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Q&A with Newly Elected Lamaze International President – Robin Elise Weiss

October 16th, 2014 by avatar

Lamaze International has a new board president and we would like to introduce you to Robin Elise Weiss. I am so delighted that Robin has assumed this role and I am confident that she accomplish great things during her term.

“Childbirth education is one of the most foundational elements of a safe and healthy birth.” – Robin Elise Weiss

© Robin Elise Weiss

© Robin Elise Weiss

Robin Elise Weiss has been elected President of Lamaze International, a nonprofit organization that promotes safe and healthy birth. Weiss is the mother of eight children and brings more than 25 years of expertise in maternal child health and building online communities to her role. She is a PhD candidate, author of more than ten books, and a leading online expert in pregnancy and childbirth. Robin will serve a one-year term beginning in the Fall of 2014.

“Childbirth education is one of the most foundational elements of a safe and healthy birth,” said Weiss. “As president, my goal is to build on the more than 50 years of incredible work and accomplishments of Lamaze by further expanding our capacity to meet parents where they – increasingly – can be found: online. I also want to ensure that Lamaze is addressing the needs of all families, by even further developing our educators both in numbers and diversity.”

In her role as president, Robin will oversee governance of Lamaze International, working with the board and committees to ensure that Lamaze programs and activities continue to fulfill the organization’s mission to advance safe and healthy pregnancy, birth and early parenting through evidence-based education and advocacy.  Robin will be also supporting the Lamaze vision of “knowledgeable parents making informed decisions.”

“Robin is a respected pregnancy and childbirth expert with years of experience as a Lamaze educator teaching both expecting parents and aspiring new educators. She brings natural leadership skills and social media expertise to her new role as Lamaze president,” said Linda Harmon, MPH, and Executive Director of Lamaze International.

Robin received her undergraduate degree in Reproductive Health, and Masters in Public Health from the University of Louisville. She is currently completing her Ph.D. in Public Health Management & Systems Science, also from the University of Louisville. Robin has been an innovator for the past 20 years on the Internet, consistently recognized for her significant role in providing unbiased childbirth education information online, including being the owner and creator of one of the first childbirth websites available.

Weiss is the author of more than ten books including: The Complete Illustrated Pregnancy Companion, The Better Way to Care for Your BabyThe Everything New Mother’s First Year, The Everything Pregnancy Fitness BookThe Better Way to Breastfeed, and The Everything Getting Pregnant Book. She is also the winner of Lamaze International’s prestigious Elisabeth Bing Award for outstanding contribution to childbirth on a national level and the Coalition for Improving Maternity Services (CIMS) Forum Award and the Lamaze International’s Presidents Award for her work with The Birth Survey. Robin lives in Louisville, Kentucky, with her husband and eight children.

I asked Robin a few questions about her thoughts on Lamaze International, her hopes and goals for the organization and some key messages for families and educators.  Join me in learning more about Robin she begins her term as Board President.

Sharon Muza: What are some of the opportunities and challenges that face our organization currently and what plan do you and the board have to meet these challenges?

Robin Elise Weiss: Last spring we had an amazing strategic planning session. I am so excited about all of the opportunities that lay ahead for us, and the fact that we all had similar mindsets about what the biggest challenges were, and a great variety of things to help us combat them. One of the things that we have a plan to address is to help increase the number of educators, in order to increase the number of women we reach with the Lamaze message. As a part of this plan, it’s important that we make that obtainable both as potential educators and as potential class attendants. This means thinking outside of the regular classroom and typical childbirth class attendee.

© Sharon Muza

© Sharon Muza

SM: When you think of the many recent accomplishments of Lamaze International, what are a few that you are most proud of? Why?

REW: One of the many things that Lamaze has worked really hard on is to build a great online presence. We all know what the data says about women’s online habits when it comes to parenting and health. Lamaze has built a great reputation with blogs like Giving Birth With Confidence for the consumer, Science & Sensibility for the educators and birth professional; as well as a variety of other means of simply being there, including Twitter accounts, Pinterest, Facebook, etc. Having ourselves out and about online gives women a chance to see that Lamaze International is an active and vital force, something that they want to have as a part of their birth, thus reaching out to their local Lamaze Certified Childbirth Educator. Being online is something that is huge part of my life, and obviously, I’ve been talking to women in this space for over 20 years. Lamaze is a leader in this area.

I am also really excited about the Push for Your Baby Campaign. It launched last year with the video and has included a series of infographics. These are designed to be quick, evidence based ways for women and families to get information and to help build that faith in Lamaze.

 SM: Why is it more important than ever to pursue and maintain certification as a childbirth educator with Lamaze International?

REW: The push for evidence-based care is one that means that all levels of care, from education to execution of the medical side need to be in sync. As we often see with doctors and midwives, it can be really difficult to stay abreast of the vast amount of information that is published in this field on a daily basis. A certification with Lamaze is the bedrock of an education that is based on evidence, but also strives to continue to increase the knowledge levels and stay up-to-date with science and the changing landscape. Maintaining your Lamaze Certification means that you know that Lamaze is helping you filter out the noise and focus on great content that you need to know to be an amazing educator. We do that in a variety of ways, not the least of which is our Journal of Perinatal Education, Inside Childbirth newsletter, our blogs, and other social media platforms.

SM: What do you believe distinguishes Lamaze International from other childbirth education organizations? For educators? For families?

REW: Lamaze International has set a high bar for the childbirth educator. In 2015, Lamaze turns 55. The changes that have happened in birthing children in the last 55 years are astounding and I am not sure that anyone could have predicted where we would be today. That said, Lamaze has always maintained that a knowledgeable childbirth educator was the cornerstone of helping families prepare for their birth, which certainly hasn’t changed in the past 55 years. But something as basic having a loved one with you when you give birth is taken for granted, that wasn’t always so.

Lamaze International reaches families through the Lamaze Certified Childbirth Educator. This is the gold standard by which all other programs are judged. We are a highly accredited certification and maintenance of that certification. You won’t find a once and done philosophy here. This keeps us on our proverbial toes.

SM: How important do you think it is for Lamaze to sit at the table with and be recognized as a serious player amongst maternal infant health organizations? Do you feel like we are there or do we have some growth in that area?

REW: The good news is that Lamaze does sit at that table and is taken seriously. Certainly there are some organizations that are more likely partners than others, but we are certainly reaching out. Just this past year, I’ve personally seen Lamaze interacting with organizations like DONA International, the American College of Nurse Midwives (ACNM), the American Congress of Obstetricians and Gynecologists (ACOG), and many others. There is always room for growth, and we will continue to reach out where it makes sense. (Don’t forget to mark your calendar for our joint conference in 2015 with the International Childbirth Education Association (ICEA)!)

There has been a large growth in the number of researchers and research that we take part in as an organization. This will continue to grow as we move forward.

SM: How can our members share with the public that this is not your mama’s Lamaze? That our organization and education offerings have moved beyond the stereotypical breathing exercises that seemed our trademark in decades past?

REW: This is one of those places that you need to simply be out there and be visible. Have your elevator speech, or speeches planned. You will get a good feel for what questions are pervasive in your community. You’ll get questions about the breathing. (I like to explain that as an LCCE, my job is to teach a variety of ways to deal with labor, not simply something like breathing, but also being active physically, and involved with your care.) You might get told that they don’t need a childbirth educator for whatever reason. (This is the perfect place to insert what makes you and your class unique! Hello – Talk up the Six Healthy Birth Practices.) Figure out what’s going on in your community and be ready.

You can also be proactive. Get out and talk about Lamaze International and what you are doing locally. Never hesitate to give a quick presentation someplace. (Yes, I’m known for traveling with a baby and pelvis for an impromptu class!) Offer to teach a quick 10 minute class on a topic at the local library (Give them a list of books to have available ahead of time!), or bookstore. Talk to others in your area and support one another, this is even better if you already have a birth network.

And social media and your online presence is also important. Share the links from our blogs and social media, particularly the infographics. These are great to put on your website, send in an email to a potential client, use as books marks, use the social media sharing buttons around the site. Share, share, share!

SM: Tell us something unusual about you that we might never know!

REW: Thanks to social media, I am not sure that I have anything unusual that’s not known. So let me tell you about something of which I am very proud – I was a Military Police Officer in the 101st Airborne Division. Being an MP has been a really unique facet of who I am as a professional and as a mother. I love to explain that I came to birth from a science perspective – the biology, chemistry, and physics – it just all works! What I didn’t understand was the touchy, feely stuff; that was difficult for me to learn. Now I feel like I have just the right amount of everything going for me – the science, the presence, and the sensitive side.

Please join me in congratulating Robin Elise Weiss on her election as board president and offer her good wishes as she begins her year of service in maintaining Lamaze International as the premier childbirth education organization.

 

 

 

Childbirth Education, Lamaze International, Push for Your Baby, Uncategorized , , , ,

Lamaze International Introduces Online Parent Learning Center!

July 24th, 2014 by avatar

Screen Shot 2014-07-23 at 2.37.54 PMLamaze International has been working hard for many decades to make childbirth education classes available and accessible to a wide variety of women and their families.  Our training programs provide opportunities for men and women all around the world to complete a workshop and become a Lamaze Certified Childbirth Educator (LCCE) in the hopes that these educators can go on to teach Lamaze classes in their communities.  Despite new educators being added to the ranks all the time, many families are unfortunately still not able to find a Lamaze class in their community.  Some families, for a variety of reasons, may be unable to logistically attend an in-person class.

“This new online parent education initiative supports a key strategic imperative in Lamaze International’s newly adopted strategic framework – Innovate Education and Expand to the Childbearing Years. Through optimizing digital technology, expanding content offerings and providing online delivery, we hope to reach more women earlier in pregnancy and throughout their childbearing years with Lamaze education.” – Michele Ondeck, Lamaze International President

Lamaze International is pleased to announce that families who cannot attend an in-person class now have another option for Lamaze childbirth education.  The Lamaze Online Parent Center launches their first class, “Safe and Healthy Birth: Six Simple Steps” this week.  This online class offers an opportunity for parents to learn about the practices that support safe, normal, healthy birth and is based on the the Six Healthy Birth Practices that we all know so well and teach about in our classes.

This first online class has been developed by Lamaze International subject matter experts using the innovative online learning platform created by Thought Industries. Great care has been taken to create an online class that is interactive, engaging, informative and offers evidence based information in an easy to learn, understandable way for parents desiring an online option for their childbirth class.  Discussion forums, downloadable documents that support the curriculum, videos, interactive activities, stories, quizzes and more all come together to create an enriching online learning environment.

Parents participating in this online class are encouraged at many points to seek out an in-person Lamaze class in their community to access the skills and expertise of local LCCEs to help them to have a safe and healthy birth.

Screen Shot 2014-07-23 at 2.39.13 PM

The concept of online learning is more attractive than ever for today’s parents who view their smart phones, tablets and laptops as the perfect devices for accessing information when and where they want it. We are poised to meet the need of this new style of learner with our Lamaze Online Parent Center.  Birth professionals and families can explore the class in a quick preview and discover all the material that is covered.  Families can enroll right away and start and move through the class at their convenience. Families can also sign up to receive notification when the additional classes are launched.

After the launch of the “Safe and Healthy Birth: Six Simple Steps” online class, families will be able to participate in additional classes scheduled to be launched later this summer.  The new class topics will include “Prepared for Pregnancy: Start Off Right,” “VBAC: Informed and Ready” and “Breastfeeding Basics.”

 ”This initiative sets the stage for broader engagement with parents through online education, offering content in bite size pieces. It creates opportunities for educators to engage with parents in the online classes as moderators, to use as pre-work or an add-on to in person classes or private consultations, to serve as content experts for future class development, and as a referral source for in-person Lamaze classes where they are available.” - Lamaze International Education Council Chair Allison Walsh

Take a moment to look around the Lamaze Online Learning Center, peek at the pilot course and consider how these online classes can be an asset for parents to take advantage of, in addition to in-person participation. The “Prepared for Pregnancy: Start Off Right” course will hopefully generate primary interest in Lamaze offerings and motivate more families to seek out classes offered by Lamaze Certified Childbirth Educators local to them. As always, you can count on Lamaze International to continue to be a leader in evidence based childbirth education.

 

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Lamaze Releases Useful New Infographic: “No Food, No Drink During Labor? NO WAY!”

July 22nd, 2014 by avatar

piece Lamaze_RestrictedFoodDrinkInfographic_FINALToday, Lamaze International releases their newest infographic “No Food, No Drink During Labor? NO WAY!” This useful infographic is available on both the Lamaze International for Professionals website and the Lamaze Parents website. The most recent Listening to Mothers III survey indicated that 60% of women did not drink and 80% did not eat during labor! (DeClercq, 2013) The common practice of restricting food and drink for laboring women is outdated and not supported by evidence.  Unfortunately, most laboring women still face resistance from health care providers and facilities when they desire to eat or drink during their labor.

Lamaze International is hosting a Twitter Chat today, July 22nd, 2014 at 9 PM EST.  Professionals and parents are invited to participate in this live Twitter discussion moderated by Kathryn Konrad, MS, RNC-OB, LCCE, FACCE (@KkonradLCCE) and Robin Weiss, PhDc, MPH, CPH, CD(DONA), CLC, LCCE, Lamaze International’s President Elect. Tonight’s topic is “Restrictions in Labor” including this infographic on eating and drinking along with last month’s infographic on moving in labor (“We Like To Move It, Move It!”) Follow the hashtag #LamazeChat.  New to participating in a Twitter chat?  Check out this article for information on how to participate and get the most out of your experience.

Lamaze International’s Healthy Birth Practices, first released in 2009, discussed in great length the benefits to moving and changing position in labor in the 2nd Healthy Birth Practice: “Walk, Move Around and Change Positions Throughout Labor“ as well as the risks to restricting food and drink in the 4th Healthy Birth Practice: “Avoid Interventions That Are Not Medically Necessary.”

These useful infographics complement the Healthy Birth Practices, are easy to share on social media and can be used in the classroom as a poster to help parents to understand how to have the safest and healthiest birth possible.

Won’t you take a moment to check out this newest infographic and share with the expectant families that you work with!  Consider sharing it on your favorite social media outlet (Facebook, Twitter, Pinterest, Instagram) and making it available in your classrooms!

If you have an interesting way you are using these infographics, or would like to just share your thoughts on the infographic topics, please let us know in the comments section. I would love to hear how you use this info in your practice.

Click here to download the newest infographic “No Food, No Drink During Labor? NO WAY!”

You may access all the infographics available here!

References

Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to mothers III: Pregnancy and birth. New York, NY: Childbirth Connection.

Childbirth Education, Evidence Based Medicine, Healthy Birth Practices, informed Consent, Lamaze International, Maternity Care, Medical Interventions, Push for Your Baby , , , , ,

Evidence Supports Celebrating the Doula! Happy International Doula Month!

May 15th, 2014 by avatar
© Serena O'Dwyer

© Serena O’Dwyer

May is International Doula Month and I am delighted to recognize and celebrate this important member of the birth team today on Science & Sensibility.  A birth doula is a trained person (both men and women can be and are doulas) who supports a birthing person and their family during labor and birth with information, physical and emotional support and assistance in women finding their voice and making choices for their maternity care. A postpartum doula is a trained professional who supports the family during the “fourth trimester” with emotional support, breastfeeding assistance, newborn care and information along with light household tasks as postpartum families make adjustments to caring for a newborn in the house.  Birthing families  traditionally have received support from family and community going back hundreds of generations.  In the early to mid 20th century, as birthed moved from home to hospital, the birthing woman was removed from her support. In 1989, the first doula organization, PALS Doulas was established in Seattle, WA, and then in 1992, DONA International was founded by by leaders in the childbirth and maternal infant health field.  Since then, many other training and professional doula organizations have been created around the world and the number of doulas trained and available to serve birthing and postpartum families has grown substantially.

© J. Wasikowski, provided by Birthtastic

© J. Wasikowski, provided by Birthtastic

Doulas and childbirth educators have similar goals and objectives – to help birthing families to feel supported, informed , strong and ready to push for the best care for themselves and their babies.  Some childbirth educators have trained as doulas as well, and may work in both capacities.  It can be a wonderful partnership of mutual trust and collaboration.  In fact, Lamaze International, the premier childbirth education organization and DONA International, the gold standard of doula organizations have joined together to offer a confluence (conference) jointly hosted by both organizations in Kansas City, MO in September, 2014. An exciting time for networking, continuing education, learning and fun with members of both organizations.

© Sarah Sweetmans

© Sarah Sweetmans

While the profession has grown considerably since those early days, the most recent Listening to Mothers III survey published in 2013, indicates that only 6 percent of birthing families had a trained labor support person/doula in attendance at their birth. (Declercq, 2013)  The most recent systematic review on the impact of doulas on a woman’s birth experience found that birthing women supported by a doula were:

  • more likely to have spontaneous vaginal births
  • less likely to have intrapartum analgesia or regional analgesia
  • less likely to report dissatisfaction
  • more likely to have shorter labors
  • less likely to have a cesarean
  • less likely to have an instrumental vaginal birth
  • less likely to have a baby with a low five minute Apgar score

There were no adverse effects reported. (Hodnett, 2013)

When the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal- Fetal Medicine (SMFM) released their groundbreaking “Safe Prevention of the Primary Cesarean Delivery” Obstetric Care Consensus Statement in February 2014, one of their key recommendations to reduce the primary cesarean rate in the USA was the continuous presence of a doula at a birth. (Caughey, 2014)

Continuous Labor and Delivery Support

Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery. Given that there are no associated measurable harms, this resource is probably underutilized. – ACOG/SMFM

dianne hamre doula

© Dianne Hamre by Kristen Self Photography

Doulas do a great job of supporting mothers, partners and families during the childbearing year and helping to improve outcomes for mothers and babies. The research shows it, the experiences of families confirms it and now ACOG recognizes the important role that a trained doula has in reducing the cesarean rate in the United States.  Childbirth educators can share this with students and maybe the next time birthing families are surveyed, the number of families choosing to birth with a doula with have risen significantly!

Doulas, thank you for all you do to support families!  You are providing a much needed service and improving the birth experience for families around the world.  We salute you!

How do you discuss doulas with the families you teach and work with?  Do any educators have doulas come in to help during class time?  Please share your experiences and let us know how it works out for you and your students and clients.

References

Caughey, A. B., Cahill, A. G., Guise, J. M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology, 210(3), 179-193.

Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to Mothers III: Pregnancy and Birth; Report of the Third National US Survey of Women’s Childbearing Experiences. New York, NY: Childbirth Connection.

Dekker, Rebecca. “The Evidence for Doulas.” Evidence Based Birth. N.p., 27 Mar. 2013. Web. 14 May 2-14.

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5.

 

 

 

2014 Confluence, Childbirth Education, Confluence 2014, Doula Care, Healthy Birth Practices, Lamaze International, Maternity Care, Newborns, Push for Your Baby, Research, Uncategorized , , , , , , , , ,

The Science Behind the Lamaze Exam and the Lamaze Certified Childbirth Educator Credentials

May 1st, 2014 by avatar

Last week, around the world, candidates for certification sat for the Lamaze Certified Childbirth Educator exam.  That test represented the culmination of weeks, months and often years of planning, preparation, studying and hard work.  While the results are still some weeks out, I thought it would be interesting to learn about the science behind the Lamaze exam and what makes it the gold standard of childbirth educator certifications from Judith Lothian, PhD, RN, LCCE, FACCE, the chairperson of the Lamaze Certification Council Governing Body. Today’s families deserve the best, so they can push for their baby, with all the evidence and research that stands behind the LCCE credentials of their childbirth educator. Learn more about attending a Lamaze workshop and explore becoming an LCCE yourself so you can offer families in your community the gold standard of childbirth education. – Sharon Muza, Science & Sensibility Community Manager.
LCCE

Lamaze International is extremely proud of the fact that the Lamaze certification examination is the only examination for childbirth educators that is accredited by the National Commission for Certifying Agencies (NCCA).  Achieving and maintaining this accreditation is a rigorous and ongoing process.

Accreditation by NCCA assures you that the exam you take will accurately measure the competencies of a childbirth educator. The seven competencies of a Lamaze Childbirth Educator are supported by job analysis research that is done every 5-7 years. The last job analysis was conducted in 2012. The results of that analysis were published in the latest issue of the Journal of Perinatal Education. Lamaze members may access the full journal online after logging in to the Lamaze website. Basing the exam on the results of a job analysis is an important way to ensure that the exam accurately evaluates the competencies of a childbirth educator. Fairness is a very important issue and to that end NCCA has evaluated our policies, our procedures and the actual exam, including the construction of items and the exam itself as well as the evaluation of its performance. The NCCA stamp of approval is a vote of confidence that experts in the certification field believe that the Lamaze certification policies are fair and that the certificate examination accurately evaluates the competencies of a Lamaze Certified childbirth educator.

Lamaze is the only childbirth educator certification program that has received NCCA accreditation. Professional standards set by the Institute for Credentialing Excellence describe the difference between professional certification and assessment based certificate programs. “Professional or personnel certification is a voluntary process by which individuals’ pre-acquired knowledge, skills, or competencies are evaluated against predetermined standards. The focus is on an assessment that is independent of a specific class, course, or other education/training program. Participants who demonstrate that they meet the standards by successfully completing the assessment process are granted the certification.” The American College of Nurse Midwives and the International Board of Certified Lactation Consultants are examples, like Lamaze, of professional certification.

In contrast, an assessment-based certificate program is a non-degree granting educational program that provides instruction and training to help participants gain specific knowledge and skills and then evaluates achievement of expected learning outcomes and awards a certificate to those who successfully pass the assessment. Childbirth educator certifications, other than Lamaze, are assessment-based certificate programs. Because of this, many educators who have childbirth educator credentials from other organizations  choose to sit for the Lamaze exam.

Why is this important? It assures you that the certification examination has met the rigorous standards of professional certification, that the exam is fair and actually measures what it is should to insure that you indeed have achieved the competencies to practice as a Lamaze childbirth educator.

The certification exam consists of 150 multiple choice questions and the questions reflect the essential information a childbirth educator should know (the competencies of a Lamaze Certified Childbirth Educator). An inside look at the process of item writing and exam construction and evaluation will give you a taste for how rigorous, and interesting, the process actually is.

The exams are put together by a test development committee that meets twice a year for 4-5 days. The committee includes expert childbirth educators, a public member who is not a childbirth educator, and, often a novice childbirth educator (a high scorer on a recent exam). Using the test blueprint (based on the latest job analysis) the committee writes questions and then a smaller group “constructs” individual exams from the item bank of questions.

nccaDraft items are written in small groups, usually 2 or 3 educators. It is actually very, very difficult to develop a fair question that measures knowledge and skills that are important for the childbirth educator to know. It is tedious work and challenges all of us without exception! Once a small group has developed an item they think has potential it is, often with great trepidation, presented to the entire committee for discussion. Leon Gross, PhD, the psychometrician (a testing specialist) is at the meetings and at this stage he will often point out potential psychometric issues related to the items, including things like “it’s too long”, “there is extraneous information,” “could there be 2 answers?” In developing and evaluating each item we ask ourselves: Is it clear? Is there only one right answer? Do we know the right answer (if we don’t then we most definitely do not use it)? Is there any overlap in the answers? We edit each draft item for content and language, keeping in mind, that the distracters (the wrong answers) should be “plausable”. It is an extremely honest and often raucous process! We all have to be prepared to have our questions torn apart! It helps to have a sense of humor and remind ourselves of the importance of the process. Then the committee decides to either put the questions in the permanent item bank or not. The entire process is done with expert psychometric support.

Our philosophy, in the writing of the items, in the evaluation of the items, and then ultimately choosing the items that will be on each exam, is that we only test what is really important to know. There are no intentional “trick” questions. It’s important to know that if the committee struggles with identifying the correct answer it is automatically not used. And, the questions are written in order to evaluate the competencies of what we constantly refer to as the ‘just good enough candidate.’ So, this is most definitely not an exam where you have to be an “expert” to pass. In order to pass this exam you need to be “just good enough”. This exam is intended to measure competencies of a beginning childbirth educator.

When the committee decides to put a question in the item bank we then establish the level of difficulty for the question. We look at each correct answer and then we look at distractors, the wrong answers. We discuss the distracters related to how plausible this distracter would be to a candidate who is just able to pass the exam. This is an example of the process:

What is the capital of Maryland?
1. Baltimore
2. Chevy Chase
3. Annapolis
4. Fredricksburg

There is one correct answer and three distracters. If you know the capital of Maryland, this is a very easy question. It’s straight recall. If you, however, don’t know what the capital of Maryland is, then you will be tempted to go for a plausible but wrong answer. The correct answer is Annapolis, but Baltimore is a plausible answer because it’s the largest city in Maryland and, of these four choices, it is the most well-known city. For someone who does not know for sure that Annapolis is the capital of Maryland they would be tempted to think it was Baltimore. Therefore, we would label Annapolis the correct answer and Baltimore a “sophisticated distracter”. We aim to have at least 50% of the exam questions with “sophisticated distracters”. The more questions with sophisticated distracters the higher the level of difficulty of the exam. It’s important to know this to understand how the passing score is determined for each test administration.

This exam is criterion referenced which means that the passing score is determined before the test is given based on the level of difficulty of the questions on the exam. Candidates who sit for the exam are never compared to each other and the passing scored is determined by how difficult the questions are, not a predetermined passing score. Candidates are evaluated against a standard not against the scores of the other candidates sitting for the exam. The more items on the exam that have sophisticated distracters, the higher the level of difficulty, the lower the score you need to pass. The fewer items with sophisticated distracters, the higher the score is that you need to pass the exam. The pass score, the cut score, for passing the Lamaze certification exam has over the last years ranged 70 to about 75.

After the exam is given, the exam is scored and reviewed by the psychometrician. A detailed statistical analysis is done. There is an analysis of each item on the exam. How many testing participants got the answer right? What distracters did those who got it wrong go for? The item analysis also identifies what percentage of the high scorers got the question correct and what percentage of the low scores got the question correct. A “good” question statistically is one that discriminates between the high scorers and low scorers. This means that you would expect a high percentage of the people that did well overall on the exam to get a question correct and those that did not perform as well on the overall exam to get the question wrong. If we find that there is an item that most of the low scores got correct and only a few of the high scorers got that question correct, we would wonder why.

After the psychometrician reviews the overall exam and each item, he will flag the questions that may look like they may not be “performing” well. The small group that constructed the exam meets by conference call to discuss both the flagged items and the comments the candidates have made related to the exam. Every comment is reviewed. Whether or not we keep an item, or don’t keep the item, is the decision of the committee. We also look at the performance of the exams that are translated into other languages and look at how individual questions performed for instance in Spanish compared to in English. We try to determine if there are cultural differences or whether there are translation problems. At times a question may be deleted from scoring in a language other than English and not in the English exam. Once we determine if there are items we will drop then the psychometrician will re-score the exam and determine, based now on the questions that remain on the exam (and their level of difficulty), a final cut score. It takes about 6 weeks to get exam results. During that time the certification team is working hard to make sure your exam is fairly evaluated.

The rigor of developing the exam, including the job analysis, and then the scoring of the exam are only one part of the requirements for NCCA accreditation. In addition, our policies and procedures related to everything from exam eligibility and grievance procedures, as well as confidentiality issues and the qualifications of both the staff and volunteers involved in the certification process, are rigorously evaluated. The end result, we hope, is a valid, reliable, fair certification exam that protects the value of the LCCE credential, and, most importantly, assures women and their families that the Lamaze Certified Childbirth Educator is competent. NCCA accreditation is a vote of confidence that we are indeed doing what we intend.

Are you an LCCE?  Can you share why you chose Lamaze International and your journey?  Are you considering becoming a childbirth educator?  Have you explored Lamaze as an option?  I invite you to consider certifying with Lamaze International and achieving the gold standard for childbirth educators. – SM

About Judith Lothian

@ Judith Lothian

@ Judith Lothian

Judith Lothian, PhD, RN, LCCE, FACCE is a nurse and childbirth educator. She is an Associate Professor at the College of Nursing, Seton Hall University and the current Chairperson of the Lamaze Certification Council Governing Body. Judith is also the Associate Editor of the Journal of Perinatal Education and writes a regular column for the journal. Judith is the co-author of The Official Lamaze Guide: Giving Birth with Confidence. Her research focus is planned home birth and her most recent publication is Being Safe: Making the Decision to Have a Planned Home Birth in the US published in the Journal of Clinical Ethics (Fall 2013).

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