Board of Certification Examination Achievement Gaps as a Barrier to Diversifying the Athletic Training Profession

Context: Achievement gaps have been well documented in the medical and health professions. Previous researchers have indicated that individuals from underrepresented minority groups consistently fall short of White candidates in performance on standardized credentialing examinations.Objective: To determine the relative risk of failure by ethnicity and first-time and retake pass rates on the Board of Certification (BOC) examination.Design: Descriptive study. Setting: Professional master's degree athletic training programs. Patients or Other Participants: A total of 3742 unique candidates with 4425 attempts between examination windows 1 of 2011-2012 (April) and 5 of the 2019-2020 (February) cycle of the BOC examination.Main Outcome Measure(s): Ethnicity as self-selected by the candidates, attempt number, result of each attempt, year, and testing window.Results: Examination candidates self-identified as White (60.4%, n = 2261/3742), unknown (ie, withheld an ethnicity selection; 10.6%, n = 395/3742), Hispanic (8.6%, n = 320/3742), or African American (8.4%, n = 313/3742). On the first attempt, White candidates passed at a rate of 93.2% (2107/2261), African American candidates at 74.8% (234/313), and Hispanic candidates at 86.9% (278/320; overall first-time pass rate for this subsample = 90.5%, 2619/2894). The relative risk of first -attempt failure was higher for African Americans than for both White (relative risk = 3.706, 95% CI = 2.903, 4.730; P < .001) and Hispanic (relative risk =1.923, 95% CI =1.368, 2.703; P . .001) candidates. For Hispanic candidates, the relative risk of first-attempt failure was about 50% lower than for White candidates (relative risk = 0.519, 95% CI = 0.377, 0.715; P < .001). Conclusions: Achievement gaps existed between White candidates and those from ethnic minority groups in athletic training. Diversification of the athletic training workforce will require ensuring equity in preparation for and success on the BOC examination.