For candidates seeking the BC-HIS credential

© NBC-HIS, 2023

NBC-HIS reserves the right to make updates to this Self-Study Guide.

Use of the Board Certified in Hearing Instrument Sciences badge and designation BC-HIS is reserved for board certificants.

Introduction   

Individuals who dispense hearing aids refine and enhance a multitude of needed skills through “hands-on” training with patients/clients with hearing loss as well as through ongoing continuing learning (continuing education or CEs). This “hands-on” experience and continual learning, above and beyond the minimum requirements for licensure, is necessary for successful completion of the National Competency Exam (NCE).

Meeting the eligibility requirements to sit for the NCE and passing the NCE is the only way to earn the Board Certified in Hearing Instrument Sciences (BC-HIS) designation.

Board Certification in Hearing Instrument Sciences accredits the skills and competency achieved by a hearing healthcare professional. By earning the BC-HIS designation, you will demonstrate your competency to the public and hearing healthcare professionals.

The NCE is the only board certification exam for hearing healthcare professionals accredited by the National Commission for Certifying Agencies (NCCA), a nationally recognized organization that reviews and accredits international competency testing for certifying organizations. NCCA is part of the Institute for Credentialing Excellence.

Purpose of the Candidate Self-Study Guide

The Candidate Self-Study Guide is a companion to the Candidate Handbook. Together, the pieces are designed to provide candidates with the information needed throughout the process of seeking Board Certification in Hearing Instrument Sciences (BC-HIS). The Handbook provides step-by-step directions and related policies for:

• Applying for board certification,
• Registering for the exam,
• Sitting for the exam, and
• Maintaining board certification.

The Candidate Self-Study Guide provides information about the domains assessed by the exam and guides candidates through the process of self-identifying areas for additional study.

Exam Development Process

The first step in developing the National Competency Exam (NCE) is for Subject-Matter Experts (SMEs) to define the scope of the examination and the target audience for the credential, including a description of the Minimally Qualified Candidate (MCQ), which defines in behavioral terms the level of competence required to pass the exam. The description of the MQC is used throughout the test development process to help ensure the test content domain and its relative level of difficulty are appropriate given the purpose of the exam and other major program parameters.

From there, SMEs work to create and launch a Job Task Analysis study and use the results of the study to create the test blueprint, which includes the competency areas (domains) assessed by the exam, the specific competencies that underlie each domain, and the weighting of each domain. Each domain is described in detail later in this Self-Study Guide.

Even though the NCE has five competency areas, it is scored as a single exam. Each item is scored as either correct or incorrect; there is no partial credit given for any item. The percentage associated with each competency area reflects the proportion of items pertaining to that area that will be on the exam.

Description of the Minimally Qualified Candidate (MQC)

The description of the Minimally Qualified Candidate (MCQ) defines in behavioral terms the level of competence required to pass the exam. The description of the MQC is used throughout the test development process to help ensure the test content domain and its relative level of difficulty are appropriate given the purpose of the exam and other major program parameters.

For the NCE, the minimally qualified candidate has two years of experience as a licensed hearing aid specialist/dispenser or equivalent. Although the individual may work with only a few tools and instruments, they should have a general knowledge of the breadth and depth of available tools and instruments. The individual should be capable of performing or understanding all tasks within the hearing aid specialist scope of practice.

Important Notes about Using the Self-Study Guide

• Use of this Candidate Self-Study Guide and/or the Candidate Handbook does not imply you will receive a passing score on the NCE. The design and purpose of the NCE is to test your skill as a hearing healthcare professional. The accomplishment of the BC-HIS designation rests upon your successful completion of the NCE.
• You can use this tool to help identify your experience level and possible gaps in knowledge or experience. Results are for your use only and do not guarantee proficiency or passing performance on the exam.
• Items (sample questions) provided in the Candidate Self-Study Guide are not, have not, and will not be included on the NCE.
• Performance on those items is not predictive of performance on the NCE.
• While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.
• NBC-HIS does not recommend or endorse any test preparation programs, practice tests, or other similar products. NBC-HIS does not require or recommend any specific preparatory pathway to be eligible to sit for the NCE. Completion of this Self-Study Guide is optional.
• The guide is also available as a downloadable PDF if you prefer to work that way. 

How to use the guide

The purpose of this guide is to familiarize you with competency areas that will be tested, and the different item formats used.

This guide is organized by competency domain. The first part of each section will list the elements of each domain and ask you to self-assess your experience and knowledge of each item. You can use your responses to map a plan of focus points for additional study, experience, or practice.

After you have completed your self-assessment of each area, you will have an opportunity to complete a few sample questions to get a sense of the type and format of questions used and how the questions relate to the test blueprint. You also may find it helpful to look at the sample questions and determine which element from the domain it assesses. A brief commentary is provided with each question to provide you with additional insight in understanding how questions are constructed and mapped to the domain.

The items are representative of the style and content of the items used on the current National Competency Exam (NCE). While some questions may have only one correct answer, some questions may have multiple options that must be chosen to answer the question correctly. If more than one option must be chosen, it will be pointed out in the question. If more than one option is asked for, you must answer with all the correct options to get credit for the question. No partial credit is given. Be sure to read the question carefully and pay special attention to words like: BEST, NEXT, NOT, DO NOT, FALSE, TRUE, SELECT ALL, MOST, and LEAST. 

Create your own learning map

At the end of the Self-Study Guide, you will have the option to add your email address and "submit." You are not required to provide your email address to complete the study guide, but if you do and "submit," the system will send you an email with your self-assessment along with links to additional information and resources. 

Domain 1 Sample Questions

Sample questions are not, have not, and will not be included on the NCE. Performance on those items is not predictive of performance on the NCE. While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.

Correct! B: Moderate to severe mixed hearing loss

Commentary: The scar tissue from previous infections causes the conductive component and continuous gunfire causes the sensorineural component.

Your answer was incorrect. The correct answer is: B: Moderate to severe mixed hearing loss

Commentary: The scar tissue from previous infections causes the conductive component and continuous gunfire causes the sensorineural component.

Correct! C: Ménière's disease

Commentary: These are the classic symptoms of Ménière's disease with low-frequency, often fluctuating hearing loss, tinnitus which is sometimes constant but more often transitory, and episodes of vertigo that typically are also transitory. 

Your answer was incorrect. The correct answer is: C: Ménière's disease

Commentary: These are the classic symptoms of Ménière's disease with low-frequency, often fluctuating hearing loss, tinnitus which is sometimes constant but more often transitory, and episodes of vertigo that typically are also transitory. 

Correct! D: Conversation in a restaurant

Commentary: Background noise can significantly affect someone with moderately severe high frequency loss, and a restaurant is a location where someone is most likely to encounter a significant amount of background noise compared to other situations. 

Your answer was incorrect. The correct answer is: D: Conversation in a restaurant

Commentary: Background noise can significantly affect someone with moderately severe high frequency loss, and a restaurant is a location where someone is most likely to encounter a significant amount of background noise compared to other situations.  

Correct! A: Understanding spouse from another room.

Commentary: This question tests your understanding of conductive hearing loss with a very good word recognition score. Speech at a distance is naturally softer, the most likely area of struggle is hearing and understanding at a distance.

Your answer was incorrect. The correct answer is: A: Understanding spouse from another room.

Commentary: This question tests your understanding of conductive hearing loss with a very good word recognition score. Speech at a distance is naturally softer, the most likely area of struggle is hearing and understanding at a distance.

Domain 2 Sample Questions

Sample questions are not, have not, and will not be included on the NCE. Performance on those items is not predictive of performance on the NCE. While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.

Correct! A: QuickSIN

Commentary: The QuickSIN will measure the ability for the patient to separate speech and noise, helping determine realistic expectations in competing noise environments.

Your answer was incorrect. The correct answer is: A: QuickSIN

Commentary: The QuickSIN will measure the ability for the patient to separate speech and noise, helping determine realistic expectations in competing noise environments.

Correct! B: Otoscopic exam

Commentary: Finding out the source of the debris can help in determining if the problem can be resolved through lavage or medical treatment.

Your answer was incorrect. The correct answer is: B: Otoscopic exam

Commentary: Finding out the source of the debris can help in determining if the problem can be resolved through lavage or medical treatment.

Correct! C: SAT

Commentary: While SRT is the traditional test method, when communication barriers exist, the SAT (speech awareness/detection threshold) is the best solution for determining the lowest threshold of speech detection.

Your answer was incorrect. The correct answer is: C: SAT

Commentary: While SRT is the traditional test method, when communication barriers exist, the SAT (speech awareness/detection threshold) is the best solution for determining the lowest threshold of speech detection.

Correct! A: Reduce the MPO

Commentary: Since normal conversation is good, you don’t want to impact that. Lowering the MPO will address the uncomfortable sounds.

Your answer was incorrect. The correct answer is: A: Reduce the MPO

Commentary: Since normal conversation is good, you don’t want to impact that. Lowering the MPO will address the uncomfortable sounds.

Domain 3 Sample Questions

Sample questions are not, have not, and will not be included on the NCE. Performance on those items is not predictive of performance on the NCE. While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.

Correct! A: TV Streamer Device

Commentary: Utilizing a TV streamer allows for the signal to be directly sent to the hearing aids, minimizing the interference of background noise in the room. 

Your answer was incorrect. The correct answer is: A: TV Streamer Device

Commentary: Utilizing a TV streamer allows for the signal to be directly sent to the hearing aids, minimizing the interference of background noise in the room. 

Correct! C: Sound localization

Commentary: This is a possible example of a rare "negative" or “NOT” question and a reminder to read all questions carefully. Three of the choices given are true challenges with IIC fittings for a mild loss patient. Sound localization is not a contraindication.

Your answer was incorrect. The correct answer is: C: Sound localization

Commentary: This is a possible example of a rare "negative" or “NOT” question and a reminder to read all questions carefully. Three of the choices given are true challenges with IIC fittings for a mild loss patient. Sound localization is not a contraindication.

Correct! A: Otitis externa and B: Exostosis

Commentary: This is a possible example of a rare question asking for two correct answers and a reminder to read all questions carefully. The presence of otitis in the auditory canal is a clear contraindication. An IIC fitting is not an impossible fitting with exostosis, but it could be an issue. However, the other two choices given are not contraindications to an in-the-ear fitting.

Your answer was incorrect. The correct answer is: A: Otitis externa and B: Exostosis

Commentary: This is a possible example of a rare question asking for two correct answers and a reminder to read all questions carefully. The presence of otitis in the auditory canal is a clear contraindication. An IIC fitting is not an impossible fitting with exostosis, but it could be an issue. However, the other two choices given are not contraindications to an in-the-ear fitting.

Correct! B: RIC and BTEs have a wider fitting range. and D: Custom devices are simpler to insert.

Commentary: This is a possible example of a rare question asking for two correct answers and a reminder to read all questions carefully. The same RIC can typically be fit with S-power through HP-power receivers, and UltraPower BTEs are currently the most powerful hearing aids available, and therefore these styles offer the widest fitting range. Custom devices are simpler to insert since they don’t require a double action of placing one part in the ear and the other part over the ear like RIC and BTE aids.

Your answer was incorrect. The correct answer is: B: RIC and BTEs have a wider fitting range. and D: Custom devices are simpler to insert.

Commentary: This is a possible example of a rare question asking for two correct answers and a reminder to read all questions carefully. The same RIC can typically be fit with S-power through HP-power receivers, and UltraPower BTEs are currently the most powerful hearing aids available, and therefore these styles offer the widest fitting range. Custom devices are simpler to insert since they don’t require a double action of placing one part in the ear and the other part over the ear like RIC and BTE aids.

Domain 4 Sample Questions

Sample questions are not, have not, and will not be included on the NCE. Performance on those items is not predictive of performance on the NCE. While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.

Correct! A: Compression too high

Commentary: Voices that are closer are typically louder. When voices are further away, they are softer. When compression is too high, softer distant voices can be significantly amplified while louder and closer voices get compressed.

Your answer was incorrect. The correct answer is: A: Compression too high

Commentary: Voices that are closer are typically louder. When voices are further away, they are softer. When compression is too high, softer distant voices can be significantly amplified while louder and closer voices get compressed.

Correct! C: Grind and polish the shell at the bottom of the aid where the redness appears.

Commentary: This is a new custom aid. A slight reduction in the shell material at the sore point is likely all that is needed for this patient, and the patient is not without the aid for one to two weeks for a lab remake. 

Your answer was incorrect. The correct answer is: C: Grind and polish the shell at the bottom of the aid where the redness appears.

Commentary: This is a new custom aid. A slight reduction in the shell material at the sore point is likely all that is needed for this patient, and the patient is not without the aid for one to two weeks for a lab remake. 

Correct! C: Create a noise program with omni directionality.

Commentary: A noise program with an omnidirectional microphone setting allows the microphones to search for speech signals from all directions. This would make it easier for the patient to hear voices from behind.

Your answer was incorrect. The correct answer is: C: Create a noise program with omni directionality.

Commentary: A noise program with an omnidirectional microphone setting allows the microphones to search for speech signals from all directions. This would make it easier for the patient to hear voices from behind.

Correct! B: Microphones are obstructed.

Commentary: Microphone obstruction would allow the indicator tones to be heard but ambient sounds to be obstructed.

Your answer was incorrect. The correct answer is: B: Microphones are obstructed.

Commentary: Microphone obstruction would allow the indicator tones to be heard but ambient sounds to be obstructed.

Domain 5 Sample Questions

Sample questions are not, have not, and will not be included on the NCE. Performance on those items is not predictive of performance on the NCE. While generally indicative of the types of questions you will find on the NCE, the items and the feedback provided with them have not undergone beta testing or a full psychometric review. They are provided to give you a general idea of how items are written to assess your knowledge and skills related to the test blueprint.

Correct! B: Proceed with audiometric testing and explain effective ear canal cleaning. 

Commentary: Opaque appearance of the TM is consistent with otosclerosis and is not a reason to halt testing or withhold treatment.  A small amount of cerumen present should not preclude testing as long as the TM is adequately visible.  In this case, the TM was clearly visible since the otoscopy revealed the opaque surface.

Your answer was incorrect. The correct answer is: B: Proceed with audiometric testing and explain effective ear canal cleaning. 

Commentary: Opaque appearance of the TM is consistent with otosclerosis and is not a reason to halt testing or withhold treatment.  A small amount of cerumen present should not preclude testing as long as the TM is adequately visible.  In this case, the TM was clearly visible since the otoscopy revealed the opaque surface.

Correct! D: Counsel on realistic expectations

An effectively fitted patient may experience difficulty hearing from a distance, especially when the TV is louder than voices at a distance. Counseling on realistic expectations and effective communication techniques is key to optimal patient care.

Your answer was incorrect. The correct answer is: D: Counsel on realistic expectations

An effectively fitted patient may experience difficulty hearing from a distance, especially when the TV is louder than voices at a distance. Counseling on realistic expectations and effective communication techniques is key to optimal patient care.

Correct! C: Using a hearing instrument buying group to secure more favorable pricing than your competition

Commentary: This is an example of a rare DO NOT item and a reminder to read the questions carefully. The question is looking for an answer that does NOT apply to the Code of Ethics. There is no restriction within the NBC-HIS Code of Ethics that precludes a practice from securing favorable pricing through buying groups. The Code of Ethics specifically does include reference to the other answers given.  

Your answer was incorrect. The correct answer is: C: Using a hearing instrument buying group to secure more favorable pricing than your competition

Commentary: This is an example of a rare DO NOT item and a reminder to read the questions carefully. The question is looking for an answer that does NOT apply to the Code of Ethics. There is no restriction within the NBC-HIS Code of Ethics that precludes a practice from securing favorable pricing through buying groups. The Code of Ethics specifically does include reference to the other answers given.  

Correct! A: Cochlear implant

Traditional binaural amplification is inadequate to improve outcomes for this patient. A cochlear implant could significantly benefit the patient’s word recognition while neither the BAHA nor the Bi-CROS will assist in sound localization.

Your answer was incorrect. The correct answer is: A: Cochlear implant

Traditional binaural amplification is inadequate to improve outcomes for this patient. A cochlear implant could significantly benefit the patient’s word recognition while neither the BAHA nor the Bi-CROS will assist in sound localization.