xx Updates to CPM Eligibility Requirements

This page is NOT yet in the site navigation because I don’t know whether it’s necessary/accurate. Based on this page on live site: http://narm.org/req-updates/ and it’s linked on this page in the new site]

NARM is pleased to announce the results of the CPM Eligibility Review Process.  This review process, which has spanned over two years and engaged the entire CPM community, was initiated by NARM in order to consider changes to requirements for entry level certification. The primary mission of the North American Registry of Midwives is to develop, administer and evaluate a certification process through a standardized system for those engaged in midwifery practice. This process results in the credential, Certified Professional Midwife (CPM), which is accredited by the National Commission on Certifying Agencies (NCCA). NCCA sets standards for the evaluation of criteria for certification that NARM follows in the development and ongoing administration and evaluation of educational content utilized in the validation of skills and knowledge required for certification. The developers of the CPM credential originally determined general education requirements outside of specific skills and knowledge content areas defined in the job analysis. These include experience requirements (such a minimum numbers of births attended prior to submission of application for testing), prerequisite education documentation (such as CPR, high school education), and requirements for documents related to professionalism (such as practice guidelines and informed consent documents). For a more detailed history on the creation of the CPM credential and NARM standards for evaluation, please see History of the Development of the CPM. The NARM Board determined that ongoing evaluation of general education requirements for all applicants should be conducted in a format that is in keeping with NCCA standards for setting competencies. The board developed a process that includes all of the steps involved in setting criteria for skills and knowledge. NARM recognizes that any changes to requirements will have an impact on the number and quality of applicants for certification. The goal is to minimize as many unforeseen consequences of any changes as possible and to ensure that all changes are made with the intention of maintaining the high level of competency that the credential ensures to the public and to our profession.

The Portfolio Evaluation Process (PEP)

The Portfolio Evaluation Process (PEP) route to certification was established at the onset of NARM to maintain an education evaluation process so that candidates with prior experience, knowledge, and skills in the field of midwifery may have their qualifications evaluated for credentialing. NARM continues to recognize the value of multiple routes to CPM certification and affirms the need to remove barriers to midwifery education for adult learners. NARM also recognizes the need to balance open pathways with the necessary rigor to achieve competencies in the scope of practice necessary to provide high quality midwifery care to US women and their newborns. A full list of new requirements and implementation dates for Entry Level PEP is now available below.

New requirements for PEP-Entry Level applications effective September 1, 2012:

• All applicants must complete a minimum of a high school education or equivalent.
• All applicants must submit proof of completion of an approved module on cultural competency for health professionals.
• The title “Active Participant” Births will be changed to “Assistant under Supervision” and must be supervised by a qualified preceptor.  Preceptors who verify Assistant under Supervision clinicals will need to meet the existing definition of a qualified preceptor. This requirement will be in effect for clinicals (births, prenatals, newborns, and postpartums) that occur after September 1, 2012.

NEW requirements for PEP-Entry Level applications effective January 1, 2013 The clinical requirements will be documented in four phases.  Documentation may be submitted as each phase is completed, or may be submitted as one complete application at the end of Phase 3.  The advantage of submitting the application in phases is to establish verification, through documentation, of meeting the requirements of each phase. Phase 1:  Births as an Observer Document attendance at ten births in any setting, in any capacity (observer, doula, family member, friend, beginning student). These births may be verified by any witness who was present at the birth. This form may be submitted when complete or at any time prior to submission of Phase 3 forms. Phase 2:  Clinicals as Assistant under Supervision Document at least 20 births, 25 prenatals (including 3 initial prenatal exams), 20 newborn exams, 10 postpartum visits as an assistant under the supervision of a qualified preceptor.  Eighteen births in this category must be completed before beginning Primary under Supervision births.  Determination of readiness for serving as Primary under Supervision is at the discretion of the supervising preceptor, and may require more births as an assistant before moving to the next step. Phase 3:  Clinicals as Primary under Supervision Document 20 births, 75 prenatals (including 20 initial prenatal exams), 20 newborn exams, and 40 postpartum exams as a primary midwife under supervision.  Two intrapartum transports are allowed if labor began in an OOH setting. CPR and NRP are submitted with this phase. The verification of Knowledge and Skills (Form 201) will be submitted with this phase, and may have been signed during Phase 2 or 3. The Knowledge and Skills list will include verification of both the knowledge base and the performance of skills in a clinical setting. The student is eligible to register for the NARM Examination once the first three phases have been submitted and approved.

• Continuity of Care: Of the 20 Primary births required under Supervision in Phase 3, five require full Continuity of Care and ten more require at least one prenatal under supervision.
• Full Continuity for 5 Primary Births: Five Continuity of Care as a primary midwife under supervision will include 5 prenatals spanning two trimesters, the birth, newborn exam and two postpartum exams. Multiple preceptors can verify the continuity of care.   The newborn exam must be done within 12 hours of the birth; maternal postpartum exams must be done between 12 hours and 6 weeks following the birth.
• Prenatals for 10 Additional Primary under Supervision births: Students must have attended at least one prenatal (in a primary or assisting role) with the mother prior to her labor and birth for 10 of the 20 primary births under supervision in Phase 3 (in addition to the 5 with full COC).

Phase 4:  Five Additional Births as Primary under Supervision: Document five additional births as Primary under the supervision of a Qualified Preceptor. These may have occurred after the last birth on Phase 3 documentation, and may be submitted before or after the Written Exam.  Only one maternal transport may be included if the labor begins in the OOH setting. Submission of this form is expected within six months of passing the exam unless a request for an extension is made. Additional Requirements (not related to Phases)

• Experience in specific settings: A minimum of five home births must be attended in any role in any phase.  A minimum of two planned hospital births must be attended in any role in any phase.  These cannot be intrapartum transports but may be antepartum referrals. These births may be included in documentation of Phases 1, 2, and 3.
• Time frames: Ten out-of-hospital primary births must occur within the last three years.  All clinicals documented on the NARM application must occur within ten years of application submission.
• Minimal time frames for entire experience: Clinical training documented in Phases 1, 2, and 3 must span at least two years. [A review of NARM application data indicates that most training spans three to five years. Theoretical/didactic education is integrated within the clinical training period.]