The Demonstration of Knowledge and Skills

Identification of the knowledge and skills necessary for certification is based on the actual practice of midwifery, and not on a specific set of protocols or regulations. The knowledge tested on the NARM Examination and the skills tested verified by Registered Preceptors are identified from the Job Analysis. The Job Analysis is a survey of the current practice of midwives across the country. From this list comes the test specifications for each examination. Many midwifery schools base their curriculum on these test specifications so that their graduates will be prepared for the certification examinations. The skills checklist portion of the Portfolio Evaluation Process is also based on this list, so midwives training through a preceptor will also learn and demonstrate the same skills. This process assures that all CPMs, regardless of path of education or experience, will demonstrate competency in the same skills. NARM does NOT specify how a CPM will utilize the knowledge and skills in actual practice. In other words, NARM does not issue standardized practice protocols. NARM does require that each CPM candidate have practice protocols in writing and utilize informed consent in communicating the protocols to the clients. 

The legal regulation of midwives varies in each state. Midwives practice completely unregulated in many states, and in other states they practice according to very specific protocols set by the state. In some states they are permitted to use emergency medications, or suture tears, or give oxygen. In other states, they may be forbidden from any of these procedures. The CPM credential verifies the midwife knows these skills whether or not they choose (or are allowed) to perform them. States that require the CPM credential for licensure are assured that every CPM has been through a rigorous process to verify knowledge and skills. The CPM is the standard for the knowledge and skills, regardless of the individual circumstances in which the CPM practices. 

CPM candidates sometimes comment on the examination questions that they are not “allowed” to make that choice based on their state regulations. NARM does not say that the midwife must base protocols on that knowledge or include that skill in practice, but must demonstrate the knowledge or skill for purposes of national certification. NARM questions are based on the test specifications and are referenced to the bibliography listed in the Candidate Information Booklet. Candidates should base their answers on the NARM Examination as well as the skills required in the CPM application on the test specifications in the CIB, and not on specific individual or state protocols. Passing the NARM Examination depends on receiving a minimum number of correct answers. Leaving a question blank will affect the total score. Each question on the NARM Examination is worth one point. Failing candidates must pay an additional fee to retake either examination.