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AAMA 2018-2019 Occupational Analysis of Medical Assistants

Findings Shed Light on Current Medical Assisting Scope of Work

The AAMA 2018-2019 Occupational Analysis of Medical Assistants reports the results of a comprehensive AAMA survey of what ​medical assistants identified as their responsibilities. Read the downloadable version or the web version below:

To ensure the currency and unsur­passed quality of the CMA (AAMA)® Certification Exam and the CMA (AAMA) credential, the Certifying Board (CB) of the American Association of Medical Assistants® (AAMA) undertakes an occupational analysis of the medical assisting profession approximately every five years. The CB used Prometric, a lead­ing testing and measurement firm, to assist with the 2018–2019 occupational analysis.

The survey instrument, derived from the initial phase of the occupational analysis process, asked a large variety of medical assistants with diverse backgrounds and employment histories to rank task and knowledge statements in order of impor­tance for their current medical assisting positions. A total of 4,054 survey recipients responded. As a result, the data derived from the survey are quite robust and pro­vide the CB with sufficient empirical evi­dence for the CB to fulfill its mission of testing knowledge currently required of practicing medical assistants and awarding the CMA (AAMA) credential to knowl­edgeable and competent medical assistants.

The findings of the occupational analysis give the CB direction to update the Content Outline for the CMA (AAMA)® Certification Exam (available on the AAMA website1), which enables the Task Force for Test Construction (TFTC ) to write exam items that measure the knowledge, skills, and professional attributes required by employers, delegating professionals, and supervisors of medical assistants. The results also provide data valuable for the Medical Assisting Education Review Board (MAERB) in revising the “Core Curriculum” in appendix B of the Commission on Accreditation of Allied Health Education Programs (CAAHEP) Standards and Guidelines for the Accreditation of Educational Programs in Medical Assisting.2 In addition, the Continuing Education Board (CEB) of the AAMA uses the information to develop continuing education vehicles that are relevant for medical assistants and other health professionals.

Development of the occupational analysis survey

A task force committee consisting of a diverse and representative group of medi­cal assistants met to develop task and knowledge statements that reflect what medical assistants need to know and be able to do to be considered competent medical assistants. Prometric staff served as facilitators of this meeting.

The task force committee concluded that there are four major domains into which the task and knowledge statements should be classified:

  • Administrative
  • Clinical competency
  • Communication
  • Legal and ethical issues

The task and knowledge statements were incorporated into the occupational analy­sis survey instrument. Each recipient of the survey was asked to rate each task statement and knowledge statement according to the following scale:

  • 0 for no importance
  • 1 for little importance
  • 2 for moderate importance
  • 3 for important
  • 4 for very important

Ranking of importance of task statements

The ratings of each task statement by the 4,054 survey participants were compiled and averaged. Because task statements deemed to be very important were assigned a numeric value of 4, the statements with the highest average rating were determined to be most important. Table 1 lists the task statements, the major domains into which they were categorized, and their importance values (from most important [4] to least important [0]).

Table 1. Ranked task statements
  Task statements Major domain  Importance
Maintain confidentiality and patient privacy (Health Insurance Portability and Accountability Act of 1996 [HIPAA]) Legal and ethical issues 3.97
2 Work within scope of practice Legal and ethical issues 3.94
3 Respect patient preferences without personal bias (respect for gender, ethnicity, developmental level, sexual orientation, etc.) Legal and ethical issues 3.93
4 Comply with the organization’s policies and procedures Legal and ethical issues 3.92
Maintain appropriate hand hygiene Clinical competency 3.91
6 Maintain accurate patient records using appropriate medical terminology  Legal and ethical issues 3.91
7 Maintain patients’ personal boundaries  Legal and ethical issues 3.91
8 Maintain professionalism (with vendors, patients, colleagues, etc.)  Communication 3.88
9 Review medications and allergies Clinical competency  3.82
10 Maintain respect for cultural diversity  Communication 3.81
11 Comply with mandatory reporting requirements (federal and state)  Legal and ethical issues 3.81
12 Adhere to standards related to patient safety  Clinical competency 3.81
13 Establish rapport with patients  Communication 3.79
14 Apply universal precautions  Clinical competency 3.79
15 Interact with patients at the level of each patient’s understanding  Communication 3.77
16 Stay up to date with facility policies and procedures  Communication 3.77
17 Adhere to federal and state regulations pertaining to minors  Legal and ethical issues 3.76
18 Obtain patient vital signs  Clinical competency 3.76
19 Document details of interaction with patients  Clinical competency 3.76
20 Identify and adapt approach to communication barriers (e.g., language, special needs, age)  Communication 3.76
21 Review and document reason for visit (including chief concern and associated signs and symptoms)  Clinical competency 3.74
22 Maintain current consent, release forms, and contracts  Legal and ethical issues 3.74​
23 Recognize how cultural differences impact patient treatment plans and adapt accordingly  Communication 3.73
24 Report findings to the provider​  Clinical competency 3.73
25 Appropriate cleaning and sterilization of equipment and rooms  Clinical competency 3.73
26 Appropriate use of medical equipment and quality control checks​  Clinical competency 3.72​
27 Obtain orders from the provider  Clinical competency 3.71
28 Ensure all parties understand the plan of care  Communication 3.71
29 Identify patient needs or urgency  Clinical competency 3.71
30 Label specimens correctly (including location, patient, date, time, etc.)  Clinical competency 3.71
31 Prepare patients for examinations, procedures, and treatments  Clinical competency 3.70
32 Prepare room and instruments for patient examination  Clinical competency 3.69
33  Determine appropriate cleaning and disposal of biohazard materials  Clinical competency 3.67
34 Report observations and summary of findings to the provider  Clinical competency 3.63
35 Stay up to date with current state regulations  Legal and ethical issues 3.63
36 Use learning resources to maintain knowledge of current medical practices  Communication 3.62
37 Apply institutional policy on safety in the workplace environment  Clinical competency 3.61
38 Participate in educational opportunities to stay up to date  Communication 3.61
39 Determine appropriate personal protective equipment (PPE)  Clinical competency 3.59
40 Review patient history  Clinical competency 3.59
41  Document patient preference (e.g., preferred name and pronouns, cultural and religious preferences)  Communication 3.58
42 Provide follow-up instructions to patients per the provider’s recommendation  Clinical competency 3.56
43 Identify safety resources (e.g., material safety data sheets [MSDS], exits, fire extinguishers, crash carts)  Clinical competency 3.54
44 Obtain history of illness or mechanism of injury  Clinical competency 3.54
45 Ensure that the patient verbalizes an understanding of their plan of care  Clinical competency 3.53
46 Identify patient rights for medication administration  Clinical competency 3.52
47 Document history of present illness  Clinical competency 3.49
48 Ask open-ended questions when interviewing patients  Clinical competency 3.49
49 Serve as a patient advocate  Communication 3.48
50 Prepare and maintain a sterile field  Clinical competency 3.47
51  Administer medications and immunizations (e.g., injectable, oral, topical, aerosol)  Clinical competency 3.46
52 Establish transmission-based (airborne, droplet, contact) precautions for patient procedures  Clinical competency 3.46
53 Identify patients’ limitations and learning strengths  Communication 3.46
54 Discuss test results with patients as directed by the provider  Communication 3.45
55 Assist the provider with procedure  Clinical competency 3.45
56 Identify problems and formulate a plan of action  Clinical competency 3.45
57 Perform standing orders  Clinical competency 3.42
58  Perform testing (e.g., Clinical Laboratory Improvement Amendments [CLIA]–waived testing, electrocardiogram [ECG/EKG], spirometry, blood collection, phlebotomy, specimen collection)  Clinical competency 3.42
59 Describe procedure and obtain consent​  Clinical competency 3.42
60 Provide information and set expectations for visits  Communication 3.40
61 Request medication refills   Clinical competency 3.39
62 Determine appropriate screening per policy  Clinical competency 3.37
63 Provide the posttreatment instructions  Clinical competency 3.36
64 Serve as a communication liaison for the health care team  Communication 3.29
65 Identify risks involved for the patient procedure  Clinical competency 3.26
66 Document the procedure details  Clinical competency 3.26
67 Identify the roles of the health care team members  Communication 3.25
68 Recommend appropriate community resources  Communication 3.25
69 Coordinate schedules among providers for continuity of care  Communication 3.22
70  Manage the provider’s schedule to ensure efficient workflow (e.g., making sure the patient has all the necessary studies, such as CT scan, MRI, blood work, and electromyogram [EMG])  Administrative 3.20
71 Perform wound and dressing care  Clinical competency 3.16
72  Draft letters per patient request (e.g., work release, return to work/school)  Clinical competency 3.11
73 Review diagnosis and health status Communication  3.08
74 Maintain accurate documentation to support coding
(Advance Beneficiary Notice [ABN] if applicable)
 Administrative 3.08
75 Manage supplies and equipment (including expiration dates and equipment quality control)  Administrative 3.07
76 Schedule follow-up care (e.g., referrals, appointment, testing)  Clinical competency 3.06 
77 Obtain a copy of patients’ outside/transferred medical record as appropriate  Administrative 3.03
78 Review appropriate office policies with patients (e.g., service animals, cancellation and late arrival policies, weapons)  Communication 3.00
79 Verify patient demographics  Clinical competency 2.99
80 Provide an after-visit summary  Clinical competency 2.98
81 Obtain patient demographics  Clinical competency 2.95
82 Conduct review of systems  Clinical competency 2.94
83 Maintain primary care physician information  Administrative 2.94
84 Obtain the appropriate Current Procedural Terminology (CPT) and diagnosis codes for insurance authorization  Administrative 2.90
85 Record accurate codes for the patient visit (International Classification of Diseases, Tenth Revision [ICD-10], Current Procedural Terminology [CPT])  Administrative 2.86
86 Initiate authorizations as appropriate  Administrative 2.86
87 Maintain up-to-date emergency contact information  Administrative 2.80
88 Provide training for support staff  Administrative 2.80
89 Collect current patient legal documents (e.g., do not resuscitate [DNR], do not intubate [DNI], living will, power of attorney, health advocacy)  Administrative 2.65
90 Maintain updated patient credentials (e.g., insurance card and eligibility, identification, consent forms)  Administrative 2.63
91 Counsel patients on the process and status of insurance prior authorization/precertification  Administrative 2.61
92 Recommend to patients to stay up to date with their insurance policy (including coverage benefits, out-of-pocket costs, co-pays, deductibles)  Administrative 2.45
93 Draft appeal letters for patient authorizations for provider review and approval (per practice) and submit appeal letters to insurance companies  Administrative 2.38
94  Coordinate provider peer-to-peer review for authorization per practice  Administrative 2.37 
95 Manage insurance co-pay and accounts receivable, and reconcile end-of-day financial reports  Administrative 1.80

Ranking of importance of knowledge statements

The ratings of each knowledge statement on the questionnaire were compiled and averaged. As was the case with the task statements, the knowledge statements of greatest importance have the highest average rating. Table 2 lists the knowledge statements and their importance values (from most important [4] to least important [0]).

Table 2. Ranked knowledge statements
  Knowledge statements Importance
Health Insurance Portability and Accountability Act of 1996 (HIPAA) 3.94
2 Privacy of patient conversations 3.93
3 Protected health information (including appropriate document handling and disposal) 3.92
4 Patient identification (e.g., name, date of birth)  3.89
Pertinent medical information 3.86
6 Electronic health record (EHR) and electronic medical record (EMR) systems, including documentation 3.85
7 Telephone etiquette 3.85
8 Vital signs (manual and electronic) 3.84
9 Medical terminology 3.83
10 Grammar (e.g., spelling, punctuation) 3.83
11 Medications and allergies 3.81
12 Disposal of hazardous materials (e.g., sharp objects, medications, biohazards) 3.81
13 Standard precautions and personal protective equipment (PPE) 3.80
14 The “rights” of medication administration (e.g., right client, right route, right dose) 3.79
15 Consent (implied, verbal, written, etc.) and consent forms 3.79
16 Scope of practice for medical assistants (state and federal) 3.78
17 Safety and emergency procedures 3.78
18 Personal boundaries 3.78
19 Signs and symptoms 3.77
20 Patient condition (e.g., mobility, special accommodations) 3.76
21 Interpersonal relationship skills (e.g., de-escalation, customer service, verbal and nonverbal cues) 3.74 
22 Procedures (sterile vs. nonsterile) 3.72
23 Anatomy and physiology 3.71
24 Personal rights of health care team members 3.70
25 Continuity of care 3.70
26 Safety resources (e.g., material safety data sheet [MSDS], exits, fire extinguishers, crash carts) 3.68
27 Tests, laboratory results, specimen collection techniques 3.67 
28 Normal and abnormal ranges 3.64
29 Patient identification and demographics 3.61
30 Roles of the health care team members 3.61
31 Body mechanics 3.60
32 Federal and state regulations (e.g., about minors and dependent adults, consumer protection laws) 3.59
33  Pharmaceutical laws regarding opioids, refills, etc. 3.58
34 Equipment (names, types, cleaning, quality control, etc.) 3.56
35 Order processes and instructions (e.g., visit summary, patient education) 3.56
36 Instruments 3.56
37 Resources available to patients (e.g., interpreters, special equipment, case managers, financial aid) 3.52
38 Documentation techniques and formatting techniques 3.45 
39 Patient visit type and pre-visit planning 3.42
40 Resources (e.g., immunization schedules, Centers for Disease Control and Prevention [CDC], local health department) 3.40
41  Electronic health record (EHR) schedule management (patient schedule and staff schedule) 3.38
42 Interviewing techniques and reporting formats 3.37
43 Office policy regarding standing orders, expiration dates, equipment quality control, licenses, certifications, credentials, etc. 3.37
44 Referral processes and resources 3.36
45 Pharmacology (administration, interactions, contraindications, etc.) 3.34
46 Required equipment and maintenance 3.33
47 Wound care 3.31
48 Acceptable identifying documentation 3.27
49 Health information management 3.26
50 Required supplies and ordering process per institutional policy 3.21
51  Institutional and state reporting requirements 3.18
52 Training resources (including risk management, orientation, and safety) 3.15
53 Patient immunization eligibility resources 3.03
54 Legal and medical documentation (e.g., do not resuscitate [DNR], do not intubate [DNI], living will, power of attorney, health advocacy) 3.02
55 Codes and supporting documentation (e.g., diagnostic codes, procedure codes) 2.95
56 Insurance types, authorizations, and resources (insurance contact information, time line, formulary, appeal process) 2.85
57 Institutional insurance policies 2.83
58  Insurance coverage for patient services and waivers (e.g., self-pay, advance beneficiary notice [ABN]) 2.78
59 Coding 2.70
60 Basic financial processes 2.59
 
 

References

  1. Exam content outline. American Association of Medical Assistants. Accessed March 5, 2020. https://www.aama-ntl.org/cma-aama-exam/study/content-outline
  2. Commission on Accreditation of Allied Health Education Programs. Standards and Guidelines for the Accreditation of Educational Programs in Medical Assisting. Revised 2015. Accessed March 5, 2020. http://www.maerb.org/Portals/0/Documents/MedicalAssistingStandards.pdf