The American Society for Clinical Pathology Board of Certification (ASCP BOC) appreciates the discussion and interest surrounding computerized adaptive testing (CAT) and examination methodology. We recognize that many laboratory professionals, scientists, experts, and examinees remain interested in understanding how CAT functions, which the updated ASCP BOC website offers resources for. We also support professional dialogue regarding credentialing processes and psychometric principles.
The ASCP BOC selected CAT as the primary assessment method for most of our credentialing examinations because it offers real-time, tailored measurement of examinee performance. CAT is also renowned and respected across academic, professional, and other medical certification examinations. CAT assures enhanced security for examinees, ensuring that once an examinee has passed a CAT certification examination, they have uncompromisingly earned that specific credential. CAT is tailored to an examinee's exact knowledge and applied skill level, providing the highest reliability measurement for a professional.
While there may be some belief that an examinee may intentionally answer questions incorrectly to lead to easier questions, and therefore, gain an advantage to pass an ASCP BOC examination, this is counterintuitive to CAT principles. The assumption is that if an examinee answers questions incorrectly on purpose, the system will begin administering easier questions that may then be easier to answer correctly.
However, computer adaptive tests generally do not work in that way. In addition to the accurate, affirmative feedback Walter offered in the ASCP Community Forum, the computer algorithm continuously estimates an examinee's ability throughout the examination. If an examinee first answers questions incorrectly and then answers those questions correctly, the algorithm is designed to examine the entire pattern of performance rather than simply the difficulty level of individual questions.
In many instances, purposefully answering test questions incorrectly leads to a much lower ability estimate, and the examinee would need to answer more questions correctly to overcorrect for the low ability estimate to meet the minimum passing score. During the examination process, examinees do not know exactly which questions to "miss", how many to miss, or how much influence each question has on the overall scoring process. Attempting to impact the computer adaptive testing algorithms and processes then becomes speculation and a riskier strategy than answering each question authentically the first time (i.e., answering the questions accurately or to the best of an examinee's ability). The ASCP BOC also values and protects the integrity of examinations and credentials, utilizing advanced technology to identify and prevent potential misconduct.
We encourage continued engagement regarding CAT and credentialing processes in ways that support patient-centric, professional-forward education, professionalism, and examination integrity. We are dedicated to being the professional credentialing partner that elevates patients' and professionals' outcomes.
The ASCP BOC website has several resources available, and we are consistently updating and developing more. If you have further questions regarding CAT, credentialing examinations, or ASCP BOC processes, please contact the ASCP BOC team directly at ASCPBOC@ASCP.org.
Kristin Blake, Senior Director, BOC Operations
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Kristin Blake
American Society for Clinical Pathology
Chicago IL
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Original Message:
Sent: 05-20-2026 08:34
From: Brett Rice
Subject: BOC's CAT Algorithm
Pearson VUE, the exam administrator, provides materials for taking notes (eg a marker and dry erase board). For any flagged question - the examinee could choose one answer, note the question number and their best choice on their dry erase board, and return to the flagged question later to quickly change the answer according to their note
To echo Walter's statements, your chances of passing will decrease with every question answered incorrectly (even if you return to it later and select the right answer, more so for the lower difficulty level questions)
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Brett
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Original Message:
Sent: 05-20-2026 01:51
From: Mark Kohlhepp
Subject: BOC's CAT Algorithm
Hey,
Continuing the idea first posed to answer questions incorrectly to get easier questions, the BOC site states the tester can mark/ label answers they are not sure about as questionable, and if time left over can go back and reconsider those answers. The only trick (if this would work) is to answer 100 questions twice in the 2 1/2 hour time limit.
Thoughts?
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Mark Kohlhepp, Medical Laboratory Scientist
CECIL PA
(412)327-0703
Original Message:
Sent: 05-19-2026 08:31
From: Brett Rice
Subject: BOC's CAT Algorithm
This makes sense. Thank you for your response
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Brett
Original Message:
Sent: 05-19-2026 06:40
From: Walter Oliveira
Subject: BOC's CAT Algorithm
Short answer: No. CAT exam questions are weighted with a difficulty level based on statistics reviewed by the exam committee and the Board of Certification staff. Successful passing is not answering a certain number of questions correctly but the overall weight of all the questions answered correctly. If you intentionally answer incorrectly to get easy questions then you will not achieve the overall minimum passing score based on the weight of all the questions. A better strategy is to use the tools provided by ASCP, particularly the Content Outline, to focus your study.
Serving on a Board of Certification Exam Committee has been the most rewarding professional experience in my 43 year career as an MLS. I encourage anyone who has a passion for excellence in certification of laboratory professionals to consider volunteering. It is hard work but truly makes a difference to patient care worldwide.
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Walter Oliveira MASCP, MLS(ASCP)CM SI
Laboratory Manager
UVA HealthSystem
Charlottesville, VA
(434) 924-5179