My reaction to the NARM *Update: I PASSED!* - Mothering Forums
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#1 of 68 Old 02-23-2008, 11:28 AM - Thread Starter
 
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I'm reposting this from my myspace blog:

UGH. What a hard test! But not in the traditional sense. I had studied things like exact amounts of vitamins and precise antibiotic doses and such... nothing like that on the test. No percentages, no need to know the names of extremely rare diseases. Just a bunch of trying to guess what is in the head of the person who wrote the question. I am not allowed to repeat actual test questions, but I am just going to approximate what I'm talking about with original examples.

Here's one "example."

A client reports that she hasn't felt her baby move in over 24 hours. What should you do FIRST?

1. Check the baby's heartbeat
2. Check the baby's position
3. Have her lie down
4. Consult her chart

Well, your gut instinct is to say, "Whoa, check that baby's heartbeat now!" And there it is, option number one, easy, huh? But then you go to option 2. Technically, you HAVE to check the baby's position before you try to hear the heart, so you know where to put your fetoscope. (You're never going to hear anything if you're listening over part of her belly where the baby isn't even lying.) So B has to happen before A, chronologically, and the question did ask what to do first, not what was most important. Then you get to C, and it is true, you're going to have her lie down first, then check position, then listen to the heartbeat. So I guess it is C. But then option 4 is consult her chart. Well... maybe she's only 18 weeks pregnant! If that's the case, it is totally normal for her not to feel the baby move for over a day, and you can reassure her. Also, you know that you might not even be able to hear the heartbeat with a fetoscope at 18 weeks, so you don't waste a lot of time trying and worrying the mother. And if she has reported this to you over the phone, of course you're going to consult her chart while you're waiting for her to get to you, or when you're on your way to her sitting at a red light. Hmmmm.... any of them COULD be right depending on how you look at it and the exact circumstances. And none of them seem AS right as 1, but that really isn't what you do FIRST.

Here's another "example":

A woman is anemic. What foods do you recommend?

1. Celery, lettuce, beets, raisins, and corn
2. Chard, hawthorn, malt-o-meal, bananas, and kiwi
3. Beans, orange juice, rose hips, chamomile tea, and carrots
4. Cauliflower, cabbage, tomatoes, whole wheat bread, and berries

OOOOOOOhkeay..... the first question that pops into my mind... WHERE'S THE BEEF? (And I'm not even old enough to remember that commercial.) Are we ALL freakin' vegetarians all of a sudden? I'm not recommending any of that $h!+. I'm telling her to get herself some organic beef and get some Floradix. But let's deal with what we have here. OK, beans, they're supposed to be good for iron. And the vitamin C in the OJ will help her absorb that iron. So 3 is looking good. But... chamomile tea?!? Carrots? That can't be it. And what are Rose Hips? They were on the test at least twice! (off to wikipedia I go...) OK, I remember reading that dried fruits are high in iron. Raisins (in option 1) are dried fruit. But the rest of that list is ridiculous, right? Hmmm. Chard? Are leafy greens high in iron? I'm not sure... I know they have calcium, maybe they have iron too... malt-o-meal is probably fortified... but hawthorn, well, first that's an herb, not a food, and I don't think it has any iron. Kiwi has the vit. C, but what does banana have to do w/ iron? Nothing. OK, last option, berries and tomatoes have Vit. C, and the bread might be fortified w/ iron, but cabbage and cauliflower? I don't think so... but I could be wrong! Why oh why didn't I spend days studying all the foods that could possibly have iron?!? I mean, if I happen to have an anemic vegetarian client who won't take Floradix, I don't suppose there's any way I could look up her options at that time. (ha ha.)

(Now I suppose that if I knew a lot about iron in foods, the question wouldn't have seemed so ridiculous... but I honestly thought I knew enough about foods w/ iron, when I clearly did not, at least for this test.)

Can you imagine 350 questions like that? This test plays with your head, man!!!

I don't know if I passed or failed. I really, really don't have a sense of how I did. I should have the results in 2-4 weeks.

postscript: I have discovered that Rose Hips are an excellent source of vitamin C. This is good news, because I think that's what I guessed on the test for one question. For some reason Rose Hips just sounded high in C to me.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#2 of 68 Old 02-23-2008, 12:03 PM
 
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If it's like that, I'm doomed to fail. You know those multiple choice tests for English lit when you're supposed to explain what the author really meant? I bombed those and this sounds like it.

Are there any practice NARMs out there, like for SATs or MCATs or LSATs?

ETA: What school did you attend? or just self-study? Curious to see how you were prepped?

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#3 of 68 Old 02-23-2008, 01:31 PM
 
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I haven't found a study guide for narm like for other tests. When I took my nursing test and my IBCLC (which is a very hard test, imho), I had study guides, that's really the best way for me to study, to practice the tests and then if I get it wrong, go back and study that part.

that way I don't spend all my time on stuff I already know, I am familiar with how to take the test, etc.

I do wish there was something, maybe someone (maybe me, but who has the time) should do a study guide?

for those enrolled in formal programs, do they include study guides or help? Our nursing program i teach at, has a great study class on how to take the test, does practice questions, goes over the major things to study and has flash cards.
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#4 of 68 Old 02-23-2008, 02:10 PM - Thread Starter
 
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There's no study guide that I've been able to find. There are some NARM-prep flash cards out there which I ordered, but I would not recommend them. I think they mostly wasted my time, to be honest, and I will be returning them for a refund.

I went to the International School of Midwifery in Miami, a 3-year program. We did not have a NARM prep class or guide or anything. (We did get to hear some really "helpful" rants about what a ridiculous test the NARM is.)

I think the MOST helpful thing I did (and maybe I flunked, so don't necessarily listen to me yet) was to basically memorize Heart and Hands. I literally outlined the whole book, memorized the protocols for things like face and breech, etc. But there were definitely things on the test that were not covered in H&H, so it isn't really enough.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#5 of 68 Old 02-23-2008, 06:33 PM
 
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Yikes! And I was so excited to receive my flashcards in the mail today! So, H&Hs, uh? Nutrition. Good grief, I'm going to be in the same boat as you in August. I always overthink questions and my train of thought would have been exactly like yours in your sample question. I can always think of a circumstance where more than one answer may be applicable. You know we always focus on the questions that stumped us after the fact. I'm sure you did well.:

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#6 of 68 Old 02-23-2008, 06:51 PM
 
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Hi

Just had a quick read.and wanted to also put quick reply on. This was my 2nd attempt at NARM. I have to say the PM test was way harder this year. I had lots of long scenarios with 3 or 4 questions linked to each.

Same thing though....there was always at least 2 things I would do, but trying to think which they would do first was hard, and then of course if I was going down the wrong line of thinking, I am likely to get all answers related to that scenario wrong!!!

Yes, feel very frustrated with it, and will await to see result, but felt more confident last time and missed by couple points...so who knows!!!
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#7 of 68 Old 02-23-2008, 07:02 PM - Thread Starter
 
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I didn't get many linked scenarios. Only about 3 or so. I bet there's a first-timers test and a 1st retake test, 2nd retake test, and so on and so forth. (Then again... maybe not. What do I know.)

About the flashcards... maybe they will be good for you. I just don't think they helped me. I think you'll know after you use them for a few hours. The flashcards I made myself going through H&H were much more helpful. If I have to retake, I'm going to go through Frye's Vol I and II and make thousands of flash cards on everything I don't know.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#8 of 68 Old 02-23-2008, 07:14 PM
 
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i just wanted to chime in that i hated the NARM test. i was convinced i failed it, and i was a good midiwfery student with plenty of clinical experience when i took it. i agree, so many questions are bogus, with many good answers. sometimes a "best" answer depends on your experience level, or where you are practicing. i felt like the test questions were often wanting me to choose between being borderline reckless and too conservative/transferring unnecessarily. awful test.
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#9 of 68 Old 02-23-2008, 10:32 PM
 
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Originally Posted by momileigh View Post

... chamomile tea?!? Carrots? That can't be it. And what are Rose Hips? They were on the test at least twice! (off to wikipedia I go...)
And that's one of my very specific complaints about the test. It assumes that herbs are a standard part of midwifery practice, and it is not and should not be. Herbalism is an entirely separate discipline, and a midwife should have specific studies before she is considered competent to recommend them (and I say this as an herbalist who knows I got the questions right).
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#10 of 68 Old 02-23-2008, 11:29 PM
 
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Originally Posted by momileigh View Post

4. Consult her chart

4. Cauliflower, cabbage, tomatoes, whole wheat bread, and berries

Can you imagine 350 questions like that? This test plays with your head, man!!!
If you have finished midwifery school and don't pass that test, there is NO hope for the rest of us! LOL! PS, those are my guesses on your "questions". Yikes, guess I have to read more. I bet you passed it with flying colors... three of my friends did last year, and one of them was sure she had failed it....I bet you did fine.
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#11 of 68 Old 02-23-2008, 11:50 PM
 
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: I don't think I ever want to take that test. :
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#12 of 68 Old 02-23-2008, 11:56 PM
 
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Thank you so much for this post!! As a newbie midwifery student, it's nice to know a little about what lies ahead. The NARM isn't like the SAT/ACT in high school where you commonly run into others who have taken it to get study tips. So it's nice to have this little discussion going so we know a little about the line of thinking to be prepared for.

Best of luck to you momileigh!!!
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#13 of 68 Old 02-24-2008, 09:27 AM - Thread Starter
 
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Originally Posted by busybusymomma View Post
: I don't think I ever want to take that test. :
And I don't ever want to retake it!!!

I reeeeeeeeally hope I passed.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#14 of 68 Old 02-24-2008, 04:13 PM
 
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So... in what ways do you wish your education had better prepared you for the test?
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#15 of 68 Old 02-24-2008, 08:50 PM - Thread Starter
 
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So... in what ways do you wish your education had better prepared you for the test?
That is a VERY GOOD QUESTION. I'm hard-pressed to answer it. I mean, going back to my "sample" questions... how do you STUDY for a test like that?!? How can any school prepare you for those kinds of questions?

I guess I could have known a little more about nutrition. Instead of lists of 6 foods with whatever nutrient, I should have known lists of 20 foods per nutrient. I feel like I know a LOT about birth control, but the questions they chose to ask were not ones I knew the answers to. (I feel that's unfair... I'm practically a walking birth control encyclopedia, I could probably write a fair-sized book about it, and I didn't know the info they wanted... why ask such esoteric questions?) One other area I might have felt weak was that I think I'm better at questions that detect or prevent complications than I am at questions on how to handle them once they occur. Not emergency-type complications, more like, hmmm.... managing someone w/ diabetes, or something like that.

There was one question about preeclampsia where I wrote something like the following on the comment sheet: "I think Elizabeth Davis would choose answer A and Anne Frye would choose answer D. Because Davis comes before Frye on your list of resources, I went with A." I think Davis comes before Frye because D comes before F, but I had to choose somehow. Once again, how do you prepare for this test?!?

So I came out of it not really feeling like there were huge gaps in my education. One of the questions in particular was WAY out in the perinatology field, and I just can't say that I think it was my school's job to educate me on something so far outside the scope of practice of any midwife.

So maybe I did ok. I'll let you know.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#16 of 68 Old 02-24-2008, 09:29 PM
 
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One of the questions in particular was WAY out in the perinatology field, and I just can't say that I think it was my school's job to educate me on something so far outside the scope of practice of any midwife.
Amen to that. There were several questions where I just stared at the paper and thought "the most appropriate answer to this question is to refer them to someone who should know the answer!" I have a very broad knowledge base from having work experience all over the map in women's health & baby care so I knew the answers to most of those questions but still recognize they shouldn't be core competencies in CPM practice. If they're going to expand the scope of what CPMs should know that's not relevant to every day practice, there are a lot more practical subjects to learn before the ones I saw on the test.
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#17 of 68 Old 02-25-2008, 05:43 PM
 
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I'm nauseated just reading your post!

I'm a nursing student and every one of our questions on our tests are like this... you wonder what sort of crazy person would write questions like that. If they want you to choose the best answer, why not OFFER the best answer as an option!

They act like you're attending births in the trunk of a car.

A mother is in the 2nd stage of labor and the baby begins to crown, which of the following would be an appropriate action:

A. Sterilize your crowbar.
B. Prop the mother against the spare tire.
C. Attempt to unlock the truck from the inside.
D. Whistle Dixie.


Well gee, they're all such good answers...

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#18 of 68 Old 02-25-2008, 06:53 PM
 
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I wouldn't quite compare the NARM exam to the NCLEX. Yes, the NCLEX will give you several correct answers and you need to prioritize to choose the right one; that tests your critical thinking skills in addition to your knowledge of the subject and that's something you want in an RN. However, with the NCLEX there is always a scientific rationale why the correct answer is the best one. With the NARM I felt there were questions where the possible choices boiled down to judgment calls; different midwives might choose to do different things and there's no way to quantify the "rightness" of one answer over another.
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#19 of 68 Old 02-25-2008, 07:22 PM - Thread Starter
 
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Originally Posted by moodyred01 View Post

A mother is in the 2nd stage of labor and the baby begins to crown, which of the following would be an appropriate action:

A. Sterilize your crowbar.
B. Prop the mother against the spare tire.
C. Attempt to unlock the truck from the inside.
D. Whistle Dixie.

I narrow it down to B versus D, and go w/ B.

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#20 of 68 Old 02-28-2008, 02:52 PM
 
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Aaaah! I'm already nervous enough about taking the NARM and the more I hear the more freaked out I get!
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#21 of 68 Old 02-29-2008, 01:57 AM
 
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Aaaah! I'm already nervous enough about taking the NARM and the more I hear the more freaked out I get!
Yep, this is me too, and I don't have $$$ to throw away to take and retake tests. Ugh! I'm really nervous about this dumb test, and I have at least a year before I have to take it.

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#22 of 68 Old 02-29-2008, 07:52 AM
 
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I'm a nursing student and every one of our questions on our tests are like this... you wonder what sort of crazy person would write questions like that. If they want you to choose the best answer, why not OFFER the best answer as an option!
Ha! I'm a nursing student too and I was thinking the exact same thing! ALL of our tests are like that!

I just took the NCLEX and it was exactly like that too! Ugh!

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#23 of 68 Old 02-29-2008, 12:12 PM
 
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There were several questions where I just stared at the paper and thought "the most appropriate answer to this question is to refer them to someone who should know the answer!"


I have found, though, that the less confident you are when you walk out of the test, the more likely you are to have passed, if that helps.

And yes, I remember thinking "strawberries? I never recommend strawberries..they're allergenic!" The nutrition questions really blew my mind.

ETA: I took NARM at the MANA conference, and my proctor was Ida Darrough herself. I think that she was very helpful and without her tip before the test, I might not have passed. She said that while many midwives will tell you that NARM is a "choose the best answer" test, it really isn't and every question on that test has ONLY ONE right answer. It really helped me to hear that, because I would look at the questions I was unsure of in reverse, asking myself, "why might this be the WRONG answer in this situation?" And yes, I did pass, though not with "flying colors" (I think my score was an 83 or 87?)

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#24 of 68 Old 02-29-2008, 03:11 PM
 
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Subbing because I want to see how you do!

Good luck!
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#25 of 68 Old 03-01-2008, 04:13 AM
 
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She said that while many midwives will tell you that NARM is a "choose the best answer" test, it really isn't and every question on that test has ONLY ONE right answer.
With all due respect to Ida, I think that's BS. There were questions on that test that had no quantifiable best answer (unless they were allowing multiple correct answers for certain questions).
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#26 of 68 Old 03-01-2008, 05:54 AM - Thread Starter
 
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There was one question that I would say was equivalent to this:

A neighbor's dog is howling while your client is in labor. What should you do?

a. Ask the neighbor to stop the dog from howling
b. Turn up the music so she can't hear the dog howling
c. Tell her to channel the dog's primal energy for her labor
d. Call the police and report a disturbance of the peace

On what planet, exactly, could you say there is ONE and only one right answer to this question? Doesn't it depend on a lot of factors that aren't stated? There may be one and only one answer on the answer key that will get you credit, but I'm sorry, that kind of question is a judgment call, and you almost have to crawl inside the head of the person who wrote it in order to answer it.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#27 of 68 Old 03-01-2008, 01:02 PM
 
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Yes! Exactly! While one of those answers can be eliminated right away, none of them are based on clinical judgment.
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#28 of 68 Old 03-01-2008, 01:08 PM
 
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yeah i remember questions along the lines of: a pregnant lady has an upset stomach. do you recommend: rest, ginger tea, yogurt, etc.

i wrote a BOOK on the feedback form detailing all the questions i thought were rediculous. but then again a lot of people find the test rediculously easy.

i know some of my problem with the test was due to the fact that i'm not a great multiple choice test-taker, and i think there are a lot of us out there. it really is a skill that not everyone has developed--particularly if you haven't taken standardized tests your whole life.

but, i still think so much of the test should be re-written. i think there is a test writting committee. perhaps they need some fresh energy?
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#29 of 68 Old 03-01-2008, 02:58 PM
 
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i know some of my problem with the test was due to the fact that i'm not a great multiple choice test-taker, and i think there are a lot of us out there. it really is a skill that not everyone has developed--particularly if you haven't taken standardized tests your whole life.
Ok, I think this is key. I will probably never take the NARM (I am considering CNM, since I already have an MSN), but I have taken the NCLEX and the NP boards. The single best thing my RN/NP program did was to make every one of our exams look like those tests. We had tons of those terrible questions. I was an english major as an undergrad, and when I started nursing school I would write an essay next to each question about how it lacked clarity, and how there were several correct answers. By the end of nursing school, I was able to get into the minds of the test writers, and mostly figure out how they wanted me to answer.

Good luck, OP! I was certain I had failed the NCLEX (which inexplicably contained at least 7 questions about heroin withdrawal/detox), and I did quite well.

Trying to get my bearings...
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#30 of 68 Old 03-03-2008, 01:31 PM - Thread Starter
 
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Thanks Jenny... I'll let you know how I did. And your edit is very funny

"If you only knew how many things I want to say and don't, you'd give me some credit."
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