Exam Information

The next Exam day 28th July 2008 then 27th July 2009

Exam Venues
The exam can be done in a number of different countries, but specific sites are initially offered in capital and/or regional cities, as listed in the current Application Supplement for your country.  Requests for additional exam sites will be considered from candidates who are a long distance from the nearest site. However, for administrative, financial and security reasons, there are restrictions on the number and location of additional exam sites.

Exam Fees
Exam fees vary according to country of residence, taking into account central and local administrative costs. The application fee is lowest for forms lodged by the end of March, higher if sent by the end of April and substantially higher for late lodgment up to the final deadline. To see the deadline dates Click Here .

Fees are detailed in the Application Supplement specific to each country. If you are interested in being a candidate for the next IBLCE exam, and believe you are likely to be eligible, you should contact us to request that we send you by post a complete Candidate Information Guide and the current Application Supplement.  Make sure you state your name and full postal address, including country.  You can download a Candidate Information Guide from the Download Centre or by Clicking Here.

Exam Content
The exam is composed of 200 multiple choice questions. The degree of difficulty is set at university masters level. Since effective lactation consultation requires assessment and decision-making skills, the questions are primarily designed to test the application of knowledge, rather than the straight recall of facts. Application questions are more realistic and enhance the validity of the exam.

The exam is administered in two sessions of 100 questions each. Of the 200 questions, 125 are cognitive, based on word scenarios, and 75 are based on photos. They are all combined for classification into Disciplines and Chronological Periods.

The Exam Blueprint gives more information about the Disciplines and Chronological Periods which the exam covers, with the number of anticipated exam questions for each shown in brackets. This outline helps you determine the relative emphasis of the exam and reflects average clinical practice. For example, Pathology (19-33) means that there will be a minimum of 19 questions and a maximum of 33 questions which address infant and maternal pathological conditions relevant to Lactation Consultant practice.

The photo section has 75 questions based on colour photographs which illustrate various situations and clinical conditions relevant to Lactation Consultant practice. Typically, candidates are asked to evaluate whether or not a problem is present, the nature of the problem, or how it should be managed. Each candidate is provided with a booklet of colour pictures to use for this part of the exam.

Although the exam is administered in two sessions, the scores for the both sessions are added together to determine each candidate’s overall score and pass/fail designation. Candidates pass or fail the examination as a whole. A higher score in one area can compensate for a lower score in another area, so the candidate passes the overall exam.

Exam Question Referencing
All examination questions are referenced to the technical/medical literature, usually to literature published within the last five years. Older scientific studies may be used if they are still quoted as reputable references in current texts. Each exam question is referenced to printed materials, not to statements made at conferences. Anecdotal material, authors’ opinions and areas where the major texts give conflicting information are all avoided. References are current to the end of the calendar year prior to the exam.

Exam Confidentiality
Each year, the IBLCE uses a percentage of previously used questions on the current exam, for validity testing. For this reason, IBLCE does not release previous exams or previously used questions, nor is the exam available for review outside the examination hours. It is considered unethical for candidates to divulge any questions on the IBLCE exam or to request information from previous candidates. If a candidate who had received inside information were to pass the exam, it would be to the detriment of breastfeeding babies and mothers and to the profession itself.

Format of Exam Questions
Each question in the exam has an introductory sentence or paragraph (stem). All the information necessary to answer the question is given in the stem or the accompanying picture. Candidates can be assured there are no additional complicating circumstances if they are not mentioned.

Many items refer to a clinical situation involving the mother and/or baby and ask what “you” should do. In these items, “you” means you in your role as a Lactation Consultant. If you have another professional role which authorises you to perform additional functions (such as a Doctor with prescribing rights), do not include these functions in the role of the Lactation Consultant for the purposes of this exam. See ILCA’s Standards of Practice for Lactation Consultants to better understand the LC role. (You can get to the ILCA website from this website via the Links page) 

Each item contains a specific question which you should read carefully to know what is being asked. The key word is capitalised. Some questions may ask for “the MOST appropriate intervention” or “which of the following would NOT be appropriate to recommend”. The purpose of these questions is not to mislead or “trick” you, but to represent the types of decisions that Lactation Consultants often confront.

For example, a mother may benefit from any of several interventions, but the Lactation Consultant should know the intervention that is MOST likely to be effective in her situation and why other interventions might not be as effective. At other times, there are several interventions which may be effective, but there is one that should NOT be recommended.

There may also be questions which ask for “the MOST (or LEAST) likely cause or explanation”. These items test knowledge of the general principles which apply to clinical practice, which candidates acquire through their clinical experience.

Each item has three to five responses, most commonly four. There is only ONE correct answer, and knowledgeable candidates will be able to identify why the other answers are not correct. IBLCE does not use true/false questions or such options as “all of the above”, “none of the above”, “a and c”, etc.

Common misconceptions and outdated ideas are often included among the incorrect responses. Candidates should not worry that these responses are intended to be correct. The exam has been checked by experts.

How the Exam is Scored
The pass/fail cut-off score is determined according to the Nedelsky-Gross technique which measures the degree of difficulty of each question, based on the number of sophisticated responses which might distract candidates from the correct response. The level of difficulty of the overall exam is, therefore, based on averaging a myriad of individual analyses of each question. The more difficult the exam, the lower the pass/fail cut-off score, and vice-versa.

The Nedelsky-Gross technique ensures that there is no arbitrary number or percentage of candidates who pass the exam each year, and that candidates are not competing against each other. It also ensures that variations in the degree of difficulty of the exam from one year to another will not affect an individual candidate’s likelihood of passing or failing the exam. Over the years, the pass/fail cut-off has ranged between 62% and 68%.

Answer sheets are computer-scanned and scored by a Consultant Psychometrician. Each sheet is checked for stray marks and possible double counting where a response has been erased and replaced. Every year some answer sheets are hand scored to check accuracy.

There is only one correct answer to each question. Each item receives one point if correct, zero if incorrect. Points are not deducted for incorrect answers, so candidates should attempt all items.

After all answer sheets have been initially scored, each question is statistically analysed according to standard psychometric procedures. This identifies any questions which did not perform as expected or were ambiguous. These questions are reviewed along with items the candidates have objected to on their critique forms. Items determined to have been defective are deleted from scoring. All candidates’ scores are then recomputed. This quality control procedure enhances reliability, validity, and fairness.

Each year, a number of previously used questions are included in the current exam, and the performance of the current candidates is compared with that of previous cohorts. This procedure enhances validity by providing a check on whether the competence level of the candidate body has changed.

The IBLCE exam has a low failure rate, yet the highest scores are typically in the high-80% range and the mean scores in the low to mid-70% range. This result demonstrates a well prepared, well screened candidate body and a challenging exam.