Download the Examinee Handbook!

The handbooks have the most up-to-date schedules, policies, and examination procedures. The handbook is updated for the current NPLEX administration.

NPLEX SCORING PROCESS

On a criterion-referenced examination such as the NPLEX, the examinee’s knowledge is measured against predetermined criteria. In this case, the criteria are defined by competencies that describe what examinees are expected to know at a specific stage of education (i.e., after biomedical training or after graduation); these competencies are outlined in the NPLEX Study Guides. An examinee is assessed solely on the basis of having met the criteria, (i.e., examinees are not assessed in relation to the performance of other examinees).

The following is a description of the steps NPLEX takes to ensure that exam results reflect the examinee’s true knowledge in relation to the criteria.

Cut Scores (Passing Standards) are Established: On the Saturday after the examinations have been administered and before the answer sheets have been scanned, a group of naturopathic physicians meet to set the initial cut scores. Because every NPLEX examination is a unique combination of old and new items (exam questions), cut scores for the current examinations are independent of the cut scores of previous examinations. NPLEX uses the nationally accepted Angoff method to set these cut scores. In this criterion-referenced method, naturopathic physicians rate the difficulty of each exam item, on the basis of the criteria, by answering the question, “What percentage of minimally competent examinees should be able to answer this item correctly?” The assessments of all raters are averaged to determine a cut score for an exam item, then the cut scores for every item in each general exam area (GEA) are averaged to determine the cut score for that GEA (e.g., Structure/Function, Diagnosis, etc.). A GEA that is judged to have many difficult items will have a lower cut score than a GEA that has many easy items (i.e., for a GEA with difficult items, the examinee will be required to correctly answer a lower percentage of items in order to pass).

Answer Sheets are Scanned: When all the answer sheets have been returned to NPLEX, they are scanned using an optical scanner. If the scanner cannot read any information on the answer sheet, the scanning operator is alerted and the answer sheet is inspected visually to ensure that the scanner has correctly read the examinee’s intended entry. Even though examinees’ names appear on the answer sheets, all scoring and analysis is done without reference to individuals or schools.

Exam Statistics are Reviewed and Item Statistics are Analyzed in Post-Test Analysis (PTA): Exam statistics (i.e., for each examination as a whole) are reviewed to assess the reliability and appropriateness of each examination. The purpose of the item analysis is to review the content of exam items that do not statistically perform as expected. Statistics calculated for each exam item are reviewed by the staff psychometrician. An item is flagged for content review if few examinees answered the item correctly, if approximately equal numbers of examinees chose each of the four responses, if the item did not appear to discriminate well between high scorers and low scorers, and/or if a re-used item did not perform as it had in the past.

Flagged Items are Reviewed by an Exam Chair: A list of flagged items for each specific exam area (SEA, e.g., anatomy, botanical medicine, emergency medicine) is sent to an exam chair. Exam chairs use standard reference sources to verify that for each flagged item the keyed answer is completely correct, that the question is clearly stated, and that none of the other response alternatives are correct. Exam chairs submit their recommendations to the PTA Committee, which makes the final decision regarding the disposition of the item. If an item is deemed valid and appropriate, no key change is made. If an item is deemed ambiguous, or if more than one answer could reasonably be construed as correct, credit may be given for more than one answer. After a decision has been made about every item that has been reviewed, changes are made to the scoring key and all examinations are re-scored to obtain raw scores for each GEA.

Initial Passing Rates are Determined: The computer compares each examinee’s raw GEA scores to GEA cut scores. If all GEAs have been passed, the examinee receives a passing score for comprehensive mastery. The percentage of examinees who pass each examination (BSE, CCSE, and the Clinical Elective Examinations) is reviewed.

Cut Scores Established by the Angoff Method are Reviewed: Using the statistics calculated in the previous steps, the cut scores determined by the Angoff method are reviewed to ensure that they are appropriate. In this review, NPLEX applies a quantitative 8-factor algorithm using three types of information: exam characteristics (e.g., how difficult this examination was compared with previous examinations, etc.), cohort characteristics (e.g., how the current cohort performed on items that had been used before, etc.), and cut score team characteristics (e.g., how stringent the current cut score team was compared to previous cut score teams, etc.). If appropriate, the cut score for one or more GEAs might be lowered.

The NPLEX Board Reviews the Exam Results: The NPLEX Board reviews the exam results of examinees who did not pass, looking at the pattern of performance on the GEAs. If, for example, a large number of examinees failed the same GEA but passed all the others, it could indicate that the cut score for that GEA was set too high, and depending on other factors, the cut score might be lowered. The new (lowered) cut scores (if any) are applied to examinee scores and new passing rates are generated and examined.

Unofficial Pass/Fail Results are Posted to the Examinee’s online Profile: Approximately six (6) weeks after the exam administration, unofficial exam results (Pass/Fail only) are posted to the examinee’s online Profile. Examinees are notified by email when these results can be viewed online. NABNE makes every attempt to ensure that these unofficial exam results posted online are correct; however, it is not possible for NABNE to guarantee that the information posted online is accurate.

Official Exam Results are Sent to Examinees: Official hard copies of NPLEX exam results are sent to examinees by regular mail within the same week. These official (hard) copies provide more detailed information than that provided in the examinee’s online Profile. The report of exam results includes a visual scale that illustrates how the examinee performed relative to the cut score in each general exam area. If the examination was failed, the report will also include a visual scale that illustrates the strength of the examinee’s performance in each specific exam area (SEA) relative to the result achieved in the other SEAs. If the examinee took any or all of the Part II – Clinical Elective Examinations (Acupuncture, Elective Pharmacology, Minor Surgery, and/or Parenteral Medicine), the report will also include a section that shows a P (Pass) or F (Fail) designation, along with the converted score(s) achieved on any or all of these examinations.

If an examinee has not completed all requirements for graduation before taking the NPLEX Part II – Clinical Science Examinations, they must complete all requirements for graduation no later than March 31st for examinations taken in February and no later than September 30th for examinations taken in August. If NABNE does not receive a letter from the ANMP verifying graduation by either deadline, the examinee’s results will be nullified and all fees will be forfeited.

Part II Exam Results are Sent to Regulatory Authorities: In the same week that official results are sent to examinees, reports of exam results for examinees who took the Part II – Clinical Science Examinations are also sent to the single regulatory authority the examinee designated on the Part II – Clinical Science Exam Application.

In situations where decisions are being made about eligibility for licensure or registration, a mastery model of scoring is most commonly used. NPLEX uses a mastery model to measure whether or not the examinee has demonstrated minimal competence in either the biomedical sciences or the clinical science concepts of naturopathic medicine. To receive a passing mark for the Part I – Biomedical Science Examination, the examinee must pass each of two general exam areas (GEAs): Structure/Function and Disease/Dysfunction. To receive a passing mark for the Part II – Core Clinical Science Examination, the examinee must pass all four GEAs: Diagnosis, Materia Medica, Other Modalities, and Medical Interventions. If the examinee has mastered the competencies and passed all GEAs, they receive a P (Pass) for comprehensive mastery. To receive a passing mark on any of the Part II – Elective Examinations (Acupuncture, Elective Pharmacology, Minor Surgery, or Parenteral Medicine), the examinee must demonstrate overall competence (i.e., there are no GEAs).

For purposes of licensure or registration, a regulatory authority is concerned only with whether or not an examination has been passed, not with the magnitude of the examinee’s score. Consequently, for both the Part I – Biomedical Science and Part II – Core Clinical Science Examinations, NPLEX reports a P (Pass) or an F (Fail) for each examinee (i.e., there are no numerical scores).

 

PART I PASSING STANDARDS

The Part I – Biomedical Science Examination is a single, integrated examination that is designed to test your knowledge of biological structure/function and disease/dysfunction.

To pass the examination, you must be able to demonstrate concurrent competence in both general exam areas (GEAs): Structure/Function and Disease/Dysfunction.

You have passed the NPLEX Part I – Biomedical Science Examination when you have correctly answered at least the number of questions that NPLEX subject matter experts (licensed/registered NDs) have determined is required to demonstrate competence in each of the two general exam areas. You are required to pass both general exam areas within the same exam administration in order to pass the examination.

 

PART II PASSING STANDARDS

The Part II – Core Clinical Science Examination is a single, integrated examination that is designed to test your knowledge of diagnosis, treatment, and medical interventions.

You have passed the Part II – Core Clinical Science Examination when you have correctly answered at least the number of questions that NPLEX subject matter experts (licensed/registered NDs) have determined is required to demonstrate concurrent competence in four general exam areas (GEAs): Diagnosis, Materia Medica, Other Modalities, and Medical Interventions. You are required to pass all four general exam areas within the same exam administration in order to pass the examination.

You have passed a Part II – Clinical Elective Examination (Acupuncture, Elective Pharmacology, Minor Surgery, and/or Parenteral Medicine) when you have achieved a minimum converted score of 75. A converted score of 75 is a scaled score that represents the minimum percentage of items you must answer correctly in order to pass the examination. It is not the percentage of correct answers. The actual percentage represented by a converted (scaled) score of 75 is usually in the range of 60-70%, depending on the difficulty of the particular examination.

REPORTING OF EXAM RESULTS

Approximately six (6) weeks after the exam administration, your unofficial exam result (Pass/Fail only) will be posted to the dashboard of your online Profile. You will be notified by email when your result can be viewed online. Your results may be viewed online for approximately ten (10) days from the date of the email notification. An official hard copy of your exam result will be sent to you by regular mail within the same week.

NABNE will make every attempt to ensure that the exam result posted online is correct; however, because the implementation of this feature requires manual transfer of data (which introduces the possibility of human error), NABNE cannot guarantee that the information posted online is accurate. NABNE suggests that you do not make any decisions based on these results.

PART I RESULTS

The official report of the Part I – Biomedical Science exam result you receive in the mail will provide information regarding your overall passing status, and will include a visual scale that illustrates your performance in each of the two general exam areas, relative to the minimum percentage of questions you must correctly answer to pass that general exam area.

Comprehensive Mastery indicates, with either a P (Pass) or F (Fail) designation, whether or not you have passed the Part I – Biomedical Science Examination. You have passed the Part I – Biomedical Science Examination when you have achieved a P (Pass) in both of the two general exam areas:

  • Structure/Function, which reflects the result you achieved on the exam questions that pertain to anatomy, biochemistry & genetics, and physiology
  • Disease/Dysfunction, which reflects the result you achieved on the exam questions that pertain to microbiology & immunology and pathology

If you fail the examination, your report will also provide a visual scale that illustrates the strength of your performance in each of the five specific exam areas relative only to your performance in the other specific exam areas.

Exam results are the property of the examinee. NABNE serves as an unbiased repository of those results. To avoid possible misinterpretation and to protect your privacy, exam results will not be reported to you by phone, fax, or email.

PART II RESULTS

If you have graduated before the exam date:

Your unofficial exam results (Pass/Fail only) will be posted to the dashboard of your online Profile approximately six (6) weeks after the exam administration. You will be notified by email when your results can be viewed online. Your exam results may be viewed for approximately ten (10 days) from the date of the email notification. An official hard copy of your exam results will be sent to you by regular mail within the same week.

If you have not graduated before the exam date:

Your exam results will not be released until NABNE has received, no later than March 31st (for examinations taken in February) or no later than September 30th (for examinations taken in August), written verification from your ANMP that you have graduated. If NABNE does not receive this letter by the deadline, your exam results will be nullified and all fees will be forfeited. Upon receipt of written verification of graduation from your ANMP, your unofficial results will be posted to the dashboard of your online Profile and may be viewed no later than March 30th (for examinations taken in February) or no later than September 29th (for examinations taken in August). If NABNE receives written verification of graduation from your ANMP after that time, you will be sent only the official hard copy of your exam results by regular mail.

NABNE will make every attempt to ensure that the exam results posted online are correct; however, because implementation of this feature requires manual transfer of data (which introduces the possibility of human error), NABNE cannot guarantee that the information posted online is accurate. NABNE suggests that you do not make any decisions based on these results.

The official report of the Part II – Core Clinical Science exam results you receive in the mail will provide information regarding your overall passing status, and will include a visual scale that illustrates your performance in each of the four general exam areas, relative to the minimum percentage of questions you must correctly answer to pass that general exam area.

Comprehensive Mastery indicates, with either a P (Pass) or F (Fail) designation, whether or not you have passed the Part II – Core Clinical Science Examination. You have passed the Part II – Core Clinical Science Examination when you have achieved a P (Pass) in all four general exam areas:

  • Diagnosis, which reflects the result you achieved on the exam questions that relate to physical & clinical diagnosis, lab testing & diagnostic imaging, and interpretation and application of research studies
  • Materia Medica, which reflects the result you achieved on the exam questions that relate to botanical medicine and homeopathy
  • Other Modalities, which reflects the result you achieved on the exam questions that relate to nutrition, physical medicine, and psychology
  • Medical Interventions, which reflects the result you achieved on the exam questions that relate to emergency medicine and pharmacology

If you fail the examination, your report will also provide a visual scale that illustrates the strength of your performance in each of the nine specific exam areas relative only to your performance in the other specific exam areas. If you have taken any Part II – Clinical Elective Examination(s), the report you receive in the mail will also include a section that shows a P (Pass) or F (Fail) designation along with the converted score(s) you achieved.

NABNE will also send, to the single regulatory authority you indicated on your Part II Application, a transcript of your Part I (or previous NPLEX results) and the official report of your Part II – Clinical Science exam results (including the Core Clinical Science and any Clinical Elective Examinations you took).

Exam results are the property of the examinee. NABNE serves as an unbiased repository of those results. Your exam results will only be released to the regulatory authority that you have designated on your application or transcript request, or to other parties with your written permission. To avoid possible misinterpretation and to protect your privacy, exam results will not be reported to you by phone, fax, or email.

MANUAL SCORING REQUEST

Every answer sheet used for an NPLEX examination is scanned by a state-of-the-art optical mark reader, and errors are reviewed by the scanning operator. The possibility of a scanning error is negligible. However, you may request a manual scoring from the most recent exam administration to verify that the answers you marked on your answer sheet(s) correctly match the answers recorded by the scanner. You will be notified of the results of this manual scoring, however, you will not receive additional information regarding your exam results (e.g., numerical scores, specific questions answered incorrectly, etc.).

If you would like to receive a Manual scoring, your request and payment must be made online no later than April 30th (for an examination you take in February) and no later than October 30th (for an examination you take in August).  The Manual Scoring Fee of US$50 for the Part I – Biomedical Science Examination, US$70 for the Part II – Core Clinical Science Examination, and US$40 for each Part II – Clinical Elective Examination must be paid using a debit or credit card.

ISSUES AND APPEALS

Because NPLEX uses an extensive post-test analysis process (including statistical analysis of individual items), the exam results sent to you reflect changes made after post-test analysis of items that did not perform as expected. Consequently, NABNE does not change exam results.

If you wish to appeal a policy decision, you must submit your appeal to NABNE in writing, addressed to the Executive Director of NABNE. Your appeal will be presented to the NABNE Board. The Board will make every effort to respond to you with a decision within six (6) weeks of receipt of your appeal.

NABNE – Appeals
Suite 119, #321
9220 SW Barbur Blvd.
Portland, OR  97219
Attn: Executive Director

RE-EXAMINATION POLICIES

PART I – BIOMEDICAL SCIENCE EXAMINATION

If you do not pass either or both of the two general exam areas (Structure/Function or Disease/Dysfunction), you will be required to retake the entire Part I – Biomedical Science Examination. If you graduated more than five (5) years ago, contact NABNE regarding additional eligibility requirements.

PART II – CORE CLINICAL SCIENCE EXAMINATION

If you do not pass any of the four general exam areas (Diagnosis, Materia Medica, Other Modalities, and Medical Interventions), you will be required to retake the entire Part II – Core Clinical Science Examination.

If you graduated more than five (5) years ago, contact NABNE regarding additional eligibility requirements.

If you do not pass the NPLEX Part II – Core Clinical Science Examination within ten (10) years of passing the NPLEX Part I – Biomedical Science Examination, you will be required to retake and pass the Part I – Biomedical Science Examination before you will be allowed to take or retake the Part II – Clinical Science Examinations. If this applies to you, please contact NABNE regarding additional eligibility requirements.

PART II – CLINICAL ELECTIVE EXAMINATIONS

Once you have taken the Part II – Core Clinical Science Examination, you may retake any Part II – Clinical Elective Examination (Acupuncture, Elective Pharmacology, Minor Surgery, and/or Parenteral Medicine) during any subsequent NPLEX administration. You will not be required to retake a Part II – Clinical Elective Examination you have previously passed, regardless of whether or not you are required to retake the Part II – Core Clinical Science Examination.

 

TRANSCRIPT REQUESTS

Prior to the NPLEX administration, NABNE sends a transcript of your previous NPLEX results to the single regulatory authority you selected on your application and, after they become available, sends the report of your results from the current NPLEX administration to the same regulatory authority.

Requests to have transcripts sent to additional regulatory authorities should be submitted after your results from the current NPLEX administration become available. This will ensure that the transcript NABNE sends will include the results you achieved for both your Part I – Biomedical Science, Part II – Core Clinical Science, and any Part II – Clinical Elective Examinations you have taken.

Submit your request and US$30 payment via the Transcript Request form. Transcript requests are typically processed within three to five (3-5) business days of receipt.

An official transcript of NPLEX exam results must be sent directly from NABNE to a regulatory authority or other entity. A transcript requested to be sent directly to you is considered unofficial and will be noted as such.