ITEM SUBMITTAL FORM
GUIDELINES FOR WRITING EXAMINATION ITEMS
Items submittal can be very helpful when you don’t have enough points to claim toward your
recertification. As an active ACI certification holder, we’d like you to try to submit as many new items as
possible. Keep the blank form included with these guidelines on hand to use for copying purposes as
needed, and submit a new item whenever you think of one! Once submitted, the items become the
property of ACI. Do not return the instructions page with your items.
When composing your questions, please adhere to the following:
1-
Save the Item Submittal Form enclosed and use it as an “original” from which you can make as
many copies as you need for items submission.
2-
Type or print clearly.
3-
Avoid items that reference specific brand names or model numbers.
4-
Avoid the type of questions using “NOT” and “ALL OF THE ABOVE”.
5-
Indicate the correct answer by placing an asterisk (*) next to the appropriate letter.
6-
Be sure that the three wrong answers you have written are “good” wrong answers (i.e., are not
obviously wrong).
7-
Be sure to provide the name of a text or other documentation where confirmation of the correct
answer can be found. If you are using online references, please list the name of the website. Points will
not be approved if this information is missing.
8-
This year we would like to request that items submitted focus on the following areas: Sections IV &
V.
Follow this link to the Examination Content Outline:
http://www.aami.org/certification/download/content.pdf
Keep those new items coming!
ACI 4301 N FAIRFAX DRIVE SUITE 301 ARLINGTON, VA 22203-1633 T+1 703-525-4890 F+1 703-276-0793 WWW.AAMI.ORG/ACI
Approved 02232015 JpM
Revised 02172015 IH
ACI
Item Submittal Form
ITEMS SUBMITTAL FORM
Proposed Exam Item:
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Multiple Choice Answers: (Indicate Correct answer with an asterisk)
A………………………………………………………………………………………………………………………
B…………………………………………………………………………………………………….…………………
C………………………………………………………………………………………….……………………………
D………………………………………………………………………………………………………………………
Examination Item for Certification:
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Certified Quality System Manager (CQSM)
Certified Healthcare Technology Manager (CHTM)
Certified Biomedical Equipment Technician (CBET)
Certified Radiology Equipment Specialist (CRES)
Certified Laboratory Equipment Specialist (CLES)
Item intended for which subject area of content outline? ……………………………………………………….
(Example: CBET V.B)
Reference(s) used to verify answer:……………………………………………………………………………….
……………………………………………………………………………….…………………………………………
Item Submitted By (print full name)………………………………………………………………………………..
Date………………………………………………………………………...…………………………………………
NOTE: Name MUST be provided if you plan to claim this activity for points towards recertification.
Each question submitted is worth 1/4 point towards ACI recertification.