Certification Program: Test Development

HSPA is a not-for-profit organization governed by a Board of Directors. The Board has established the Certification Council, and granted authority to the Certification Council, to independently make essential decisions related to standards, policies, and procedures of the certification program. These decisions are made independently of, and under no influence by, any other individual or business entity within or outside of HSPA.


  1. To establish the framework for the CRCST, CER, CIS, and CHL exams, several focused workshops—each addressing a different aspect of the test development process—are held. The first workshop, a Job Task Analysis (JTA), involves Sterile Processing (SP) Subject Matter Experts (SMEs) defining the tasks, knowledge and skillsets most pertinent to each certification. The results of the JTA are used to create and/or validate the content of the exams and ensure that they accurately reflected changes in the profession. A key component of the Job Analysis is the release of a profession-wide survey completed by hundreds of SP professionals. Survey respondents’ participation helps to determine the knowledge and skillsets deemed most vital to the profession. The SMEs use the survey findings to finalize the exam blueprints.
  2. Following each JTA, a series of additional workshops are held: a Test Specifications meeting, which documents the relative importance of each exam’s content areas and how many items should be written to each objective; Item Writing and Review, which involve the writing of new exam questions and the review of the newly-created questions and existing exam questions; Form Review, which involves a final review of the test form and how the questions on the form work together; and finally, Item Analysis, which involves a statistical and analytical review of exam items to help improve the quality and accuracy of the exams.
  3. In-between the Form Review and Item Analysis, a pilot exam is offered for each certification. The performance of pilot exam participants is measured against a predetermined standard. For the CRCST, CER, and CHL standard-setting study, the Angoff standard-setting method—supplemented by the Beuk Relative-Absolute Compromise method—is implemented during a two-day standard-setting meeting facilitated by the Prometric Testing company. These methods use an SME panel to first reach a consensus on the acceptable level of knowledge and skill that is expected for passing candidates. SMEs then review each examination item to determine the level of knowledge or skill that is expected. SME ratings and difficulty predictions are analyzed by Prometric to provide a recommended cut score. Lastly, the recommended cut score is reviewed and approved by the HSPA Certification Council.
  4. The exam Content Outlines, as created through the Job Task Analysis, detail the specific areas of knowledge necessary to perform the duties associated with each certification. The Content Outlines also detail the percentage weight for each of the exam sections. The higher the percentage weight, the more heavily the questions in that area will affect your overall test score.


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  • HSPA’s Central Service Technical Manual (8th ed.) OR HSPA’s Sterile Processing Technical Manual (9th ed.)
  • ANSI/AAMI ST79 (2017)
  • AORN’s Guidelines for Perioperative Practice (2023)

logo certification hspa cis


  • HSPA’s Instrument Resource Manual (1st ed.)
  • HSPA’s Central Service Technical Manual (8th ed.) OR HSPA’s Sterile Processing Technical Manual (9th ed.)
  • Rick Schultz’s The World of Surgical Instruments (2018 ed.)
  • ANSI/AAMI’s ST29 (2017 ed.)

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  • HSPA’s Endoscope Reprocessing Manual (2nd ed.)
  • ANSI/AAMI’s ST91 (2022 ed.)
  • CDC’s Essential Elements of a Reprocessing Program for Flexible Endoscopes (2017 ed.)
  • SGNA’s Guidelines for Use of High-Level Disinfectants & Sterilants in the Gastroenterology Setting (2017 ed.)
  • SGNA’s Standards for Infection Prevention in Reprocessing Flexible Gastrointestinal Endoscopes (2018 ed.)
  • SGNA’s Standard of Infection Prevention in the Gastroenterology Setting (2019 ed.)

logo certification hspa chl


  • HSPA’s Central Service Technical Manual (8th ed.) OR HSPA’s Sterile Processing Technical Manual (9th ed.)
  • HSPA’s Central Service Leadership Manual (3rd ed.)
  • ANSI/AAMI’s ST79 (2017 ed. with Amendments A1, A2, A3, A4:2020)
  • AORN’s Guidelines for Perioperative Practice (2023 ed.)