Reflections From The ABSM Information Session At SLEEP 2011

 This is a reprint of a letter recently published at By Cindy Altman, RPSGT, R.EEG/EP T., President-Elect, BRPT .

What are your thoughts?:

Did the AAST have prior knowledge of the AASM/ABSM decision to develop a credentialing exam that by design is easier to pass? Did the AAST ask the AASM/ABSM to develope such an exam and credential?

Did/Are certain members of te AAST Board of Directors (present or past) participating in the development of such a credentialing process while serving on the AAST Board of Directors? If they are/did, are you OK with that?

Has sufficient information been released to the professional sleep community by either the AAST/AASM/ABSM to support the claims made about the pass rate of the RPSGT exam or the skills sets of the new RPSGT’s?

If you are an RPSGT, are you yourself planning on supporting the new credential by paying the ABSM $25 to be grandfathered in to the new credential?

Do you think that this is all meaningless and that an influx of newly credential sleeptechs will have no impact on your current salary or employment opportunites?

By Cindy Altman, RPSGT, R.EEG/EP T.
President-Elect, BRPT

“I recently attended an American Board of Sleep Medicine (ABSM) technologist examination information
session at the American Association of Sleep Technologists (AAST) program in Minneapolis. Most
technologists went to lunch, but a hundred or so were present.

Dr. Richard Rosenberg gave the presentation. Dr. Nathaniel Watson was also there. He was introduced
as president of the ABSM and he sat next to Dr. Rosenberg on the stage but really didn’t say much.

Dr. Rosenberg is a full-time American Academy of Sleep Medicine (AASM) employee, and Dr. Watson
is on the AASM board of directors. How can the ABSM be “an independent, nonprofit, self-designated
board” separate from undue influence by the AASM? The relationship between the two groups is not

On several occasions Dr. Rosenberg let the audience know that he trained in sleep with Dr.
Rechtschaffen, and he serves on the Committee for Accreditation of Polysomnographic Technologists
Education (CoA PSG). He talked of all the good the AASM has done for sleep technologists and
education. He forgot to mention the role that the AAST and the Board of Registered Polysomnographic
Technologists (BRPT) played in advancing technologists’ professional status, or in the formation and
continued support of the CoA PSG.

Dr. Rosenberg said there was absolutely no financial motivation, as rumors implied, behind the
development of the new technologist exam. He said the ABSM simply wants to offer a technologist
examination that is relevant for all “stakeholders.” And they want a pass rate that is higher than the
RPSGT exam…for the good of the profession. In other words, for the good of the physicians who employ
the techs who are unable to pass the RPSGT exam. After all, he implies, the problem in passing the
RPSGT exam is with the exam itself, and not the individuals or educational pathways.

To them, it doesn’t matter that the BRPT works with a well-respected professional testing company,
or that the BRPT uses best practices for developing, maintaining, reviewing, delivering, and scoring
the RPSGT examination. Or that it uses a geographically and professionally diverse group of Subject
Matter Experts. Or that at every step along the way, the RPSGT examination is checked for validity
and relevance not only by the professionals in the field, but by professionals in the testing community.
What matters is that the ABSM believes it has produced a better technologist exam that will result in a
higher pass rate. After all, the ABSM knows “some psychometricians” who help with the exam. What
matters is that the ABSM will do what the AASM asks.

Dr. Rosenberg said the ABSM would apply for NCCA accreditation for the technologist examination.
He fumbled with the terms and relationship between the Institute for Credentialing Excellence
(ICE), the National Commission for Certifying Agencies (NCCA), and the National Organization for Competency Assurance (NOCA), which is now ICE. I hope he gets these organizations straight for his
next presentation.

Dr. Rosenberg blamed the RPSGT exam pass rate on “stifling” the development of formal sleep
technology education programs across the country. He based this on a conversation with a dean at a
school in the Chicago area. Dr. Rosenberg talked about the dissatisfaction physician’s have with the
RPSGT credential, yet he has no data to support that. The AASM is certainly capable of surveying a
large number of people and institutions to determine the extent of this dissatisfaction…if they were

Dr. Rosenberg repeatedly referred to outdated RPSGT exam pass rates and did not discuss the
difference in pass rates based on educational pathway or over time, or compare the pass rates of similar
examinations with multiple pathways. When program directors from two different schools challenged
the assertion that the exam was too difficult for CAAHEP students, Dr. Rosenberg indicated their schools
were the exception, not the norm.

Dr. Rosenberg told us that the RPSGT requirement for AASM sleep center accreditation would still stand.
Yet when asked if he would put that statement in writing, he let the audience know it wouldn’t have any
weight. When asked if the new examination should be viewed as a mid-level credential, with the CPSGT
on the lowest level and the RPSGT on the highest level, he made it clear that the new credential was to
be on equal terms with the RPSGT.

Dr. Rosenberg reminded the audience that the AAST supports the new exam. He let us know AAST’s
immediate past president and current president have been involved in the development of the ABSM
technologist exam. The audience was already aware of AAST’s position to support “all” technologist
examinations—even those not yet developed or evaluated—but it was surprising that AAST leaders
were actually assisting in the exam development. This was news to current AAST board members as
well. Did Dr. Rosenberg let the cat out of the bag?

When it was time for questions and comments at the end of the presentation, not one person stood
up to voice support for the new exam. However, many stood in line to question or comment on the
purpose of it. At times those in attendance clapped enthusiastically in support of the techs or physicians
who challenged the ABSM. Suffice it to say, the new ABSM technologist examination was not well

So why, exactly, is the ABSM getting involved in technologist credentialing? Could it be that the BRPT is
truly an independent organization adhering to best practices in credentialing, and the AASM does not
like that?

The RPSGT is the Gold Standard. Don’t let grandfathering into the new credential confuse you. While
it is “only $25” and you may think that you have nothing to lose, you do. You risk losing the professional
identity that technologists have worked for over 32 years to achieve. As technologists we can stand
united to keep the RPSGT credential strong. Don’t let the AASM divide and conquer. That is really what
this is all about.” 

Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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