If you are a medical professional working with Holter monitoring, EKGs, or stress testing who wants to take your education to the next level, you may be interested in the Certified Cardiographic Technician (CCT) exam. This exam will require you to demonstrate how much you already know and push yourself to learn more. After passing the exam, you will be recognized by other medical professionals for your credentials and capabilities in your field and patients whose health and well-being is further ensured by your qualifications. Becoming certified may result in your eligibility for job advancement or an increase in salary. Also, as more and more hospitals begin to require certification from their employees, you will find yourself with more job opportunities than you otherwise might have.
The CCT exam consists of approximately 130 multiple-choice questions. A small number of these questions will not count toward your final score. These questions will be used for statistical purposes in the writing of future exams. There will be no indication on the CCT exam of which questions count and which do not. You will be given a 2 hour time limit in which to finish the exam. The material covered will consist of 6 major content areas. These are basic cardiovascular anatomy and physiology, which constitutes 14% of the exam, ECG techniques and recognition, which constitutes 32% of the exam, basic cardiovascular electrophysiology, which constitutes 16% of the exam, stress test techniques, indications, and contraindications, which constitutes 11% of the exam, ambulatory monitoring, which constitutes 20% of the exam, and cardiac medications, which constitutes 7% of the exam. This is a computer-based test.
If you think taking the CCT exam may be the right career choice for you, first determine whether or not you meet eligibility requirements. If you do, you can proceed to the application process. Along with your application and all appropriate materials documenting your eligibility, you will be required to submit a fee of $160. Your application will either be approved or disapproved for a testing seat. Upon notification of approval, you will be able to register for an exam appointment. There are more than 200 testing sites within the United States and more than 3000 international testing locations. Testing sites with vacant seats and the dates of those openings will be provided for you to choose from when you go to schedule your appointment. If you have a disability, special arrangements can be made for you, but you must submit a formal letter requesting special accommodations and explaining your reason for needing them. You also will be required to submit documentation verifying your condition that precludes you from testing at one of the official sites.
On the day of the exam you must arrive early with two forms of identification, one of which must have a photo of you. You don’t need to bring a calculator, as you will not be allowed to use it during the exam. The computer you will be testing on, however, will have a calculator with all of the necessary features to answer math-based problems. You also do not need to bring scratch paper and pencils. Before the exam begins the proctor will give you a pen and an erasable board for working problems. No electronics will be allowed in the testing room.
After you have finished the test, you will receive your score immediately over the computer. It should take 2-3 weeks for you to receive your official results by mail. Scores will run from 500 to 900, and a score of 650 will be required to pass. Since exam results are determined by computer, you have the option to request that your exam’s score is verified if you think there are any problems. This will cost you $50. You also have the option to request that your scores get sent to any educational program you are currently enrolled in.
CCT Exam Content
The Certified Cardiographic Technician (CCT) exam tests over 6 basic categories of content. These are basic cardiovascular anatomy and physiology, ECG techniques and recognition, basic cardiovascular electrophysiology, stress test techniques, indications and contraindications, ambulatory monitoring, and cardiac medications. To maximize your study time, you should focus your preparation around these areas of content and the numerous topics associated with each of them.
The first area is basic cardiovascular anatomy and physiology. This category will make up 14% of the entire exam. Questions will focus on the heart, the heart and coronary circulation, physiology, and anatomical terms. Be able to label the parts of the heart in a diagram with the appropriate terms. You should know what each of these constituent parts do on their own and how they work together.
The second area is ECG techniques and recognition, which accounts for 32% of the exam material. Know about the instruments associated with stress testing, Holter monitoring, and ECG. Know how to record information in this area and determine when an error has arisen. Questions may ask you to define, recognize, measure, or interpret waveforms. You may have to identify cardiac arrhythmias. Some safety information regarding the electrical equipment used in your job will probably appear in this portion of the test.
The third area is basic cardiovascular electrophysiology. This section will make up 16% of the CCT exam. The topics covered in this section may include transmembrane potential, action potential, refractory, and the electrical conduction system of the heart.
The fourth area is stress test techniques, indications, and contraindications. This section accounts for 11% of the exam. Some examples of topics that may appear in this section are those related to stress testing and pharmacology. You might be questioned on the use of ergometers or the interpretation of an exercise electrocardiogram, which tests for changes in heart rate as a patient walks or jogs upon a treadmill. These are only a few examples. Use them as jumping off points for further study in this area.
The fifth area of content on the Certified Cardiographic Technician (CCT) exam is ambulatory monitoring. This particular section will come out to 20% of the entire test. Ambulatory (or “Holter”) monitoring involves a patient wearing a portable device for a specific period of time, typically 24 hours. This device will monitor electrical activity throughout the body for the period of time it is worn. Medical professionals will then interpret what has been recorded. This section may require you to answer questions on such topics as preparing a patient for ambulatory monitoring, indications and contraindications for future action, and interpreting the results of monitoring.
The sixth and final category of content on the CCT exam is cardiac medications. This section will make up 7% of the exam content. For this section you should know about categories of cardiac medications and specific types of cardiac medications and the conditions under which they should be used. You also might be asked to demonstrate your understanding of indications and contraindications for the future use or discontinuation of medications in certain situations.
These are the major areas of content that will be featured on the CCT exam. The examples provided illustrate the kinds of question topics that may be associated with these categories, but they are in no way definitive. Be thoroughly knowledgeable of each content area and all topics that might fall into those categories before the exam. There are some general topics that may fall into some or all of these categories that you might want to review. These are ECG calibration methods, ECG measurements, problems that may arise with ECGs and their solutions, lead placement, waveforms, somatic tremors, and electrical interference. In studying you should take into account the percentage each category constitutes of the exam. Take all material seriously, but spend more time on those areas that hold more weight.
CCT Exam: Eligibility and the Application Process
The Certified Cardiographic Technician CCT exam itself is really the second step in becoming certified. The first hurdle you must get by is actually receiving approval to take the exam. This entails assessing whether or not you meet the eligibility requirements associated with the exam and completing and submitting all application materials. There are several different ways you can qualify.
Regardless of the route you take to meeting eligibility requirements, you must hold a high school diploma or GED. If you have one of these, you must meet then meet one of four different additional eligibility requirements. The first method for qualifying is being enrolled in a cardiovascular or allied health training program at the time of application. If you have already graduated from one of these programs you will qualify, but it is enough that you at least be a student. If you have already completed the program you must submit your completion certificate as proof that you have finished the program. If you are still in the program, you can verify your student status with a Student Verification Letter or transcripts from your educational institution. This qualification route has the number CCT1.
The second way you can qualify is by holding a job in Cardiovascular Technology or in allied health. Your job must be approved by the American Medical Association (AMA). An Employment Verification Letter will be required if you are applying under these qualifications. This qualification route has the number CCT2.
The third method for qualifying is by obtaining an associate’s degree, bachelor’s degree, or higher from an educational institution. You will also qualify if you have completed all courses required for the degree but not yet graduated. The degree must be in the sciences or in an area related to physical health. To substantiate your qualifications through this avenue, you will be required to submit a Student Verification Letter, transcripts from your educational institution, or a completion certificate. This qualification route has the number CCT3.
The final route to meeting eligibility requirements is through volunteering. If you have volunteered in the area of Cardiovascular Technology for at least 2 years, you will qualify. This must be on a full-time basis, and your activities must involve direct technical experience under proper supervision. An Employment Verification Letter will be considered appropriate documentation verifying this experience. This qualification route has the number CCT4. If you do not meet any of these requirements, you will not be rewarded a testing seat for the CCT exam.
Go forward with the application process if you are confident of your meeting one of these areas of eligibility requirements. You will find an application on the Cardiovascular Credentialing International (CCI) website under the tab labeled “Examination Application & Overview Booklet.” The CCI puts out numerous certification exams, so when you fill out the application, be sure to indicate that it is the CCT exam you are applying for by checking the appropriate box. You will also need to indicate which qualification heading you qualify under by circling CCT1, CCT2, CCT3, or CCT4. You must indicate whether you have taken the exam before or not. If you have, a minimum of 6 months must have elapsed since you last took it. Fill out the rest of the application as the instructions direct you. Finally, you must sign the Affidavit found in the application.
Mail the application, the appropriate documentation associated with your qualifications, and all appropriate fees. Fees for the CCT exam should come out to $160. An extra $50 fee is required for international applicants. Mail all of this material to the address provided in the Exam Overview Booklet. This address is also located at the bottom of the exam application. Note that you cannot fax any of your application materials. They all must be sent in together by mail. You will shortly after be notified by email of your approval to test.
CCT Exam: Study Strategies
Even if you have worked in the cardiographic technology field or taken classes in this area, you will need to devote a good deal of time to studying in order to pass the Certified Cardiographic Technologist (CCT) exam. It is imperative that you master all pertinent skills and information, not just so that you can obtain certification credentials and qualify for greater job opportunities, but principally so you can ensure the safety of your patients. Studying for this exam will require the commitment of your time and attention, but if you are willing to make that commitment, you stand a good chance of passing on your first try. There are a number of ways you can approach studying to maximize your chances for success.
Implement a strict study schedule. You should plan to begin months before your exam date. In fact, as soon as you decide to take the exam you should begin studying. Plan to study at a regular time and in a regular place each day. This will help you develop a routine, and once you have gotten into a habit with this routine, you will be less likely to let other things interfere with your studies. The environment you choose to study in should be quiet and free of distractions. A library would be an ideal place. If you have other obligations throughout the week, split your time up. For example, you could study for 2 hours in the mornings and for 2 hours in the evenings. After you have set aside a clear amount of time that will be dedicated to studying for the exam each day, make a list of goals—getting to the end of a certain chapter by the end of a certain day, for example. Note the categories of content that will be covered on the test and use them as a guide for what material to focus on.
As you are studying, highlight all relevant material you come across. Once you have made it to the end of a certain checkpoint, go through your highlighted material and determine which information is the most significant. Add this information to a study guide that you can build upon each day. You could also try writing a summary after every chapter you finish. You will probably end up writing much of the same material you have highlighted, but in your own words, which will help you strengthen your comprehension. You will also automatically filter out most of the information that is less important. Use flashcards to record and review brief pieces of information, like terminology.
At some point in your preparation for the CCT exam it would be wise to talk to someone who has already taken the exam. They can tell you about material featured on their exam, strategies they used for certain kinds of problems, and methods for relaxing your nerves before you go into the exam. Even if there is not much you can learn from them that you haven’t already learned in your own study, you will at least walk away feeling less nervous because you will know someone who has made it through successfully.
Once you have been studying for several months and feel comfortable with your level of knowledge consider taking the CCI Self-Assessment Exam (SAE). These exams can be purchased at the CCI’s website for about $50. The SAE will feature approximately 100 multiple-choice questions similar to those you will encounter on the actual CCT exam. This is not an online exam. After your order is processed you will be sent a test and answer sheet. You will take your SAE, filling out all of the bubbles on the answer sheet appropriately, and send it back in to the CCI for grading. Within 2 weeks you should receive your score. Use this assessment test to determine your strengths and weaknesses and alter your study accordingly.
Becoming certified as a CCT is not as easy as passing one test and then carrying the credentials for the rest of your life. If this were the case, over the years your certification would lose its value and meaning. At a certain point, your expertise would become more of an assumption than something you have proved by meeting standards that apply to all CCTs across the board. You might not be up-to-date with medical and technological advances in your field, and you might simply forget some of the information that is supposed to make up the foundation of your qualifications for your job. It is required of all CCTs to renew their certification on a regular basis, and because of this requirement your credentials retain their value.
Your certification expires every 3 years. In order to renew it before this time, you must pay regular fees, meet continuing education requirements or retake the CCT exam, and regularly demonstrate your understanding of the Cardiovascular Credentialing International (CCI) Code of Ethics by reading them and giving your signature as a sign of your agreement to adhere to all that they outline. Paying your fees is the first requirement you must meet to recertify. This cost comes out to $150, and it must be paid before your 3 year deadline. If you do submit all recertification materials by the 3 year deadline, you will enter into a 90 day “grace period” in which you have a second chance to send in these materials. This tardiness will require an additional $50 in fees. It is possible to pay all fees online with a credit card.
The second step in the process of renewing your certification is accumulating a mandatory amount of continuing education units (CEUs). The CCT requirement is 16 CEUs. This requirement is waived in the first 3 year period because it will be fulfilled by your passing the CCT exam. After the first 3 year period following your certification you will begin to attain and document your 16 CEUs triennially.
There are several ways you can garner CEUS. You can participate in activities sponsored by the Accredited Sponsors of the Accreditation Council for Continuing Medical Education (ACCME). These particular CEUs are called Continuing Medical Education (CME) units. You can gain CEUs by logging contact hours with the Accredited Providers of Continuing Education in Nursing by the American Nurses Credential Center (ANCC). These contact hours can also be logged with one of the ANCC’s Accredited Approvers. You can gain CEUs by logging contact hours with professional organizations employing the American Registry of Radiologic Technologists (ARRT) Recognized Continuing Education Evaluation Mechanism (RCEEM). The final way you can gain CEUs is through logging contact hours with a Continuing Education Provider (CEP) that has been approved by the Board of Registered Nursing (BRN). A list of these providers can be found in the CCI Examination Application and Overview Booklet.
Whatever method you choose to accumulate CEUs, the activities you participate in must be directly related to cardiovascular technology and/or patient care in order to count. Note that if you miss the renewal deadline the 90 day “grace period” is only an extra period of time in which to submit all necessary fees and materials for recertification; you will not be allotted extra time to participate in continuing education activities.
If you do not want to recertify through continuing education, you can retake the CCT exam. To do this you must meet eligibility requirements, apply, and be approved for testing. The test will be the same as the first one you took. The only difference will be in the selected questions.
The last step in recertification is reading the CCI Code of Ethics and signing them. These are found on the CCI’s website. By signing you are demonstrating your understanding of the guidelines that hold you accountable to patients and coworkers and asserting your professionalism in the work place.