Alternate Assessment of Home Care Aide Knowledge amongst Three Language Groups

A U.S. state healthcare department requested Prometric to provide recommendations for developing an alternate assessment for their Home Care Aide (HCA) written exams that reduces the need to depend on reading abilities, but still captures declarative knowledge. The HCA written exams were administered in the language of the test-taker and the healthcare department assumed the test is failing due to biases in the test. Prior to developing a new test, however, Prometric statistically analyzed the performance of the current, non-English language written exams to identify any areas of potential bias that may be negatively impacting candidate’s performance. At the time of the initial engagement, the written exam was offered in 13 languages: English, Russian, Spanish, Simplified Chinese, Arabic, Tagalog, Vietnamese, Korean, Khmer (Cambodian), Laotian, Somali, Samoan, and Ukrainian. A team of experts, including the authors of this session, conducted an item performance analysis of the three highest-volume exams for non-English candidates (Spanish, Russian, and Korean). Compared to English-language test-takers (n = 772) who had a 91.71% pass-rate, Russian-language test-takers (n = 17) had a 94.12% pass rate, Spanish-language (n = 23) test-takers had a 73.91% pass rate, and Korean-language test-takers (n = 7) had an 85.71% pass-rate (all are improvements over the pass-rates of prior administrations with higher cut scores. Analysis of the current data indicate some test items are not performing as well as expected.