FMC General Information

Why to Consider FMC Credentialing

Communication related to electronic fetal monitoring (EFM) has been identified as a significant contributor to sentinel events. Errors and variations in interpretation of EFM tracings can result in poor, suboptimal management decisions that may contribute to subsequent neonatal encephalopathy. Thus, the Joint Commission has specifically called for adoption of a common clinical language to facilitate better communication.

Credentialing in EFM

Currently, there are numerous institutions requiring credentialing in EFM for health care providers interpreting EFM tracings on Labor and Delivery. There is little doubt that an expectation of credentialing will expand. In addition to hospital systems, many insurance companies not only require EFM credentialing but also offer premium discounts. With successful completion of the FMC exam, medical professionals can also receive credit from the American Board of Obstetrics and Gynecology (ABOG) for Maintenance of Certification (MOC) Part IV: Improvement in Medical Practice. Completion or maintenance of the Inteleos Fetal Monitoring Credentialing program may be used to maintain NCC's Electronic Fetal Monitoring (C-EFM) Certification.

Examination Overview

In effort to establish a common understanding of EFM interpretation, the Inteleos credentialing exam combines both knowledge and judgement questions to assess various aspects of EFM based on the clinical situation. This credentialing exam is a unique tool that identifies specific areas of strength and weakness in EFM interpretation by individual, institution, or professional group.

The knowledge questions (KT) take a familiar form (single answer, multiple choice). The judgement questions use an innovative approach called Script concordance testing (SCT). It tests clinical reasoning as it relates to decision- making. The SCT question format describes a clinical scenario and an initial management plan. Then as the case evolves an additional piece of specific information is provided. The examinee is then asked how the initial plan might be affected by the new piece of information. A unique aspect of the SCT question is that there is more than one acceptable answer, attempting to mirroring real clinical practice.

Additional Background and Theory on SCT

Knowledge Question:

How would you describe the decelerations in this tracing? Select all that apply.

  • Early
  • Late
  • Variable
  • Prolonged
Knowledge Question Medical Strip

SCT Question:

Case Context:

A 25-­‐year-­‐old G1P0 patient presents at 41 weeks in spontaneous labor. Ruptured membranes are confirmed and the initial cervical exam is 3/+1/100%/vtx. The initial FHR tracing is shown in Panel A.

SCT Question Medical Strip

Your management plan is...

Continue FHR monitoring and expectantly manage

...and then you learn the following additional information:

2 hours later, you review the FHR tracing shown in Panel B and note that the cervix is unchanged.

SCT Question Medical Strip

How does this additional information affect your thinking about the management plan?

  • Strongly invalidates
  • Could invalidate
  • No impact
  • Could support
  • Strongly supports

More Information

For more information about the Inteleos credentialing exam, please email fmc@inteleos.org.


1 Nouh, T et. al., "The Script Concordance Test as a Measure of Clinical Reasoning: A National Validation Study," The American Journal of Surgery, Volume 203, Number 4, April 2012
2 Charlin, B et. al., "The Script Concordance Test: a Tool to Assess the Reflective Clinician," Teaching and Learning in Medicine, Fall 2000
3 Charlin, B et. al., "Scripts and Medical Diagnostic Knowledge: Theory and Applications for Clinical Reasoning Instruction and Research," Academic Medicine, Volume 75, Number 2, February 2000.