The CCKE is a comprehensive test of your clinical cardiovascular knowledge and is designed for a more experienced NP or PA clinician; it is not intended for someone newly out of training. To be eligible to participate, you need to have accrued a minimum of 2,000 hours in cardiovascular medicine in the last 3 years, with a portion of that time spent in direct cardiovascular patient care.

As part of the online application, you will:

• Submit your current license with date of expiration.
• Provide information about your cardiovascular medicine experience.
• Submit a professional associate recommendation using one of the two template options below.

For any questions regarding the application process, please email us at ccke-nppa@acc.org.

• Validate your eligibility for participation in the Program by reviewing the list above.
• Apply for the Program online and submit proof of eligibility. You'll learn if your application has been accepted in approximately 4 – 6 weeks.
• Prepare for your exam.
• Verify that your system is compatible with ACC's exam delivery system by taking a brief sample exam and reviewing the resources in the CCKE Exam Hub.
• Take the exam.
• Learn your score 1 – 2 months after the exam.
• Celebrate your success!

The Certified Cardiovascular Knowledge Examination is administered online twice a year during a four-day testing window. The exam may be taken from your home or office; there is no need to travel to a testing center. You will have 7.5 hours to answer CCKE questions. There is an optional 24 hours offered which can be taken between sections. During the testing window, the exam is available 24 hours a day and remains open until 11:59 p.m. ET on the last day.

To take the CCKE, you must have:

• A private space that is free from disruptions for the time allotted for the assessment.
• Reliable internet access.
• The devices and browsers outlined in the table below:

The Certified Cardiovascular Knowledge Examination is developed, evaluated, and approved by subject matter experts and psychometricians to ensure that it provides a fair and reliable estimate of proficiency.

Prior to the exam, questions are written by cardiovascular NP and PA experts trained in effective question writing. The questions undergo a rigorous review process to ensure that each question is fair, clinically accurate, and relevant. The questions are also aligned to the 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine document which identifies the knowledge and skills necessary for NPs and PAs practicing in cardiovascular medicine. The questions selected for inclusion on the examination must be of good quality and meet statistical and content specifications.

Following each exam administration, questions are evaluated based on their statistical properties. Questions that do not meet statistical criteria are reviewed by a committee prior to scoring the exam. Any question deemed as flawed or inappropriate is removed from scoring. The final scoring of the exam is based on the number of questions that have been accepted as suitable.

Reliability is the extent to which the CCKE consistently measures the core components of cardiovascular medicine. The reliability of the examination can be affected by the uniformity of the questions, the length of the exam, as well as the quality of questions. The reliability of the CCKE will be estimated using internal consistency methods such as Cronbach's alpha once we have gathered sufficient data.

This exam will be offered twice in 2024:

The CCKE is available 24 hours a day during the dates noted above and will be available until 11:59 p.m. ET on the last day.

Once you start the exam, you have 31.5 hours within a four-day window to take the CCKE.

With 3 minutes available for each 30-question section, you may take up to 1.5 hours per section; 7. 5 hours to complete the exam. You have an optional 24 hours of break time which can be divided and taken after any section. Therefore, you can plan for 31.5 hours during the four-day window to complete the exam.

The CCKE window is open for four full days. The exam will open on Thursday, Sept. 19, at 12:01 a.m. and remain available until Sunday, Sept. 22, at 11:59 p.m.

As you prepare for the exam, review, and print the CCKE Tutorial and CCKE Checklist.

Application Fee $25*

Exam Registration Fee

*$25 Application fee is not refundable.

CCKE Refund Policy:

• CCKE cancellations made 8 – 21 days prior to the exam will be subject to a $50 administrative fee.
• No cancellations within 7 days, or one week, prior to the exam and no refunds will be issued.

All CCKE cancellations must be sent in writing to ccke-nppa@acc.org.

Deferrals are not available with the CCKE. If you have already registered for an exam and need to choose a different date, please submit a cancellation request as noted above and register for a future exam.

This exam covers the field of cardiovascular medicine. The list below shows the specific topics that are covered and their relative weight on the exam:

To prepare for the CCKE, download and print the CCKE blueprint and review the additional details about each medical content category.

This exam covers the field of cardiovascular medicine. The exam will cover some of the clinical competencies outlined in the 2020 ACC NP/PA Competency Document.

2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine: A Report of the ACC Competency Management Committee | Journal of the American College of Cardiology (jacc.org)

Preparation for the CCKE is subjective and you are welcome to use any resources for study and practice. Here are some ideas that may be useful to you as you prepare for the exam.

To assess your gaps and areas that require more focus, use the CCKE blueprint. This chart provides additional details about the specifics within each medical content category. Note that the percentage of exam by medical content category is also listed in the column.

Once you have assessed what you want to study, the ACC has different clinical information and resources that may be helpful to you.

ACC offers numerous resources to set you up for success!

• Clinical Review and Resource Guides are freely available online! View the list of guideline-related study tools and other resources to help you prepare. In addition, you may want to also print the information from Table 3 and Table 5 from the 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine.
• Webinars: ACC's Cardiovascular Team Section offers topic-specific webinars to help prepare for the CCKE. Note the webinars below and watch the CV Team Section page for additional offerings.
  Webinars:
  • Stable Ischemic Heart Disease
  • Congenital Heart Disease
  • Pulmonary Hypertension Diagnosis and Management
• ACCSAP: ACC's Adult Clinical Cardiology Self-Assessment Program (ACCSAP) provides a comprehensive overview of the field of cardiovascular medicine and includes 700+ self-assessment question. ACCSAP is available at a reduced rate of $300 (member)/$350 (non-member) for NP/PAs interested in using it as a study tool for the CCKE. To purchase at this rate, please call Member Care at 800-253-4636, x5603. ACCSAP, which is normally a five-year subscription, is now available as a one-year subscription to NP/PAs looking for a study tool for the CCKE.
  To learn more about ACCSAP, visit HERE.
  • Note: ACCSAP offers enough credits and MOC points in Medical Knowledge for all your licensing and certification requirements (CME/MOC/AAPA/CNE credit).

Candidate Score

Candidate scores are determined by the number-correct formula where a correct response will count as one and an incorrect response will count as zero.

While ACC strongly recommends that candidates attempt to answer every question, failure to complete every question does not immediately imply you did not pass the exam and there is no penalty for guessing.

Passing Score
What's the Passing Score for This Exam?

The passing score is determined based on the results of a content-based standard-setting study by a panel of subject matter experts followed by review and final approval by ACC's Certification Governance Work Group.

The standard-setting study is conducted by cardiovascular subject matter experts invited by ACC to participate as a standard setting panelist. Panelists are representative of U.S. NPs/PAs and reflect diversity in age, geographic location, and years of experience.

ACC uses the standard setting method known as the modified-Angoff. Under the guidance of a psychometrician, selected panelists review each question to determine the basic level of knowledge or skill that is expected. The recommended passing score is based on the panel's estimated difficulty ratings for each exam question. The recommended passing score from the standard-setting study is then reviewed and approved by ACC's Certification Governance Working Group. The passing score for the exam represents the minimum score needed to identify individuals with an acceptable level of knowledge and skill.

Passing the Exam

The CCKE is a criterion-referenced test meaning that exam outcomes are a result of comparing a candidate's score to the passing score standard. If the candidate's score is equal to or higher than the passing score, then the candidate has passed the exam. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

Score Report

A score report showing the candidate's score and the passing score will be available 1-2 months after the examination test window. ACC will notify candidates by email when scores are available.

Candidates who pass the Certified Cardiovascular Knowledge Examination will receive the following benefits and resources:

1. A Score Report that includes a recommended list of content to study based on the questions answered incorrectly.
2. A printable Certificate for display purposes
3. A Digital Badge that can be used in email signatures, on LinkedIn, etc.
4. Recognition on ACC's website
5. Credit Toward AACC or FACC Status
6. The right to use a "CCK" Credential after their name. (CCK stands for Certified in Cardiovascular Knowledge)

The CCK credential will be valid for a minimum of five years, after which candidates will need to demonstrate continuous competency to continue using it. More details will be provided on ACC's website soon.

Yes, examinees who pass the CCKE may now include the credential "CCK," which stands for "Certified in Cardiovascular Knowledge". This credential demonstrates that participants successfully passed this exam which tests cardiovascular knowledge and clinical expertise.

Examples of how to use the CCK credential are shown below.*

Erica F. Smith, APRN, AACC, CCK
Ann B. Jones, PA-C, FACC, CCK

*These are fictitious names to demonstrate use of the credential.

The American College of Cardiology provides reasonable accommodations to examinees with documented needs for special accommodation. Examinees wishing to request accommodation should submit a completed request form and supporting documentation at least 60 days prior to the exam date. Submit requests to ccke-nppa@acc.org.

Your exam fee covers the cost of one exam; if you take the exam a second time, you will need to pay a second fee. Application fee is not refundable.

You may take the exam multiple times, but not consecutively. If you take the November 2023 exam and do not pass, then you must skip the Spring 2024 exam and try again in the fall. If you take the Spring 2024 exam and do not pass, then you must skip the Fall 2024 exam and take the following exam in 2025.

Hospitals and practices that register three or more approved applicants from the same institution at the same time and complete the exam will receive the following benefits:

• The $25 application fee will be waived for applicants registered at the same time.
  • The hospital/practice will be recognized on ACC.org for its commitment to providing the highest quality of care.
  • ACC will send a personalized certificate for display that acknowledges the hospital's/practice's commitment to cardiovascular care.

Hospitals and practices that register five or more approved applicants as a group and complete the exam will receive an aggregate report that shows how the team scored on each area of the exam. See the example report here.

For additional information regarding group applications and registration, please fill out the forms below and submit to Brenda Hindle at bhindle@acc.org.