and PANRE) include both scored and pre-test items, and examinees have no way of distinguishing between the two types of items. This allows NCCPA to collect important statistics about how the pre-test items perform on the exam, which informs the final decision about whether a particular test question meets the standards for inclusion as a scored item on future PANCE or PANRE exams. All items presented in PANRE Longitudinal Assessment (PANRE-LA) are scored unless flagged for removal during statistical analysis.

Setting the Passing Standards 

To pass an NCCPA exam, a PA must reach or exceed the passing standard (i.e., passing score) assigned to that specific exam (see table below). The passing standard is determined via a process called standard setting. Standard setting requires a panel of PA content experts with first-hand understanding of the core medical knowledge, skills, and abilities a Board Certified PA should possess for safe and effective practice. The panelists are chosen to be representative of the entire PA profession on a set of criteria including practice setting, practice focus, experience in the field, and other demographic variables.

These content experts engage in a standard setting process known as the modified Angoff method, which requires panelists to review individual test questions and decide whether someone who is just barely qualified to practice would be able to answer the question correctly. The ratings provided by the content experts are aggregated to define a recommended passing score. The recommended passing score then goes to the NCCPA Board of Directors for consideration and final approval.

Exam  Scale Range  Passing Standard 
PANCE  200 – 800  350 
PANRE  200 – 800  379 
PANRE-LA  1000 – 1500  1150 


Scale scores are used to place all scores on a unified scale to adjust for small differences in difficulty of the set of questions an examinee receives. This scoring method ensures no one is unfairly advantaged or disadvantaged by receiving easier or more difficult questions than another individual. As such, the number of correct answers required to meet the passing standard will vary from one examinee to another. 

PANRE-LA Scoring 

Board Certified PAs participating in the PANRE Longitudinal Assessment (PANRE-LA) will receive an interim score following the completion of each quarter reflecting their cumulative performance on scored questions. As a PA progresses through the assessment, their cumulative score will change. The interim score is presented in the form of a graph that displays performance in relation to the passing standard and to other participants. Cumulative performance is a reflection of a collection of scored questions as opposed to an average of quarterly scores. Scores are not broken down by quarter for two reasons:

  • Interim and final scores are based on cumulative performance on the scored responses from 8 of 12 possible quarters.
  • Each quarter starting with the second, 5 topics are repeated to reinforce existing knowledge and facilitate learning. In these cases, the better of the two responses is counted and the other response is removed from the score.

Cumulative scores are calculated each quarter. In the first quarter of each calendar year, scoring is delayed for data collection and test item analysis, but scores will be updated no later than the start of the second quarter. Beginning in the second quarter of the year, scores will update immediately upon completion of 25 questions.

After participating in 8 quarters, PAs who have met or exceeded the passing standard will receive notification that they have passed and have met their recertification exam requirement. PAs who have not met the passing standard after 8 quarters can continue participating in the PANRE-LA process until the end of the three-year assessment period. After each subsequent quarter, scores will be recalculated using only the scored responses from the best 8 quarters to determine if the passing standard has been met, and PAs will be notified when they have passed. This allows PAs the opportunity to continue closing their knowledge gaps and improving their performance to hopefully achieve the passing standard before the conclusion of the PANRE-LA administration.

PAs who do not meet the passing standard within 12 quarters will have up to 3 attempts to take and pass the PANRE at a Pearson VUE testing center before the end of their recertification exam cycle.

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