Translation of Credentialing Examination for Providers with English as a Second Language: An Exploratory Study

Racial and ethnic minorities disproportionately suffer the burden of adverse health outcomes in the United States. Increasing the diversity of healthcare providers may help decrease disparities in outcomes. Unfortunately, language barriers may affect performance in nursing school and credentialing examinations. The purpose of this exploratory study was to identify current practices and trends affecting the translation of credentialing examinations. Commissioned by the National Board of Certification and Recertification for Nurse Anesthetists, a survey was sent to the credentialing organizations soliciting information about their exam translation practices and considerations. Among the 27 credentialing organizations (two licensure and 25 certification organizations) that completed the survey, 63% were from healthcare. All the organizations offered their credentialing examinations in English. Some offered their examination in Chinese/Mandarin (15%), Spanish (11%), French (7%), and Arabic (7%). The majority (78%) do not translate their examinations into another language. Among the six credentialing organizations translating their examinations, 67% translate one, and 17% translate two examinations. Most use the forward and back-translation techniques. For organizations embarking on a multilingual credentialing program, it is imperative to ensure psychometric equivalence of their examinations. Translation can help ensure that candidates are tested on their intended competencies, not their language proficiency.