Studying for the NARM

[momileigh]

Any advice?

I am NOT looking for inappropriate "help" from people who remember test questions. Just general advice regarding books to read, topics to review...

So far my game plan is to read Heart & Hands and Anne Frye's Dx Tests cover to cover.

For anyone who has passed in recent history, what do you think was most helpful in preparing you?

[nashvillemidwife]

These are my recommendations, as a CPM and as an educator:

You have to be familiar with the material before you can "study" it. To do so you need more than Heart & Hands, and reading the Frye lab book cover to cover just for the NARM exam is a waste of your time as very little of it will be covered. The amount and detail of information she provides is astronomically more than most midwives need to know to properly care for clients. Keep it as a reference and make it your goal to learn about these things as you grow as a midwife, but don't dwell on it now. The other books below will contain all the pertinent information you need to know about lab tests in pregnancy.

I would recommend Varney's Nurse Midwifery (3rd or 4th editions), and Anne Frye's Holistic Midwifery Vols. 1 & 2. Those Frye tomes are also going to provide you with an overwhelming amount of information, but it will be more valuable to you than the lab book. Gabbe's Normal and Problem Pregnancies is a medical text book, but provides good, solid information (and I actually trust Gabbe's information more than Frye).

Take notes when you read; write down stuff you think is important but you're likely to need help remembering. Write down a few sentences on each topic you need to remember on an index card and carry them with you. Pull them out whenever you get a chance, like waiting in traffic or even when you sit down on the toilet. Tape one to each mirror, stick one or two on the fridge. Use one as a book mark. When you're ready give that card to someone who can test you on recalling that information. When you get it down pat throw that index card away, tape a new one to the mirror, etc.

Now you've learned the information, so it's time to study the finer points.

In the Candidate Information Bulletin there is a list of "Written Test Specifications". Look at each item on that list and ask yourself "what could they possibly ask me about this topic that I couldn't answer?" Write it down. Now you've got your own customized study guide without having to sort out the extraneous information you don't need to study because you've already got it. Don't gloss over anything until you've really pondered how much you know about each of those topics. I won't be specific, but I think the test touches on a few areas that are not necessarily part of a midwife's job expectations. However, after the test when I went back and looked at the Specifications they were plainly listed there and I had skipped right over them.

[momileigh]

Thanks so much for the advice!

I have Varney's, but I really find it dry as a bone. I have a hard time reading it. I enjoy Frye's tone more. I guess I'll go ahead and buy her HM V I&II.

At my school, advice regarding the NARM tended to consist of ranting about what a horrible test it is. You have been much more constructive.

[olive&pimiento]

You are awesome, Nashvillemw!!! Thank you from all of us who plan on taking the NARM soon.

[Midwife Kris]

When are you taking the NARM exam? Since you just graduated from midwifery school, you should have binders full of NARM prep to review, and recent classes fresh in your mind. IMHO Varney's is overkill for this exam. NARM is an entry-level exam and Heart and Hands is an adequate review guide.

[sevenkids]

Originally Posted by Midwife Kris

When are you taking the NARM exam? Since you just graduated from midwifery school, you should have binders full of NARM prep to review, and recent classes fresh in your mind. IMHO Varney's is overkill for this exam. NARM is an entry-level exam and Heart and Hands is an adequate review guide.

I agree, Varney's and Anne Frye is too much info that will clutter your brain and you won't be tested on. (I am one of a very few dissadents who couldn't stand Anne Frye's books and I never refer to them.)

My advice would be to NOT study.....you should already know what you need to know to pass the exam. If you feel like you need to brush up, Heart and Hands is more than enough. The NARM is not horrible, it's very basic knowledge.

I think the main point you need to remember is the exam is not state law specific, so forget about state laws when answering the questions. The answers will apply to the LM, the CPM, and those who practice illegally.

Don't stress about it, the exam you took to pass Shari's school is way harder!

[momileigh]

I can't thank you all enough for the input... but I do have a question for those saying it is very basic knowledge: why do so many people flunk?!? IME the pass rate on first-timers is, like, 50%. PLENTY of Shari's graduates flunk the first time, and numerous flunk the second time as well.

When I was at the NARM conference, I talked to several girls (not from my school) who had just taken the exam. While of course they could not go into specifics, they all conveyed that it was a very difficult exam.

One midwife I know did tell me that it was "all common sense." But then I found out (by someone who KNOWS) that she flunked the first time! If it is entry-level common sense, why do people flunk?

I really don't want to flunk this test. I've never flunked a test I cared about in my life.

[sevenkids]

I think people fail because they overthink it and spend too much time on studying Varney's!

I think the biggest mistake people make is applying their state laws to the answers....for example, "if" they ask you (this is NOT on the test, btw!) "You arrive at the home of a laboring woman, and perform a VE and discover her to be 8 cms and the baby is breech. What do you do next?" The answer is NOT "call your back-up OB and transport", the correct answer would be the best answer provided to manage a breech safely.

Also, people tend to overthink the exam and believe it's more complicated than it is, or that the questions are "trick" questions. They're really not trick questions, NARM wants you to pass, and the answers really are that simple.

When I was taking it, I imagined each case scenario as a living, breathing pregnant woman in front of me. Look at the whole picture of each case before you try to answer the first question.

Definately don't study the night before the exam, find something relaxing to do instead. I went to the hotel pool and hung out with some hunky football players from Atlanta who had a cooler full of Thai beer.
Don't stress it!!!

[momileigh]

Oh, and to answer Kris' question, I'm taking the NARM Feb. 20th.

[momileigh]

I've heard of that, people thinking that NARM is testing them on whether or not they'll break the law, and assuming that none of the correct answers would involve doing something illegal in Florida. I don't *think* I'll be prone to making that kind of mistake.

Does taking the kids to Disney World count as a relaxing pre-NARM activity?

[1stimestar]

Originally Posted by momileigh

Does taking the kids to Disney World count as a relaxing pre-NARM activity?

Hahaha I would guess NO. Good luck!

[nashvillemidwife]

momileigh, my reading recommendations are for someone going through the PEP process and have had no organized academic education. I didn't know that you had gone to a school. If you have already been educated then by all means all that reading is overkill!

For someone who is completely self-taught I still think those books are the best way to go.

I didn't realize so many people fail the exam, though I would be very interested to see a breakdown of the failure rate for MEAC grads versus PEP, and also for midwives who have experience in any kind of higher ed versus those who don't.

As in every thing else I hold some pretty heretical opinions about that NARM process, but I'm afraid they'll get me in trouble!

[momileigh]

Oh, thank you for clarifying! I'm still going to use a lot of your recommendations for studying, though. My school is not MEAC accredited (yet), but I don't have to do PEP because we are recognized by the state of Florida. I'm an "agency candidate" for NARM/CPM. (I don't know if I'm saying that exactly right. It is a little confusing.) I've wanted to get Frye's other books anyway for my own studying and reference, so I went ahead and ordered them. Might as well have them to study for the test, if I'm going to buy them anyway. (I got some money for graduation, what better way to use it? Hmmm... I guess I could have bought a doppler... maybe I'll get some passing-the-NARM congratulation cash too! )

It sure would be interesting to know who (as in what educational experience) passes and who fails and on what subjects. I really wonder. I'd also love to know the actual pass rate as opposed to what it seems like to me.

I think being 100% self-taught is incredible!

[teachinmaof3]

Great post!

Can someone tell about the portion of the exam with the QE? I'm just starting my studies and while I'm not worried about someday taking a written test, the part with the QE scares the crap out of me!!!

[FairFlowers]

I studied Varney's and Anne Frye's Vol. II cover to cover (almost) and highlighted important facts, figures, and passages to remember. I reviewed lightly Heart & Hands, Frye's lab book, and Frye's Vol. I.

I agree with the person who warned against studying the night before! If you don't know it by then, cramming won't help. Relax and unwind.

The other thing that I noticed was that sometimes the most obvious answer wasn't offered as a choice! The questions on the test require you to think on all levels. Sure, you recommend iron rich foods to a woman who is anemic, but what other kinds of foods would you recommend? Your answer to a question may be the most obvious and first thing to be done, but the correct answer may be something that you would recommend or do beyond the most obvious.

Does that make sense?

Don't answer the question until you are sure of your answer or sure you don't know. Don't second guess your answers.

It was a difficult test. But it wasn't horrible. I passed it the first time and you (all) can too.

Good luck!

[nashvillemidwife]

Originally Posted by momileigh

I've wanted to get Frye's other books anyway for my own studying and reference, so I went ahead and ordered them.

They're certainly worth having as a reference and I do recommend that you make it a goal to read it all, but not for the test!

It sure would be interesting to know who (as in what educational experience) passes and who fails and on what subjects.

I would also very much like to see the breakdown on subjects. I was 110% prepared for that exam and it only took me about 2 hours to complete it (either I had to have aced it or I didn't know anything). Of course I passed, but my score was not nearly as high as I expected. But I also knew immediately that most of what I missed had to have been on postpartum care.

Originally Posted by teachinmaof3

Can someone tell about the portion of the exam with the QE? I'm just starting my studies and while I'm not worried about someday taking a written test, the part with the QE scares the crap out of me!!!

You meet with the QE, she asks you to demonstrate some skills, you do them, and you pass. That's pretty much it.

Seriously, if you think you know your skills well enough to be a CPM, then it's not rationale to think you don't know them well enough to pass the assessment. I was nervous too, but remember: what's the worst that can happen? You fail the assessment. Realistically, what's the worst thing that can happen if you fail? You have to repeat the assessment, this time knowing what to expect and what you need to work on. Don't sweat it.

I always start something like that by just telling the other person that I'm nervous. Unless they're just a total b****, they're going to say something comforting.

Originally Posted by FairFlowers

The other thing that I noticed was that sometimes the most obvious answer wasn't offered as a choice! The questions on the test require you to think on all levels.

I've not really heard other people complain about the test, but this really bothered me. Yes, any good test is composed of questions that make you think (an untrained monkey can memorize). But there were just a couple questions where the responses provided were purely subjective. They were more like "what would you do..." and there was no scientific rationale for any of the responses. It was purely a judgment call. Yes, there were some responses that were better than others, but not the kind where if you were sitting in a peer review and another midwife said "I did this" you really had any business to say "that was the wrong thing to do". Does that make sense?

Don't sweat it though. Those was just one or two questions that irked me, you don't need to worry that most of the test is going to be trick questions. Who knows, maybe they don't actually have a correct answer and everyone gets it right. I do know that I want to get in on one of those test writing workshops and raise hell about inappropriate questions. I guess it's because I have an education degree, so I was taught how to write a proper test.

[cathicog]

Nashvillemidwife, thank you a bundle! I am also currently studying(still have 3 continuities to do, then send my paperwork in) and am studying mostly on my own(but I have been studying for over 20 years!)...and Frye's is what I have been working on, slowly but surely. Hope to be able to finish and take my test in Aug... Thanks for the study tips! PS, I am also in TN...

[momileigh]

Oh, if only you could revise the test before I have to take it... Much has been made of those "judgment call" type questions at my school.

One former student told me that this would be a good sample question for the NARM:

1. What should you educate a client about?
a. Sex during pregnancy
b. nutrition
c. kegels
d. baby care

I think she was exaggerating.

Thanks for the encouragement!

[Maggi315]

this is one area I think we need someone to develop a study guide manual. For every other test I have taken including my nursing exams and my lactation exam, there are study guides. For lactation, linda smith has a great review book, basiclaly full of q/a's, with the reason for the correct answer. I also did an online study course through health e-learning (I think that's the name), which was the same thing.

This made my life soooo much easier, I was able to take these practice tests, and then if i didn't know something or felt weak in an area, I could go and do further research. But it helped weed out the stuff I already knew.

Wonder why we don't have that with narm? Nurse midwives, fnp's, everyone else have study guides and practice tests, I think it's time someone do it! I would love to, but have no idea how to even go about doing that.

I am taking the NARM this summer. I have been ready since 2004, but through a series of unfortunate events, have continued to have to postpone, so Iam determined to get this done this summer!!!

[Midwife Kris]

Originally Posted by momileigh

It sure would be interesting to know who (as in what educational experience) passes and who fails and on what subjects.

What I would like to know as someone who passed it, what questions/scenarios did I fail to answer correctly. When you pass, you pass. When you fail, it's detailed out for you to make improvements for the next try.