NBC-HIS Exam Committee Application 2024

NBC-HIS Exam Committee

Application Form
NBC-HIS has a wonderful opportunity for highly motivated professionals to share their hearing healthcare knowledge and expertise as Subject Matter Experts (SMEs) working on exam development work.

The committee meets to contribute to exam development activities and will review the format, content, structure, and outcomes of the National Competency Exam (NCE). The committee is supported by NBC-HIS’ contracted psychometric partner. Strict confidentiality of all examination and meeting content is required.

Participation in test development activities is a rewarding experience that allows volunteers to develop new professional skills and learn from your peers.
Requirements, Qualifications & Availability

Qualifications. All applicants must:
- Be board certified in good standing;
- Have a minimum of two (2) years of full-time dispensing experience;
- Have a current State/Provincial license or Certificate of Registration (where applicable) that allows for the dispensing of hearing aids.
Requirements
- All selected committee members will be asked to sign a confidentiality agreement and conflict of interest disclosure. Note that participation on this committee will preclude you from work on any NCE exam preparation or similar programs.
- To protect the confidentiality and integrity of both the NCE and the education and exams offered by the International Hearing Society, professionals who have worked on any of the following IHS projects are not eligible to serve on the exam committee: International Licensing Examination for Hearing Healthcare Professionals (ILE), Practical Examination, Distance Learning for Professionals in Hearing Health Sciences course, the Advanced Education Project, or the IHS Board of Governors. If appointed to the Exam Committee, you are precluded from participation in these activities for a period defined in the confidentiality agreement.
- Strict confidentiality of all examination and meeting content is required.
Availability. If selected, exam committee members will need:
- A passport or appropriate documentation for travel to the United States. Travel expenses consistent with NBC-HIS policy will be covered.
- To attend an in-person meeting in May in Michigan. New exam committee training will be provided at this meeting.
- To attend an in-person meeting in July or August in Michigan. Exact dates to be determined after the May meeting.
- To participate in virtual meetings as called and to complete work independently between meetings.
- The two meetings this year are likely the only two in-person meetings for the duration of this committee term assignment. Additional meetings will take place approximately once a year virtually.
I have the above listed qualifications, meet all requirements, and agree to participate as listed above if selected for the NBC-HIS Exam Committee.*

Clear
Selection Process and Timeline

Applications are due by March 6, 2024

Applications will be reviewed first by a nominating committee and then the NBC-HIS Executive Council. Please note that reponses provided within the form will be shared without edits.

Notifications to selected members will happen by the end of March.

The committee will have its first meeting in May in Michigan. Participation in this meeting is mandatory for selected exam committee members.

Committee terms are for three years. Members can apply for three consecutive three-year terms. Applications are required for each term.

Under the guidance of the standards for the accreditation of certification programs created by the National Commission for Certifying Agencies, NBC-HIS seeks a representative sample of hearing healthcare providers to include a range of dispensing experience, job settings, geographic regions, cultural, ethnic, and gender diversity for all exam development work. Optional questions are included within the form to assist the nominating committee in meeting that standard.
Name*

First NameLast Name
BC-HIS Certificate Number
Preferred Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home addressBusiness addressOther
Preferred E-mail*
example@example.com
Alternate E-mail
example@example.com
Preferred Phone Number *
Alternate Phone Number
Dispensing License/Registration Number *
State/Province issued *
Expiration Date *
List all other State/Provinces in which you hold a license/registration along with the number and expiration date
May 3-4May 5-6May 10-11May 31-June 1
A second meeting is planned for July or August. Please provide your availability for an in-person one-day meeting during that time.
List any conflicts during these months.
YesNo
Why are you interested in serving on the exam committee?
What unique skills, qualifications, perspective, or experiences would you bring to the exam committee?
AudiologistAudiology AssistantEducatorENT-OtolaryngologistHearing Aid Specialist/Hearing Instrument PractitionerResearcherTrainerOther
ACABC-HISCCC-AOther
High School Diploma or GEDACA college course workSome college course work (studies not related to ACA)Associate's DegreeBachelor's DegreeMaster's DegreeAuDPhDMD/DOOther
Company Name *
Job Title*
Which of the following BEST describes the type of practice you are associated with?*
Amplifon Corporate RetailGN/Beltone/ReSoundCostcoLucid/HLT/Sam’s ClubMiracle-EarOticon/HearingLife RetailSonova/Phonak/Unitron/Connect Hearing RetailStarkey/Audibel/American Hearing CentersWSA/Signia/Widex/HearUSA
If you selected "owned by a physician practice" above, please specify type of medical office/setting:
(Ex. ENT, Primary Care, Ophthalmologist, etc.)
Your role within the practice is?*
Geographical setting which describes the facility at which you practice the dispensing of hearing instruments:*
For how many years have you been dispensing hearing instruments?*
YesNo
Are you a member of a professional association? Please list:
YesNo
Please provide the name of the organization, positions, and dates of prior activities:
Have you done any work similar to exam development? If so, please describe:
Previous experience is not required. Training will be provided.
Under the guidance of the standards for the accreditation of certification programs created by the National Commission for Certifying Agencies, NBC-HIS seeks a representative sample of hearing healthcare providers to include a range of dispensing experience, job settings, geographic regions, cultural, ethnic, and gender diversity for the exam development activities. Optional questions are included next to assist the nominating committee in meeting that standard.
Gender
18-2526-3031-4041-4951-6060-olderPrefer not to answer
American Indian or Alaska NativeAsianBlack or African AmericanHispanic, Latino or SpanishMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhitePrefer not to answerOther
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