When participants complete one of the PEP books they can apply to Bettercare to write the formal examination. Each book has its own examination. Successful candidates receive a completion certificate. The examination consists of 75 multiple choice questions. As these questions are selected from the chapter tests and candidates must score at least 80% to pass. Currently, the clinical skills are not tested at the end of the course although some hospitals have arranged their own skills examinations.

The group leader has the responsibility for arranging the time and venue for the examination. A reliable person (usually a nursing manager) is asked to convene the examination and mark the examination papers. As the responsibility for studying the PEP book is taken by the individual participants themselves, their sense of pride and achievement is great. They are encouraged to arrange a celebration where the certificates can be awarded.