<I suggested we should sort of have to describe the process of coming up
with
an answer, but a nightmare indeed... to create a universal standard for
checking the answers. And who's gonna appoint the members of the panel and
find out about their competencies...? What if an incompetent lc is in the
position where she has to pass or fail a possibly way-over-entry-level
candidate...? Very difficult...>

When I took my state licensing exam for mental health, we had an oral exam
(which has now been discontinued).  I was presented with several vignettes
and had to quickly devise a diagnosis and treatment plan, including any r/o
or referrals I would make.  The panel consisted of two licensed mental
health professionals.  As I recall (this was 20 years ago), the licensing
board solicited people who would sit on the panel for a number of years (the
licensing exam being given once a year).  There was some training and
evaluation involved, although I don't recall exactly what was involved.  I'm
sure there was some kind of stipend.  When I took my exam, I felt
particularly prepared as I'd been working in outpatient mental health for a
number of years.  For better or worse, I was used to being given a very
limited amount of time to collect pertinent facts, make at least
a preliminary diagnosis, as well as a preliminary treatment plan.  Others I
know who I considered at least as competent as I felt less prepared as they
had not practiced in that environment.

Given the standard of care for an IBCLC, I'm sure something like this could
be created.  It would take time and money to do so.  Some folks would be
better at it than others (both the taking of and evaluating of the exam).
OTOH, the oral exam was eliminated (for CA MFTs) in 2003 or 2004.  The
rationale was that
the Office of Examination Resources submitted documentation that indicated
that "research has shown that multiple-choice questions, when properly
developed, can measure higher-order cognitive processing than the basic
cognitive processing associated with recall and comprehension.  In addition,
research has also shown that situation or vignette-style multiple-choice
questions can measure complex, higher-level cognitive skills.  The clinical
vignette multiple-choice questions were developed as an alternative method
of measuring the critical knowledge and skills associated with the
entry-level LCSW and MFT practice."  Of course, I find no references to said
research.  and isn't that a terrible sentence?  Anyway, this change was also
made partially in response to a shortage of mental health professionals, the
cost of administering the oral exam, and a couple of other factors that I
can't quite recall.

Just an example of what another field has done/is doing in terms of
licensing.

Mary Wagner-Davis

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