NBSTSA will announce the recipients of the 2026 NBSTSA Student Academic Merit Award in May 2026.

Beware of Imitation Credentials

Some credentials allow candidates to sit for a certification exam without completing a single verified surgical case. Under certain pathways, a candidate can complete a fully online program, pass an examination, receive a credential, and arrive on day one having never held a surgical instrument in an operating room. That credential may look valid on an application. The gap in preparation is real, and your institution absorbs it.

“A Level I trauma center in Northeastern Ohio recently hired two graduates of a fully online surgical technology certificate program. On their first day, they were asked to scrub in. They could not. They had never been in a skills laboratory. They had never been in an operating room. The hospital’s HR department had reviewed their credentials and found nothing irregular.”

-Surgical Technology Educator, Northeastern Ohio

Only the CST® credential requires verified, documented clinical training: a minimum of 120 in-person patient cases in actual operating rooms, completed and reviewed by NBSTSA® before exam eligibility is granted. That verification happens before your new hire ever crosses your threshold.

The Joint Commission accredits more than 20,000 healthcare organizations in the United States. For virtually every hospital, that accreditation is the basis for Medicare and Medicaid participation, insurance reimbursement, and institutional credibility.

The Joint Commission’s Human Resources Standard HR.01.06.01 requires hospitals to define and verify competencies for all staff who provide patient care, before they provide it. The Commission is explicit that for surgical environments, this includes competency in sterile technique, sterilization, and high-level disinfection.

The Commission also draws a formal distinction between education, training, and competency. Competency requires knowledge, technical skills, and ability: the capacity to correctly apply both to a real patient in a real surgical environment. A passing score on an online exam provides evidence of knowledge only. When a practitioner arrives without verified OR experience, the burden of establishing the remaining two attributes falls entirely on your institution, not on the credentialing body that issued the certificate.

When a Joint Commission surveyor traces patient care and asks how your facility verified that a practitioner was competent to perform the procedures they performed, a credential that required no clinical training before issuance is not a sufficient answer to a deficiency finding.

Hiring CST® and CSFA® professionals shifts the starting point. Their knowledge and clinical competency has already been documented, verified, and validated before they walk through your door, so your team can focus on integration and performance, not remediation.

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The Cost of Getting It Wrong

The financial and patient safety stakes are quantifiable.

OR time costs an average of $36 to $37 per minute, with higher-acuity and specialty settings running considerably more (Childers & Maggard-Gibbons, JAMA Surgery, 2018). A break in sterile technique, a missing instrument, or a mishandled specimen can translate into tens of thousands of dollars in lost OR time per incident, before malpractice exposure is calculated.

Surgical site infections cost more than $20,000 per admission and extend hospital stays by an average of 9.7 days. Nationally, SSIs cost the healthcare system more than $3.3 billion annually (Forrester, Maggio & Tennakoon, Journal of Patient Safety, 2022). Patients who develop SSIs face longer stays, higher readmission rates, and significantly higher 12-month mortality (Shambhu et al., Joint Commission Journal on Quality and Patient Safety, 2024).

The research is also unambiguous on the relationship between clinical training and outcomes. A systematic review published in the Annual Review of Biomedical Engineering found that poor technical skill is associated with severe adverse outcomes, including death, reoperation, and readmission, and that technical errors were implicated in permanent disability or death two-thirds of the time in an analysis of U.S. malpractice claims (Vedula, Ishii & Hager, 2017).

When a surgical technologist or surgical assistant arrives without verified clinical training, your institution assumes the full training burden while patients are on the table, and your OR clock is running.