Revamping the National Licensure Examination Study Guide at NAB

Written by Bostrom

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For 37 years, the National Association of Long-Term Care Administrators Boards (NAB) and Bostrom have brainstormed and collaborated on many projects, all with the overarching goal to advance public protection along the senior living and health services continuum through enhanced professional standards.

NAB is a voluntary, non-profit organization made up of members of state boards or agencies/jurisdictions and maintains four national licensing examinations for senior living and health services administrators: The Core of General Knowledge (CORE), and three line of service specialty exams for Nursing Home Administration (NHA), Resident Care Assisted Living (RCAL) and Home and Community Based Services (HCBS).

In 2017, NAB launched the first ever digital study guide to support candidates preparing to take the national licensure examinations. The team wanted to move away from a printed guide that becomes dated even upon publishing. While innovative, the examinees were not fond of this change and shared many complaints with the organization. Additionally, NAB was not able to make any edits without going back to the original developers, which was a significant investment each time.

In 2020, a professional practice analysis (PPA) was conducted, which resulted in a major reorganization of the NAB Domains of Practice, moving from five to four main content areas as well as the addition of 10 subdomains. This was the catalyst for the redevelopment of an enhanced study guide. The Bostrom staff team led the charge, and, in December 2021, began working with a group of dedicated NAB volunteers to brainstorm the vision for the redeveloped guide based on user feedback.


The overall goal for the team is to have study guide with content that was engaging, yet realistic to the learners therefore creating an individualized learning experience unique as each future administrator who will use this guide. The team looked to combat some common complaints by making it more nimble, interactive, and user-friendly.
Engaging and Interactive
User-Friendly Experience
Dynamic and Nimble Content
It was important for them to create a well-rounded product that worked for many different learning styles. Turning innovative ideas into a tangible product was a large undertaking that involved not only the educational expertise of Bostrom staff, but a task force that was comprised of member representatives from the academic community in addition to the professional community. The team also engaged students who were preparing for their NAB exams to pilot the first module of the redeveloped guide to not only gain early feedback, but to make changes to future modules as needed. It was crucial that users were being heard and feedback was appropriately implemented.
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“Each of us were critically important to the overall success of the project and we knew that and leaned on each other for our parts. I also think it helped having a leader like Michelle [Grachek, Bostrom Account Executive and NAB President] who didn’t really let us take shortcuts. Some of the brainstorming would yield great ideas that were accompanied with more work and instead of letting us get away with coming up with another idea that was less work, Michelle would encourage us to stick to that thread and do the work because it was worth it in the end. She kept us on task and helped us keep a frame of reference for where our work was headed all along.”

Ben Higgins
NAB Study Guide Task Force member and Director of Healthcare Operations, Friendship Retirement Community

Solution for Success

The final product was developed around an interactive learning approach that engages study guide users in learning opportunities for hands on, real-world methodology.

Throughout the study guide, users can glean insights from the following:

  • Interactive Content: The guide holds activities such as identifying “What’s wrong with this picture?” and interactive videos/photos that demonstrate ways to share important information about this profession with licensees.
  • Game-Based Learning: Includes escape room challenges, trivia, crossword puzzles, sorting, and even games modeled after popular television shows.
  • Situational Analyses: There are a total of 40 unique scenarios that are based on real-life occurrences from administrators within their companies or communities.
  • Practice Questions: A crucial portion from a candidate viewpoint, these questions mimic actual examination questions.
  • Discussion and Reflection Activities: Narrative response items help candidates in critical thinking. Discussion topics encourage engagement among other and reflection activities ask the user to personally think about the scenario.


Since the guide launched on November 30, 2022, results have been overwhelmingly positive.

  • There has been an average sales increase of 51.75% when comparing previous years.
  • 800 new, active users have utilized the guide.
  • The momentum generated is being leveraged to enhance the promotion of the conference and membership recruitment

Even with the successful new study guide launch, the team is looking to proactively create features that benefit users. Potential additions include implementing “Ask the Expert” webinars, a self-assessment tool, and a practice test integration.

Are you ready to create impactful member experiences?

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