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What’s “Fair Game” for the IBLCE Exam?

Here’s a question I hear many, many times from many exam candidates or even re-certificants: “Will [fill in the blank] be on the exam?” And, my response is often, “It’s fair game.”

First, a caveat: I’m not on IBLCE’s exam committee. Never have been, never will be! I don’t have secret intel to share – except the intel of experience. I’ve taken the IBLCE exam enough times to know what seems to be fair game.

Read on for the 10 most common issues related to fair game on the IBLCE exam. (And stay tuned for my next post, about what is not fair game!)

What’s fair game?

1. Everything on the IBLCE’s Detailed Content Outline

I’ve said it many times – studying this document is key to knowing what content you can expect to see on the exam. Example: The Outline mentions hormones. You should fully expect to have at least one question (perhaps more!) about any of the hormones in the human body that pertain to infant feeding or maternal pregnancy/lactation.

Note that some topics are broadly stated – like “breast surgery.” While most of us think of this as meaning augmentation or reduction, it may also include mastectomies or other forms of breast surgery. Any of this could appear on the exam.

Keep in mind, too, that the Outline identifies chronological areas as well as topics. Questions about infants who are premature and those who are 7 months old – and more – are all fair game! What else might you see on the exam? Read on:

2. International issues and health policies

Most of my readers are from the US, so it’s natural for them to look to the American Academy of Pediatrics for expertise first – and anyone else second. However, when preparing for the IBLCE exam, we’ve got to remember that the “I” stands for International. The exam absolutely addresses breastfeeding issues throughout the world, so be prepared to adopt a more global perspective.

IBCLC candidates can be expected to know and implement recommendations from the World Health Organization that pertain to breastfeeding, including those related to HIV, medications, and more.

3. Application-level questions

I would venture to say that nearly all of the questions on the IBLCE exam are written at the application (not the “recall”) level. While you will need to recall basic facts and information, you should expect questions that present mini-vignettes and ask how the IBCLC would handle such a situation. There is more emphasis on doing rather than just knowing.

4. Pictures and other images are fair game

You probably have been told to expect clinical pictures on the IBLCE exam, but there are other images as well. Line drawings, graphs, growth charts, research data, and more are all “fair game” for the IBLCE exam.

5. Anything within the Scope of Practice

Here’s another IBLCE document to review – and understand – before you sit for the exam. “Fair game” includes content that you need to know in order to carry out your role as an IBCLC assisting a breastfeeding dyad. Sure, there are hundreds of hormones in the human body, but you will not be asked about details such as their molecular structure. But knowing factors that inhibit or release those hormones, consequences of dysfunctions of specific hormones as related to breastfeeding and any other clinical concepts are, in my opinion, all “fair game.”

6. Exam items with qualifiers

You’ll need to read carefully when you sit the IBLCE exam! By my estimate, about 25 percent or more of the test items use qualifiers such as first, least, most, primary. All four “answers” to an item might be legitimate and doable and logical – but which would you do first, or which one is most important? Make sure you watch for those qualifying words!

7. Exam items about healthcare sciences

I can’t tell you whether you’ll be asked about theories of Piaget or Erikson; I don’t know for sure! But I do know that the Outline mentions “development,” and I can surmise that developmental theories would be “fair game.” And while I can’t recall ever having had a question on handwashing, or biohazards, topics such as infection control and workplace safety are required for exam eligibility. So, I’d say that’s “fair game,” too. Be prepared!

8. “Old” information is fair game

It’s common to assume studies published more than five years ago are outdated. Nothing could be further from the truth! The big push for evidence-based practice has resulted in more emphasis on higher levels of evidence, rather than publication date. Some basic underpinnings for clinical practice are always appropriate fodder for the exam.

9. Drugs used in other countries

Even if a drug is no longer acceptable in the United States, you should not be surprised to see it on the IBLCE exam if it is commonly used elsewhere. You may need a working knowledge of its likely indications and possible side effects because it is an international exam.

10. Diagnostic procedures

Ultrasounds, biopsies, and more – you’ll need to review these. Diagnostic and therapeutic procedures are specifically mentioned on the IBLCE Detailed Content outline.

Truly, I have no crystal ball. I cannot tell you what questions you or other exam-takers will face. But I honestly believe I have given you plenty of ideas for what constitutes “fair game.”

How prepared do you feel for the whole range of topics that might be “fair game” on this exam? Tell me in the comments below!

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