The National Certification Corporation (NCC) would like to comment on the article, “The case for an electronic fetal heart rate monitoring certification exam.” We would clarify that there are differences between credentialing and other general assessments. Each type of assessment has its place to foster better care for the obstetric patient. Credentialing is a rigorous procedure that must comply with established criteria to be considered a valid assessment tool.

General assessments, as proposed, can take a number of forms, which are not subjected to the same rigorous development and psychometric standards. The 15,000 professionals who have taken the NCC electronic fetal monitoring (EFM) examination demonstrates that the need for a credentialing examination is already being met, is well established, and is widely used.

The process proposed of creating 2 separate examinations appears to be counterproductive to the goals of promoting multidisciplinary communication and collaboration related to EFM tracing interpretation and management. A major benefit of the NCC EFM examination is the ability of the perinatal team to acknowledge credentialing has been achieved on the same content, and interprofessional providers have a similar understanding of applying the principles of EFM to clinical practice. The concept of 2 separate examinations seems to be a step backward in promoting teamwork in the perinatal setting.

The author cites studies demonstrating that the NCC credential examination has been shown to improve outcomes. Despite this evidence, they go on to claim that the existing NCC examination is “suboptimal,” believing it is focused on purely factual information and interpretation of static segments of a fetal heart rate tracing. The NCC EFM credentialing examination ensures providers can apply standardized terminology to clinical management scenarios including decision making in response to changing information. Thousands of providers hold this credential, and they have found it to be a fair and effective instrument for evaluation knowledge of EFM.

The NCC applauds all efforts that strive to improve patient care, and although EFM education and credentialing are both worthy endeavors, it is important to recognize that each has a different purpose and application to clinical practice.