The CPM Certification Process: Combining Advanced Learning Theory with Time-Honored Tradition

AUGUST 2013 Enews Articles

The CPM Certification Process: Combining Advanced Learning Theory with Time-Honored Tradition
by Ida Darragh

Competency-based education has been implemented for many years in alternative learning schools, experiential programs, and apprenticeship traditions, but has more recently come to be associated with standardized education. The U.S. Department of Education (USED) has endorsed competency based education as “a structure that creates flexibility, and allows students to progress as they demonstrate mastery of academic content, regardless of time, place, or pace of learning.”

Competency-based education has been the core of the educational pathways to certification by the North American Registry of Midwives (NARM). Beginning in the late 1980’s, the Midwives Alliance of North America created a core competency committee, a certification committee, and an education committee. These committees worked to define how competency, education, and certification could best reflect the emerging direct-entry midwifery profession. In 1992, NARM established the core competencies for Certified Professional Midwives via a series of Certification Task Force meetings and Inter-Organizational Workgroup meetings across the United States involving hundreds of midwives. Those competencies have been updated and revised according to the standards of the National Commission on Certifying Agencies, which requires a job analysis every few years to identify current job-related competencies. All applicants must demonstrate competency in all of the identified skills by verification from qualified preceptors who serve as instructors and clinical supervisors. Competency includes both the knowledge behind the skill and the competent application of that knowledge in a clinical setting.

Verification of knowledge and skills must occur as a pre-requisite for sitting the certification exam. Multiple pathways are recognized as options for acquiring the education, including classroom, online coursework, and individual instruction. In keeping with the valued characteristics of competency-based education, learning is not measured by “seat time” or time spent learning, but by verification from a qualified preceptor. The most important element of learning is verified by the competent application of that knowledge in a supervised clinical setting, again verified by a qualified preceptor. The determination of competency is based not on a single demonstration, but on multiple demonstrations that occur throughout the period of supervised experience. Because every birth is different, the application of knowledge and the performance of skills will also be different with each birth. For this reason, students must demonstrate competency over a period of time with a defined number of supervised clinical experiences.

A challenge of the apprenticeship model is for preceptors and students to find the best “fit” to suit each learning/teaching style. The structure of the NARM application process has been revised so that documentation is done in four phases, which gives multiple opportunities for the students and preceptors to evaluate each other’s performance in meeting the apprenticeship goals. This Portfolio Evaluation Process is a true portfolio that gives the student feedback on progress, and concrete evidence of the strengths and weaknesses of their preceptor-apprentice relationship. As defined in competency-based education, the process is flexible but the outcomes must reach a defined level of competency. In the NARM process, after completion of the education and supervised clinical practicum, outcomes are again evaluated through a second assessment of skills performed by a qualified preceptor who was NOT involved in the training of the student, and by a passing score on the certification exam, an 8-hour written exam.

The NARM process leading to the Certified Professional Midwife credential is a unique but proven method that combines the advanced learning theory of competency based education with the time-honored tradition of apprenticeship. The content, or curriculum, of the education is well defined, while allowing the learning process to be suited to each individual. The acquisition of knowledge is self-paced and flexible, but the demonstration of competency adheres to a more structured and formal assessment protocol. This combination provides the most individualized education while assuring that all routes of education lead to the same competently prepared midwife.

For more information about NARM, see:

For more information about the USED statement on competency-based education,click here.

Ida Darragh is a Certified Professional Midwife and is licensed in Arkansas. She has been the NARM Director of Testing since 1998.

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