In the early 2000s, a concerning trend emerged in healthcare data, revealing a notable increase in pre-analytical errors affecting patient care. Articles in reputable journals highlighted significant mistakes in various healthcare practices, raising concerns about the implementation of guidelines and standards. Despite a surge in allied healthcare graduates, errors persisted, even with increased industry certification and new state regulations mandating credentialing.Recognizing healthcare as a contact sport, where practical skills matter, we realized the importance of assessing clinical abilities beyond written examinations. Amid challenges in patient care quality due to inadequately trained graduates contributed to costly errors, impacting patients, hospitals, providers, and the economy.To address this issue, a dedicated group of educators and practitioners established the NCMA, a national certification agency. With a mission to reduce pre-analytical and performance errors in healthcare. With our two-part exam approach for verifying applied skills and theoretical knowledge