Posts Tagged ‘LCCE’

Lamaze Parent Satisfaction Survey Will Benefit Families – Educators Play a Key Role in Increasing Response Rate

November 3rd, 2015 by avatar

VoteSurveyParticipation at in-person childbirth education classes has been on the decline in past years.  There has not been much research on the benefits of taking a childbirth class, and with the plethora of information available online, it is no surprise that enrollment may very well be on the decline.  At the same time, cesarean rates and obstetrical interventions have overall been increasing.  Maternal and neonatal morbidity and mortality rates have not been improving either.

In the 2013 Listening to Mothers  (LtM) III report, 59% of all first time mothers took childbirth classes, compared with 70% in the 2002 LtM I report.  In 2013, 17% of experienced mothers took classes, down from 19% in 2002 (Declercq, 2013, Declercq 2002).

Lamaze International, with its diverse and experienced team of Lamaze Certified Childbirth Educators, is in a unique position to collect data on the experiences of parents who take Lamaze childbirth classes and utilize Lamaze International resources.  The Lamaze staff and Board of Directors have developed and initiated a Parent Satisfaction Survey that can be filled out by families who have completed a Lamaze class.  The survey is meant to be completed after the birth of their baby, so that the information can be used to determine how their Lamaze class impacted their actual choices and experience.

The information being collected in this Parent Satisfaction Survey can play a key role in helping to:

Understand the impact of Lamaze classes

Data collected through these surveys can be used to understand the impact of Lamaze classes on families and birth outcomes and guide further research on this topic. Exploring this area of research can help Lamaze and other organizations to access funding to further develop and continue studying this important topic

Lobby for improved access

Information gained through these post-birth surveys  can be used to educate lawmakers on the outcomes of births when families participated in birth classes and encourage legislators to offer reimbursement and increased access for childbirth education classes across all socioeconomic and ethnic categories. Lamaze International plans to repeat their “Hill Day” campaign and lobby Congressmen/women in early spring of 2016 by visiting them in their D.C. offices and sharing information about maternal infant health and outcomes experienced by parents and infants during the childbearing year.

Improve information and educational materials

The results of the survey can help Lamaze International to be sure their message is on target and their educational materials are effective in sharing information on best practices, evidence based care and informed consent and refusal.  Lamaze can continue to develop curriculum and services that help families to “Push for Their Baby” during pregnancy, birth and postpartum.

Help LCCEs to deliver education

Every childbirth educator’s goal is to communicate important information to expectant families through engaging and effective activities.  Aggregated survey information can help Lamaze International provide information and direction to all the LCCEs so that they can assess how they can continue to provide valuable and useful information to the families participating in their Lamaze classes.

Share the message with other stakeholders

Information gleaned from the survey will be shared with policymakers and key third-party organization stakeholders at upcoming roundtables that Lamaze representatives facilitate in and host.  It is important for health care providers, hospital administrators and maternal infant health organizations to recognize how effective Lamaze childbirth classes can be be in creating a safe and healthy birth for participating families.

Linda Harmon, Lamaze International’s Executive Director took a moment recently to answer some questions about the Parent Satisfaction Survey.

Sharon Muza:  There is not a lot of research available on the effectiveness of childbirth/Lamaze classes.  Do you feel this information could be used as the basis of that research?

 Linda Harmon: Lamaze has commissioned a White Paper which will present the evidence related to childbirth interventions overuse in the US hospital system, and the effects they can have on childbirth outcomes, and present the argument that evidence-based prenatal education is a critical avenue for women when making childbirth care decisions.  The parent satisfaction survey will support this research by providing data from the parents who have used Lamaze resources.

SM: How could the information gained from this survey be used to further reimbursement for families who take childbirth classes?

LH: Data gained from the Lamaze Parent Satisfaction Survey will be used to provide important insights about the impact of Lamaze childbirth education on the experiences and outcomes of pregnant women and their babies. These insights will provide valuable information to support discussions with healthcare insurers, hospitals and other strategic partners to advance Lamaze education.  Preliminary data from the Lamaze national parent satisfaction survey shows that women engaged with Lamaze have a cesarean rate of 20%. That’s about 13% less than the national cesarean rate of 33%.  If a 13% reduction in cesarean could be translated across the U.S., the potential cost savings would be nearly $4.7 billion annually.

SM: Lamaze International is an international leader in childbirth education and offers a great curriculum filled with best practice and evidence based information.  Have initial survey responses indicated that our classes have been a useful component for families welcoming a child?

LH: The preliminary data is very positive, but we need substantially more parent survey responses to  validate general trends. In the initial review of survey findings in March 2015,  we compared what women told us in the Lamaze survey with what women reported in the highly-respected national survey Listening to Mothers III: Pregnancy and Birth.  Early survey responses show that 94% of women taking Lamaze classes say that education provided by Lamaze improved their childbirth experience and 91% feel well informed about decisions in labor and birth.

You Can Help Advocate for Childbirth Education

Lamaze Certified Childbirth Educators play a key role in getting the word out to the families who participate in their classes.  Through information received from you, families can be directed to the survey and asked to participate.  During the online survey, participants are asked a handful of simple questions that seek to learn if childbirth education improved their birth experience.

Lamaze has put together many resources for LCCE educators to help you understand the importance of this survey.  These resources include:

  • An FAQ to help you become familiar with the survey and encourage you to participate.
  • How to introduce the survey in class – We have created sample messages and instructions for  encouraging your students to sign up for the survey
  • Promote the survey – We have developed a sample email you can send your class, introducing them to the survey, as well as sample Facebook, Twitter and blog posts.

Every family that participates in the survey will receive a coupon for a discount on a Lamaze toy.

Win a 2016 Lamaze International conference registration

If you encourage participation, you will be entered to win a complimentary Lamaze International 2016 Annual Conference registration. If your name is referenced as their childbirth educator in the survey, you will be entered in the drawing—and the more your name is referenced, the more entries you will have!  This is a real bonus reason to share the survey with parents, even beyond the benefits to research and programs. 

 Are you already encouraging your families to take the Parent Satisfaction Survey?  Share your experiences in the comments section.  If you have not yet begun to communicate information to your families about the survey, I hope that you will reconsider as you recognize the importance of your role in collecting this valuable data.


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.

Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Risher, P. (2002). Listening to mothers: Report of the first national US survey of women’s childbearing experiences. New York.

Babies, Cesarean Birth, Childbirth Education, Lamaze International, Lamaze News, New Research , , , , , ,

Thanks IBCLCs – For Helping New Families Meet Their Breastfeeding Goals

March 5th, 2015 by avatar

IBCLCDayLogo 2015(2)Yesterday was IBCLC Day – a special day set aside once a year to recognize the hard work and efforts that International Board Certified Lactation Consultants provide all all year long in support of breastfeeding for mothers, babies and really, the entire family.  IBCLC Day is sponsored by the International Lactation Consultant Association, a professional organization for IBCLCs around the world.

Becoming an IBCLC is no easy feat; the requirements to become credentialed are very rigorous and involve many clinical hours and an exhaustive exam.  Continuing education hours and/or retaking the exam are required every 5 years to maintain the credentials.  There are over 27,450 IBCLCs worldwide.

Some IBCLCs are also Lamaze Certified Childbirth Educators.  Both organizations represent the gold standard in their field and it is not surprising that some professionals seek out both qualifications.  When an LCCE is also an IBCLC, their class families can really benefit.  The LCCE is able to weave in a rich knowledge of breastfeeding topics and information throughout the class, as well as share information about common challenges that they see when working as an IBCLC.

creative commons licensed (BY-NC) flickr photo by robysaltori: http://flickr.com/photos/robysaltori/4604876371

CC flickr photo by robysaltori: http://flickr.com/photos/robysaltori/4604876371

A lactation consultant can use their childbirth education skills to hone their communication and help families understand the nuances of feeding their babies when they are delivering breastfeeding information during a consultation.  The two professions can complement each other beautifully.

Of course, the scope of practice of LCCEs and IBCLCs is different, and it is important to recognize the separation and to wear the proper hat when conducting yourself professionally in either capacity.

For official information on how to become an IBCLC, check out the information on the International Board of Lactation Consultant Examiners (IBLCE ) site. If you are considering becoming an IBCLC, there is an Facebook Group just for you, where you can discuss the different pathways, find out more about the requirements and costs, and receive the support of other men and women exploring the IBCLC process and preparing for the exam.

I reached out to some Lamaze Certified Childbirth Educators, who are also IBCLCs, to ask some questions and learn more about experience of wearing both hats.  Teri Shilling, Ann Grauer and Ashley Benz generously shared their thoughts below.

Sharon Muza:  Which credential did you receive first, your IBCLC or your LCCE?

Teri Shilling: I received my LCCE first.

Ann Grauer: I was an LCCE first. I never thought I’d be an IBCLC but one year the policies fit me and I decided to go for it.

Ashley Benz: I became an LCCE first and then an IBCLC. My goal had always been to become a lactation consultant. I knew that it was a long road and I was so interested in getting started working with families that I did a couple of certifications before I was ready to take my IBCLC exam.

SM: How does having both credentials benefit your students and clients?

Teri: So much of my work as an IBCLC is education – by the bedside, on the phone, etc.  Keeping things simple and memorable is key.  The certifications speaks to my professionalism and commitment to continuing education

Ann: I had a CLC before my IBCLC—I’ve always felt that I wanted and needed more information on breastfeeding. I’ve taught breastfeeding classes since the beginning but the information explosion in that one topic is incredible!  I feel very strongly that it serves my childbirth classes well that I have that credential and that being an LCCE serves my breastfeeding clients. I see things from a “facilitator of education” standpoint, rather than a traditional IBCLC standpoint.

Ashley: Because a lot of what a lactation consultant does is teach, I use the skills I’ve gained from teaching Lamaze class in breastfeeding consultations. In Lamaze class, I use my knowledge about breastfeeding and mother-infant bonding.

SM: Does your IBCLC knowledge influence how and what you teach about breastfeeding? 

Teri: Yes, I think it does, but I have been an IBCLC for 20+ years and can’t remember what I taught before.  But being an IBCLC gives me first had experience with the big bumps in the road many women hit during the postpartum time.

Ann: Yes. I’ve actually simplified what I teach. Being an IBCLC, means I now appreciate that parents need simple and honest information that they can incorporate into their parenting.

Ashley: I probably emphasize the need to seek proper help more than other educators. My class focuses on the basics of breastfeeding and assumes I’ve convinced my students to get support for issues that arise.

SM: What would you recommend for other LCCEs who might want to be an IBCLC? What are the challenges?

Teri: Do a community search for where the gaps are in support – is there a breastfeeding coalition in your area? It is important to network.  Find a mentor.  I would say go for it.  More education never hurts.  The challenge is being employed as an IBCLC as a non-nurse.  It helps if you are the entrepreneur type and able to set up a private practice.

Ann: If you’re a non-RN you will have to work incredibly hard. The system is set up to be medically-minded and there is not appreciation/understanding of what non-RNs bring to the table. Which, by the way, is a lot. Rather than focusing on becoming an IBCLC, allow yourself to enjoy the journey of learning and you’ll be there before you know it.

Ashley: The major challenge of the IBCLC path is that it can be very time (and often financially) intensive. I recommend checking out the IBLCE website and see if there is a pathway that you already fit into. If not, make a five-year plan to become an IBCLC.

SM: Where do you think it gets tricky wearing both hats?

Teri: I don’t think it does.  I love being able to be part of the continuum from pregnancy to postpartum.

Ann: I don’t think it does. My confidence is in the mother and baby. I’m just here to help in any role I can.

Ashley: Whenever you have multiple sets of skills, it can be difficult to maintain appropriate business boundaries and communicate those to your students and clients.

Careers as both a Lamaze Certified Childbirth Educator and an International Board Certified Lactation Consultant are fun, challenging and very rewarding.  They are a wonderful compliment to each other and families can benefit from the knowledge that someone who holds both credentials can share when serving in either role.  Are you an LCCE who has considered or would like to become an IBCLC?  Are you already on that path?  Share a bit about your journey in our comments section and let us know.

Babies, Breastfeeding, Childbirth Education, Newborns , , , , , , , , ,

Series: Journey to LCCE Certification – Mission Accomplished!

December 4th, 2014 by avatar

By Cara Terreri, LCCE

 photo credit: kevin dooley via photopin cc

photo credit: kevin dooley via photopin cc

If you have been following Cara Terreri in our Series: Journey to LCCE Certification, you know Cara was last seen hard at work preparing for the LCCE examination.  I received good news from Cara yesterday, and wanted to share her update with you.  Please join me in congratulating Cara on successfully passing the Lamaze exam and receiving the credentials “LCCE”.  I would like to congratulate all of you who also received news of your passing score.  You should be proud of your accomplishments.  If others would like to explore becoming a Lamaze Certified Childbirth Educator, please check out our certification page on the website for information on how to start. – Sharon Muza, Science & Sensibility Community Manager.

The final days

At the culmination of nearly two years, the longest part of which was the last five weeks waiting to hear news, the results are in… I passed the exam and am now a Lamaze Certified Childbirth Educator! Though I felt confident in my knowledge and abilities, self-doubt crept in during the weeks leading up to the exam. I amped up my studying and review time in order to feel more sure in my knowledge. Walking through the door of the testing site, my nerves took a back seat and I felt ready.

My test experience

My test-taking experience was, overall, positive. Many of the questions were reasonable and fair, and for a good number of them, I quickly found the answer. For other questions, however, I really had to closely read the question and think hard about my answer. I could always narrow it down to two answers – it was those last two that really tested my knowledge! The testing system allows you to “flag” a question if it’s one you want to go back and review. Two hours into the exam, I was finished answering questions. I was more than thankful for the additional hour to review the questions I had flagged. For two questions, I felt strongly about sending feedback to staff, a feature available to me during the test.  This feature made me feel like the test was truly created to be fair and open to my feedback. When the test results were released, I was pleased to see that a question had been eliminated, and I was hopeful that it might have been one of the questions I flagged.

Lamaze core values

cara lcceLamaze prides itself on promoting evidence based information and the LCCE exam is no different – questions are created fairly (not intentionally tricky), and cover a wide range of in-depth information that a competent and effective childbirth educator should possess. As someone who writes on behalf of Lamaze for parents everywhere, and as a budding educator and doula, holding the LCCE credential is invaluable. It provides added credibility, yes, but perhaps more importantly, it holds me accountable. Ongoing education is so critical in our field! Throughout the years since working with Lamaze, I’ve come to learn so much about the organization in comparison to others. It’s the level of dedication and commitment to education that encourages me to grow further with Lamaze as my foundation.

What’s next

Now that the exam is complete, the real work begins! Since moving and settling into a new community, I now am ready to create a business plan for 2015 and begin teaching locally. My earlier professional goals centered around doula work, but until I can solidify extended child care, that will have to wait. Teaching classes, however, is very doable and it’s also something I truly enjoy.

Did you also pass the exam?  Share your good news in our comments section and let us know what your next steps are!  Where will you be teaching?  What type of classes?  Let us knw! We want to celebrate with you and wish you all the best as you start your work as an LCCE. – SM

About Cara Terreri

Cara began working with Lamaze two years before she became a mother. Somewhere in the process of poring over marketing copy in a Lamaze brochure and birthing her first child, she became an advocate for childbirth education. Three kids later (and a whole lot more work for Lamaze), Cara is the Site Administrator for Giving Birth with Confidence, the Lamaze blog for and by women and expectant families. Cara continues to have a strong passion for the awesome power and beauty in pregnancy and birth, and for helping women to discover their own power and ability through birth. It is her hope that through the GBWC site, women will have a place to find and offer positive support to other women who are going through the amazing journey to motherhood.


Childbirth Education, Guest Posts, Lamaze International, Series: Journey to LCCE Certification , , ,

Series: On the “Independent Track” to Becoming a Lamaze Trainer

December 2nd, 2014 by avatar

By Jessica English, LCCE, FACCE, CD/BDT(DONA)

Last month, LCCE Jessica English began the path to become an independent trainer with Lamaze International, as part of the just opened “Independent Track”  trainer program.  This new program helps qualified individuals become Lamaze trainers – able to offer Lamaze childbirth educator trainings which is one step on the path for LCCE certification.  She’s agreed to share her trainer journey with us in a series of blog posts; “On the Independent Track to Becoming a Lamaze Trainer”, offering insights at key milestones in the process. If this is a program you are interested in, look for information in 2015 on how to apply for the 2015 cohort.- Sharon Muza, Science & Sensibility Community Manager.

When I first saw the invitation to apply to become an independent trainer with Lamaze International, my heart leapt! As a doula trainer, I’d long wanted to extend my training work to include childbirth educators but I’d heard the process to become a Lamaze trainer was complicated. The announcement that landed in my inbox said that there was a new, simplified pathway to becoming an independent Lamaze trainer. As I prepared to launch a new business venture that included many facets of my skill set: DONA birth doula trainings, childbirth classes, business training/coaching sessions and more, it seemed so clear that becoming a Lamaze trainer fit right in with my path. Yes! Count me in!

© Tanya Strusberg

© Tanya Strusberg

I was “in” wholeheartedly, but I still needed to apply and be approved. The application asked about our qualifications and our vision for a Lamaze program. Several days before the application deadline, Laura Ruth in the Lamaze office told me that they’d already received a lot of applications. My nerves set it! The closer the deadline came, the surer I was that becoming a Lamaze trainer was the right path for me; I hoped the review committee would agree.

The wait to hear back was blessedly short. Less than a week after I submitted my application, I heard back from Lamaze International that I’d been approved as part of the first cohort of independent track trainers. How exciting! I immediately started laying plans to travel to Washington, D.C. for the “train the trainer” session, praying that my November doula clients would either have their babies before I left or wait for my return. I also needed a sub to teach my own Thursday night childbirth class.

Thankfully, three babies came in nine days, I found a fantastic sub, and I headed to D.C. with a clear calendar. (Thank you for aligning, birthy stars!) I arrived Wednesday night and met my roommate, Trena Gallant from Halifax, Nova Scotia. Before our official training ever began, our informal education started with the opportunity to share stories and techniques as experienced educators and (doula) trainers. My LCCE heart was already bursting!

I’d been curious from the beginning about who would be in the training, and it was fun to watch the room fill Thursday morning. Several of my fellow DONA-approved birth doula trainers were in the group, there were a handful of other folks whose names I recognized, and I saw a few new faces. The 12 of us hailed from the United States, Canada and even Australia. Everyone participating in the training was an experienced educator, and we had several accomplished Lamaze trainers and leaders in the room to help guide us as well. I was excited know we’d have the chance to connect throughout the weekend.

The morning began with ice breakers and climate setters with our experienced facilitator, Tom Leonhardt. Once we all felt comfortable together, we dove into the science of adult learning. Even as an experienced educator and trainer, I enjoyed the chance to reanalyze how adults learn. One of the things that I love about Lamaze International is its emphasis on evidence-based information, and this training was no different. There’s great science on adult learning, and Lamaze ensures that your trainers understand how to use that science to help new educators create great classes. I appreciated that the training itself was highly interactive – implementing the same proven techniques we were discussing. I picked up some new ideas and other information was reinforced. I was able to explore my own teaching style and its strengths and weaknesses. An expert facilitator, Tom guided us and brought us back to task when we ventured just a little too far down an occasional rabbit hole.

Saturday was spent on additional teaching analysis and introduction of the primary objectives for our Lamaze curricula. Another reason I adore Lamaze is that they lay down core objectives for educators and then allow each LCCE to teach in his or her own way. I discovered that the trainer process was similar. Each trainer will complete a needs assessment for her community, region or country. We are tasked with using a planning table to detail content for each objective, then listing our teaching techniques and evidence-based resources. In part because all Lamaze International training seminars qualify for nursing contact hours, the process of getting your training program accredited is rigorous – just another reason that Lamaze is the gold standard in our field! I could see the work ahead.

On Saturday afternoon we broke into pairs and developed an assigned training module. Each team delivered its 20-minute teaching session beginning Sunday morning. My partner and I volunteered to present first, which allowed us to fully enjoy the rest of the presentations without any thoughts about our own session. What a delight to watch so many incredible educators work their magic! I think we all picked up techniques and language from one another. We reminded ourselves again and again that we were training educators and not parents. That was an interesting shift, as we’ve all been teaching families for years or even decades. We glowed with the praise from our peers and humbled ourselves to received constructive feedback on what could have gone better. What an excellent model for us to follow as we prepare others to teach!

Saturday ended with an exploration of best practices in dealing with challenging participants. I love that Lamaze International wants us to explore these issues with new instructors! Being a great childbirth educator is about so much more than just understanding birth. The science and art of teaching are critically important to our work and Lamaze International is devoted to helping to build truly great teachers around the world.

As I said goodbye to my new colleagues Monday afternoon and wound my way through a weather-challenged journey home, my thoughts turned to next steps. As my new venture- Heart | Soul | Business ramps up, I’m carving out time to work on my Lamaze curriculum. Branding and marketing are on my mind as I solidify plans to combine birth doula workshops, childbirth educator seminars and advanced business trainings to help other birth workers thrive in this heart-centered work. My background is in marketing, public relations and business administration, so that trifecta of trainings feels like the perfect combination!

A variety of questions remain for me. Which cities need childbirth educator, doula and business trainings? How can I help to even further distinguish the Lamaze name in an increasingly crowded marketplace? What are the pieces of a kick-butt curriculum that will help grow strong, confident educators who can make a difference in diverse communities and in their own unique styles? What will it be like to work on that curriculum with Lamaze International’s amazing lead nurse planner, Susan Givens? I’m strongly committed to continuing to teach families and attend births in my home community, but how will those commitments balance with an increased travel schedule?

Stay tuned, friends. I’m diving in and I’m excited to have you along for the journey.

About Jessica English

jessica english head shotJessica English, LCCE, FACCE, CD/BDT(DONA), is the founder of Heart | Soul | Business. A former marketing and PR executive, she owns Birth Kalamazoo, a thriving doula and childbirth education agency in Southwest Michigan. Jessica trains birth doulas and (soon!) Lamaze childbirth educators, as well as offering heart-centered business-building workshops for all birth professionals.

Childbirth Education, Guest Posts, Lamaze International, Series: On the Independent Track to Becoming a Lamaze Trainer, 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.

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).

Childbirth Education, Evidence Based Medicine, Guest Posts, Journal of Perinatal Education, Lamaze International, Lamaze Official Guide Book, Push for Your Baby, Research, Series: Journey to LCCE Certification , , , , , , ,

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