Discover how a national certification board is transforming high-stakes assessment through inclusive innovation and human-centered design. This session offers an inside look at the creation of a new multimodal certifying exam that better reflects the realities of modern emergency medicine. Learn how diverse stakeholders including emergency physicians, standardized patient actors, and public members collaborated to develop realistic case scenarios focused on communication, professionalism, and clinical judgment. Attendees will gain practical insights into designing dynamic, scalable, and trustworthy certification programs that elevate clinical excellence and public trust.