It happens. Not everyone passes the IBLCE exam the first time. At least a few times each season, my staff and I are asked: “I failed the exam. Can you help me to pass it next time?”
In almost every case, the person asking doesn’t know why they failed the first time, or how they can ensure they succeed this time. Almost every person who takes my Lactation Exam Review or Comprehensive Lactation Course passes the exam. Hence, most of these inquiries are from people I don’t know, whose previous study strategies I know nothing about. To help them figure out how succeed in earning their IBCLC credential this time, I rely on a core set of questions.
1. How did you complete the 90 hours of lactation-focused education?
Most IBLCE exam-takers choose one of two approaches to meeting the requirement for 90 hours of lactation-focused education. They either take a 90-hour comprehensive course, or they use a “hodge-podge” approach. “Hodge podgers” pick up 5 credits here, 2 credits there, 7 credits in the other place, and so forth until they reach the 90-credit mark. They’re eligible to take the IBLCE exam, but seldom are they prepared for it.
It’s human nature to be drawn to the information that seems interesting rather than that which is necessary but possibly less exciting. But attending a “hodge podge” of smaller lectures or events puts one at risk for failure. Sure, you can to acquire the 90 lactation-focused hours. But it rarely — if ever — gives you the full range of information you will face on the IBLCE exam.
Completing a comprehensive course is, in my view, critical if one wants to become a “professional” and, it is often essential to exam success. Look for one that has been approved by the Lactation Exam Accreditation and Approval Review Committee (LEAARC). (I will be offering in several cities nationwide.) LEAARC approval ensures that a course offers 90 hours and covers all of the IBLCE exam content. This is the best way to make sure that the candidate is at least exposed to exam-relevant information. (Whether or not they retain that information is another story.)
2. Did you take a review course?
I have taught thousands of aspiring IBCLCs in my review course, offered in several cities each year or online. While not everyone needs a review course to pass the exam, attendees often tell me that the course helps them figure out how to structure their study time, or how to review the pertinent material when they study.
However, a “review course” only works if you really are reviewing the material — not if you’ve never learned it before! A review course is not a magic bullet, and it’s not a replacement for a comprehensive course or other lactation education. Still, if you lack a strong grasp of all of the topics being tested. It’s also helpful if you cannot find the time and the discipline to review topics — especially those that aren’t typically encountered in routine clinical care. Simply stated, a review course is an effective means to review previously-learned material. But it’s not the only way.
3. What active learning/reviewing strategies did you use?
Although often attributed to Confucius, it was probably Xunzi who first said, “I hear and I forget; I see and I remember; I do and I understand.” Perhaps a better translation would be: “Seeing leads to better retention than hearing alone, but true learning and retention is most likely to occur when it is put into action.” Therefore, I encourage IBLCE exam candidates to use active learning strategies throughout their journey to the exam.
In their initial preparation, candidates must learn academic knowledge and clinical decision-making. And, they should pick the particular active learning strategy that best suits the particular knowledge they wish to acquire. For example, it’s critical to master the terminology for decoding in-depth questions, and flash cards are a fabulous way to really nail it. Another effective active learning strategy is writing. As the old saying goes, “Thoughts disentangle themselves when they pass through the lips and fingertips.” Writing out a “mind map” of a particular concept — for example, a diagnosis, symptoms, treatments and so forth — is a great way to actively learn all of the ins and outs to that particular diagnosis. Of course, working in the clinical area is an ideal way to experience active learning!
Active learning is just as important — perhaps more important — during the review phase. Certainly, practice exams are a popular and effective active learning strategy. We’ve noticed that people who have successfully completed our practice exams almost always pass the IBLCE exam on their first try.
The exact strategy you use probably doesn’t matter, but I urge you to find and use multiple active learning strategies. Just having information go into your eyes or ears doesn’t help much with getting it into your brain. And, lest I sound like a broken record here, learning is the first step; you must also retain it.
4. Do you know the topics you’ll face on the IBLCE exam?
It sounds silly to register to take an exam without knowing what it will be about, right? Some people do. Just the other day, I asked a caller what sorts of topics she would expect to find on the exam. To my utter astonishment, she began talking about the IBLCE Pathways. I explained that the Pathways are means to qualify for the exam, but do not reflect the exam content. She felt bewildered. Just months away from her exam date, she had never looked at the IBLCE’s Exam Content Outline.
It seems that many people think the exam will cover positioning and latch with maybe a few problems like yeast or tongue-tie thrown in. Some assume that it will mostly address strategies for communicating with and counseling the breastfeeding mother. There’s certainly a hefty dose of those topics on the exam, but the candidate who studies only those topics cannot hope to pass the exam on the first try. The exam is actually much, much broader; as a look at the Content Outline reveals, it includes such issues as pharmacokinetics, public health policy, and much more. It also covers time frames, from the prenatal phase through toddlerhood. Some exam candidates don’t know this before taking the exam. That’s a set-up for failure.
5. What do you do in real life?
Although it may feel like it at times, no one spends all of their time studying for the exam. I always ask people “What do you do in real life?” I hope that the response reflects the kinds of experiences that would enable them to deal with the broad range of questions that they’re likely to face on the IBLCE exam, or that it helps us to pinpoint some gaps.
For example, a candidate whose experience is mostly telephone counseling for mothers with older infants and issues such as tandem nursing, teething, and nursing strikes may find herself completely prepared for questions on those topics, but completely unable to answer questions about a wide range of other important topics, such as newborn jaundice, characteristics of premature babies’ oral reflexes, and more.
6. How are you on recall, and on knowledge application?
Say you’ve learned a lot of facts, concepts, or principles about lactation management. You can easily recall the temperature needed to achieve Holder pasteurization, which type of T cell is most affected with HIV, and how the size of the molecule affects a drug. But you can’t stop there. Most of the exam is designed to test how well candidates can apply the facts in clinical care.
Think of IBLCE exam questions as having three parts:
- the timeline (the baby is so-many hours/days/weeks/months/years old, or the mother is so-many weeks pregnant or postpartum)
- the situation
- what would you do about it
The key to that third piece is likely to swirl around one of these actions: reassure and/or listen, help to resolve the problem, or refer the mother to someone who can. (It sounds so simple when explained that way; on exam day, it seems much more complicated!)
Again, a practice exam comes in handy here. The results reveal a lot about the questions you missed, such as whether you didn’t know foundational information, or whether you knew the information, but could not apply it. Many — or most — of the questions on the IBLCE exam are fairly situational in nature.
7. How savvy a test-taker are you?
Some people seem to possess a natural ability to take tests. For most of us, that’s not the case. If you find yourself overthinking a question or reading too much into it, take heart. You’re not alone. When I sit for the exam, I sometimes second-guess myself. A photo of a baby who is well captures my attention as I keep looking for what’s wrong with it. Or, I “know” the right answer immediately but think that my instant response signals that I’ve missed something less-obvious.
Fortunately, you can develop test-taking skills. It’s just another kind of knowledge you’ll want to acquire — and apply — on the path to IBCLC success.
If you’ve failed the IBLCE exam, you’ll want to think these through before you take your next step. We have some great resources to help you so get started on your success today!