Preparing for the Canadian Midwifery Registration Examination

revised July 2007

Study Suggestions

1. The goal of the CMRE is to ensure that you are competent in all aspects of midwifery as outlined in the Canadian Competencies for Midwives. In order to best understand what is covered on the exam, you should read that document closely.

2. The CMRE Blueprint describes the structure of the exam, including how many questions cover each general topic area. Ensure that you read this closely and understand what is being covered and the standards used (for example, for measurements).

3. Reference Texts lists the textbooks that were used to develop exam questions. You should ensure that you study using these key textbooks, ensuring that you have the most up-to-date versions of each text you are using.

4. The Resources document outlines additional books and resources that can help you to better understand midwifery practice in Canada. Since you are being tested on your ability to work in the Canadian model using Canadian standards of practice, it is important that you understand and are as comfortable as possible with Canadian midwifery.

5. If you are not familiar with multiple-choice questions, you should look for opportunities to practise taking exams in that format. The Ontario Exam Prep Guide listed in the Resources document includes practice exams related specifically to Canadian midwifery.

Exam Tips & Sample Questions

Question Content

Each question is designed to test a specific entry-level competency from the Canadian Competencies for Midwives. Questions are developed by teams of experienced Canadian midwives with reference to at least two valid, current reference books from the list provided on this site.

Multiple Choice Questions

The questions on this exam are in a multiple choice format. All questions have a stem and four possible answers. For example:

Iron absorption is inhibited by: orange juice wholegrain bread coffee root vegetables

 

Candidates should select the ONE best answer to the question presented. You will receive one point for each correct multiple choice question. (Note: If a candidate selects more than one option, no points will be rewarded for that question.)

Each question should be answered in an average of 1.4 minutes. If you spend more than that on a question, you are taking time away from other questions.  If you are unsure of an answer, leave it and go back to it later to ensure that you have time to cover all the questions you do know.

You should use your best judgment and try to answer every question as you are not penalized for wrong answers (they receive 0 points).

Answers are recorded on a multiple choice answer sheet, similar to the one below. You must completely fill in the circle with the correct answer. Please make use of the rulers provided to ensure that you record the answers on the correct lines.

Case-based Questions

Most of the questions are case-based.  This means that a case, or midwifery scenario, is presented in a sentence or paragraph followed by between three and five questions.  All of these questions relate to the information provided in the case, and candidates must read the case to fully understand each question.  A sample case is below:

Kiko, 32 yrs, is visiting the midwife for her first prenatal appointment in this pregnancy. She has had two previous pregnancies. The first, at 16 yrs, was a vaginal delivery at term. Four years ago, she had a baby by cesarean section for breech presentation at 36 weeks.

 

Timing

The exam is a total of 7 hours in length and is divided into two 3.5 hour parts. 

Some Common Errors on Midwifery Written Exams in Canada

• Missing key words in the question, such as "most" or "not", and therefore misunderstanding what is being asked.
• Inadequate knowledge of the scope of practice of a Canadian midwife, especially when to consult or transfer care.
• Inadequate understanding of the principle and practice of informed-choice and inability to use appropriate phrases when counseling a client.
• Incorrect knowledge of drug dosages.
• Insufficient knowledge of common complications of the newborn.

Sample Questions

SAMPLE Case-Based Multiple Choice Questions:

Susan is at home in active labour and her midwives are in attendance.

Questions 1 and 2 refer to this situation.

1. Susan is lying on her back on her bed. One of her midwives performs an internal exam and feels a small triangular fontanel at a location of one o’clock and a suture line running diagonally from the fontanel to a location of seven o’clock. What is the position of the fetal head?
   
   1. Left occiput anterior
   2. Right occiput posterior
   3. Right sinciput anterior
   4. Left sinciput posterior

Correct answer is A. The triangular fontanel represents the posterior fontanel. If the posterior fontanel is at one o’clock with the sagittal suture running toward seven o’clock, the occiput is anterior and left.

1. The baby’s head is born. On the next contraction, the head turns so that the baby is facing Susan’s right thigh. This reflects:
   
   1. The descent of the head past the ischial spines
   2. The rotation of the baby’s shoulders
   3. The delivery of the posterior shoulder
   4. The rotation of the baby into an occiput posterior position

Correct answer is B. The baby’s head is born by extension, after which it restitutes by rotating 45 degrees to the left or right in alignment with the shoulders. The shoulders then rotate to the anterior-posterior position in order to navigate the pelvic outlet. The head then rotates another 45 degrees to face the maternal left or right thigh.

Competency: Intrapartum IV, A, 1. the normal process of labour including the mechanisms of labour and delivery.