"These candidates can and do pass the exam based on being a post partum or labor and delivery nurse for years, presumably some studying, and with a one week course to fill in the gaps, bingo, they are close enough to pass. Even more disconcerting is that IBCLCs in private practice have also not developed the skills necessary to solve more that the basic latch and sore nipple problems. And let's not even discuss the ever growing concern of mothers who enter the consultation with sore nipples and low milk supply and come out with a pump and a decision to express milk and bottle feed the baby. Breastmilk feeding is not the same as breastfeeding, although you'd be hard pressed to understand the difference in some areas of the country. Practice hours and lactation specific areas, as well as medical background education for non-medical candidates are other areas which desperately require review. How can it be that some candidates pass the exam with as little as 500 practice hours, and others require 6000? Are the standards set 20 years ago based on post-secondary education still valid? The quality of the practice hours could well be more important than the quantity. Yet, there is no mechanism to monitor these hours. Financially for IBLCE, realistically, administratively, it is impossible, unless candidates would be willing to pay thousands of dollars for the exam process, and they are not. Few people realize that our credentialing organization exists nearly exclusively on exam income (small additional income is derived from CERPs fees, which, however, do not even cover the cost of administering the CERP program). It is unreasonable to expect to run a business (rent, utilities, insurance, salaries, office supplies, exam development and administration expenses, board meeting expenses, legal and psychometric fees, etc...) AND add individual assessment requiring time, travel, hospital/work environment set up time, etc. with a staff of 4 or 5? Prospective candidates went nuts a couple of years ago when the additional requirements for the "background in" education requirements were announced several years ago, so much so that applications to take the exam went up considerably, then dropped equally considerably the following year. Why? These 'additional requirements' were perceived as unrealistic and unfair burdens that previous candidates and nurses didn't have to meet. And what were we taking about here? 8 clock hours of education in areas meant to help non-health care professionals and those with no prior exposure to understand the basics, and be able to communicate on an elementary basis with other HCPs without making fools of themselves. Clock hours, not university credits. For anatomy and physiology hardly enough time to even learn to identify the body's major systems let alone learn anything about physiology. Yet complaints. I remember a woman to ask if "large animal anatomy" (she was a pre-vet major in another life) could be used to fill this requirement. What kind of professional, gold-standard behavior is this? Her argument: humans are really large animals. Answer: No. Concerns have been raised about falsification of hours and educational experience in exam applicants. I have no doubt that this happens. Again, resources force IBLCE to believe that applicants are telling the truth, that supervisors signing off are honest, that education providers are guaranteeing that students spend the entire courses with their butts in the their chairs. Spot checks are made, tips are followed up, suspicious applications are investigated, and each application is completely read checked to make sure the math is correct, but beyond that, realistically, what can be done? (Just FYI, the certification industry standard is that not every application is checked; generally a random sample is taken.) Do you want the breastfeeding police to go out to verify each application? And do you want to pay for it? That would involve an increase in exam and recertification fees. And even if each application is checked, if the supervises signs an affidavit that the hours are correct, short of subpoenaing hospital records (unrealistic at best), one is forced to accept their statements, true or false. The costs involved would be astronomical. Current exam fees do not even allow the organization to rent sufficient office space, pay employees average nonprofit wages, or exhibit at conferences that would be ideal venues for recruiting. Perhaps the large number of hours necessary encourages fraud; role delineation studies are meant to keep these requirements current and valid, so perhaps we will see changes in the future. 45 hours of lactation specific education are required to sit the exam. Think about this. 45 clock hours is required to prepare for a career. There are no requirements as to the content of these 45 hours. Theoretically, it could be 45 hours of basic positioning and latch, and the applicant would have met the requirement. How many clock hours do other people spend in classrooms preparing for their careers? At the present time, these hours are not even required to be CERPs (although it is strongly recommended), which would guarantee at least a certain level of quality and relatively valid subject matter. What happens is that most people accumulate their hours, rush off to take the "lactation consultant course" which through clever marketing and hospital administration pressure seems to have become a "requirement" to sit the exam -it is NOT--, which gives you 45 CERPs, and voila you are eligible to sit the exam. Taking any 45 hour course or review type course in the time immediately before sitting the exam if anything, should serve as a review of what you have learned over the past years you have accumulated your practice hours and read the books (at least some of them) on the recommended reading list. It isn't currently a question on the exam application, but I would love to see a poll of how many of the candidates read any of the books on the list before the exam. They don't even read the entire Candidate Information Guide, based on questions I was accustomed to answering. Ideally, individuals preparing to become IBCLCs should be thinking of it as at least a 2-3 preparation experience. I always advised "newly in love with breastfeeding" IBCLC wannabe's to take a week-long course, do some reading from the recommended reading list, go to some conferences, and THEN begin accumulating hours. If they were nurses, and had already begun (or indeed finished) their hours, they still need to do these activities. All of this, and more, is in the Candidate Information Guide. 45 Hour Requirement, Continuing education and the CERP system: The CERP system is another area that, I believe, needs major review and revamping. Currently, CERPs are granted after an evaluation of the program, the speakers CV, the program bibliography, and payment of a miniscule fee. Other than this, there is no verification of the speaker's actual knowledge on the subject, or skill at presenting the information. Even more disturbing, there is no sure way to verify actual attendance and LEARNING of the attendees at the sessions. Course providers often cannot even verify attendance, let alone that participants learned anything. I personally have attended more than one conference and registered only to find the completed CERP certificate for 15 or more CERPS already in the folder! Why not just see the sites of Chicago or New York in this case? Do you? Which brings us to another point. Recertification is currently required every 5 years by exam or CERPs, and at 10 years by exam only. The recertification by CERPs is, essentially, a gift. Continuing education has not been linked to continuing competency. The only means of guaranteeing continuing competency is through examination. Our young field is continually changing. So are others. Other allied health care professions and international professional certifications require recertification by exam every 2 or 3 years. Practicing with out of date information is a Code of Ethics violation. Think about that one. " (continued) *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html