Navigating the NBRC Changes: What Respiratory Therapy Students Need to Know for 2027
The way you earn your CRT and RRT credentials is shifting in 2027. The NBRC changes introduce a new Respiratory Therapy Examination, replacing the old format and the Clinical Simulation Exam. This blog breaks down the exam structure, how scores will determine your credential, and what to expect if you plan to test after 2027. Stay informed to keep your respiratory therapy goals on track.
Understanding the 2027 NBRC Credential Changes
A New Single-Exam Approach
Starting in January 2027, the National Board for Respiratory Care (NBRC) will implement a significant change in how respiratory therapists earn their credentials. The current two-exam system will be replaced by a single comprehensive test called the Respiratory Therapy Examination. This represents one of the most significant NBRC changes in recent years and will affect all respiratory therapy students planning to sit for the boards after December 31, 2026.
What's Happening to the CRT and RRT Credentials?
Don't worry - both the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) credentials will still exist. The difference is how you'll earn them. Instead of taking separate exams, your performance on different sections of the single Respiratory Therapy Examination will determine which credential you receive. This streamlined approach aims to maintain high standards while making the qualification process more straightforward.
The New Respiratory Therapy Examination Structure
Exam Format and Time Allocation
The new examination will consist of 160 multiple-choice questions and will have a total time limit of 4 hours. This time will be divided into two distinct 2-hour sections:
Section One: Focuses on breadth of knowledge across the respiratory therapy field
Section Two: Concentrates on depth of clinical judgment and decision-making skills
This balanced approach ensures candidates demonstrate both comprehensive knowledge and practical clinical reasoning.
Credential Determination
Your performance on the exam will determine which credential you earn:
Meeting the lower cut score will qualify you for the CRT credential
Achieving the higher cut score will earn you the RRT credential
This means you can potentially earn your RRT credential in a single testing session, rather than taking multiple exams as required under the current system.
Goodbye to the Clinical Simulation Exam
Clinical Simulation Exam Replacement
The new Respiratory Therapy Examination effectively replaces the current Clinical Simulation Exam (CSE). The second section of the new exam will incorporate elements of clinical judgment and decision-making that were previously assessed in the CSE, but in a different format. This change addresses some of the challenges associated with the CSE while still thoroughly evaluating clinical reasoning skills.
Benefits of the New Approach
This Clinical Simulation Exam replacement offers several advantages:
More consistent evaluation of clinical skills
Reduced testing time and costs for candidates
Streamlined credentialing process
Maintained focus on critical thinking and patient care scenarios
Timeline and Transition Period
Current Pathway Remains Valid Until 2026
If you're currently in a respiratory therapy program or planning to test before the end of 2026, you'll still follow the existing pathway:
Take the Therapist Multiple-Choice (TMC) Examination
If you achieve the higher cut score on the TMC, take the Clinical Simulation Examination (CSE)
All current credentials will remain valid after the transition, so there's no need to retake exams if you're already certified.
Preparing for the 2027 Exam Updates
For students testing after January 1, 2027, preparation should focus on the new exam format. While the core knowledge and skills remain similar, the testing approach will be different. Educational programs will likely adjust their curricula to prepare students for the new examination format as 2027 approaches.
Maintaining High Respiratory Therapy Standards
The NBRC has emphasized that these changes are designed to uphold the high respiratory therapy standards the profession is known for. The new examination will continue to thoroughly assess the knowledge and skills needed for safe and effective practice, while removing unnecessary barriers for qualified candidates.
What This Means for Students
If you're a respiratory therapy student who will graduate after 2026:
You'll prepare for one comprehensive exam instead of potentially two separate ones
Your study approach may need to balance breadth of knowledge with in-depth clinical reasoning
You'll have the opportunity to earn your RRT credential in a single testing session
Looking Forward
These CRT RRT credentialing changes represent an important evolution in respiratory therapy professional standards. By staying informed about the 2027 exam updates, you can better prepare for your future career path.
Remember to regularly check the NBRC website for official updates and detailed information as the transition date approaches. Your educational program will also provide guidance on your graduation timeline and how these changes may affect your credentialing journey.
The respiratory therapy profession continues to grow and adapt, and these examination changes reflect a commitment to maintaining excellent patient care while creating a more efficient pathway to professional practice.
