The following situations has recently come up:

* A RN who was a supervisor and has not worked with patients for over 18
years suddenly being made the breastfeeding specialist.  She used the time
she admitted she gave "bad advice" working as a nurse on the postpartum
floor (18 and more years before) and the Georgetown one week course as her
requirements to take the test.

* A RN who had not completed the 30 hours of continuing education was
allowed to take the test but would not receive her certificate until she
showed proof of going to the 10 more hours she needed.  If she did not meet
the requirements, why was she allowed to take the exam?

* a woman who said she was 1000 hours short of practice time said she was
going to lie so she could take the exam this year.  Think of it, if a
hospital wanted to say they had an LC on staff, any suprevisor could write a
letter saying her employee had enough hours.

My suggestions, after taking the exam this year (research pathway):

* Because the slides are on paper, the exam could be legnthened. It now has
only 200 questions and I ended up finishing way before the time I could
leave the room.  More questions would allow us to test more areas of
expertise and one question alone would not have too much weight.  One
question alone cannot test a person's total knowledge on a subject.

* the IBLCE should conduct "focus groups" of people who just took the exam
to discuss the questions and pictures.  A lot could be learned about how
each question was viewed and if the questions tested what was intended.

* the IBLCE should still continue to require the exam for 10 year
re-certification.  This would force studying to ensure you are up to date
and not just attending possibly the same continuing education programs over
and over again if you can re-certify by continuing education.
or
* Devise an "expert" level exam for those who have been certified for ten
years or more. The entry level exam should be too easy for those who have
been practicing all those years.  It seems silly to test their entry level
skills.

*  The exam should not focus on things that can be easily and should be
looked up (such as individual drugs).  Those who work with the drugs will
memorize this information anyway, but those who only occasionally work with
drugs should NOT rely on their memory. Testing of what the reference says
and how the LC uses the info would be more helpful.

Terriann Shell, IBCLC
Delaware