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In 1994, a practice analysis (role delineation study) was conducted on the profession of hand therapy. This study was conducted as a follow-up to the original study conducted by the American Society of Hand Therapists (ASHT) in 1985. A representative group of content experts developed a description of hand-therapy practice, and this description was validated using a questionnaire. The questionnaire was distributed to a random sample of 400 certified hand therapists (CHTs), of whom 50% responded. The respondents provided confirmation of the accuracy of the description of hand therapy. The survey results were used to update the test specifications for the Hand Therapy Certification Examination. The results enabled the Hand Therapy Certification Commission to improve upon its certification program by clarifying and expanding the definition of hand therapy. The 1994 findings were also compared with the results of the 1985 study.

In 1991, the first Hand Therapy Certification Examination was administered to candidates throughout the United States. Since then, the examination has been given annually. The purpose of this paper is to summarize the processes that have been used to develop the examination as well as to report demographic data about the examination and certification candidates. Overall, the results of test administration have been very good. Twenty-two hundred therapists have become certified hand therapists. Eighty-five percent are occupational therapists, and 88% are female. Most candidates have practiced for ten years or less and have maintained caseloads of upper-extremity patients for three to six years. The examination has performed well. Reliability coefficients have been 0.91 or greater for each administration. The mean scores on the examination have decreased each year, from 148.4 in 1991 to 129.4 in 1995.