The exam questions are written and reviewed by specially trained CPMs according to standards set for accreditation by the [National Commission for Certifying Agencies].
The passing score for all exams is set through a process called the modified Angoff Method, which allows for evaluation of the difficulty level of each item on a mathematical scale. Each version of the exam may have a slightly different passing raw score (number correct). All scores are reported on a scale where 75 represents the passing grade.
The exam contains 350 multiple choice questions, each with four possible answers. Only one answer is correct based on the information given in the question. Candidates are not asked to choose the “best” among a series of correct answers. Though three of the answers may seem plausible, there is always something that makes those three answers incorrect and/or irrelevant to the question.
Setting the passing standard (cut score) for the NARM Exam
The passing score is determined using the modified Angoff Method, where groups of subject matter experts (CPMs) rate each question on how likely a competent, but entry-level, midwife would answer it correctly. Based on the assumption that not all competent midwives will get every question right, but that each question should be clear and relevant enough to be answered correctly by most entry level midwives, the raters give each question a score based on how many competent midwives out of 100 would choose the correct answer. These scores are averaged to determine the passing score. This is a standard process used to set passing scores on many certification exams. The NARM Board has the final authority to determine the passing score, and may adjust the score upward or downward by one Standard Error of Measurement if they feel that the raters have judged the exam too harshly or leniently.
Because each question has a rating, and each form of the exam contains an assortment of questions from the Item Bank, the raw score (number of correct answers out of 350 questions) may vary slightly for each form of the exam. The forms currently in use have passing raw scores from 277-280, or approximately 80% correct answers. Reporting the score on a scale where 75 is the passing score allows a comparison of the passing or failing scores on different forms of the exam. For example, on an exam where the passing score is 277, a score of 278 would pass. On an exam where the passing score is 280, the score of 278 would not pass. A score below the passing score will be reported as a scaled score of 74 or lower, a score right at the passing score will be reported as a scaled score of 75, and a score above the passing score will be reported as 76 or higher.