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Bogren M, Jha P, Sharma B, Erlandsson K. Development of a Quality Assurance Assessment Tool to meet accreditation standards for midwifery education: A Delphi study. Women Birth 2024; 37:101660. [PMID: 39047523 DOI: 10.1016/j.wombi.2024.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/20/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Ensuring the quality of midwifery education is critical for producing a qualified and competent midwifery workforce for sexual, reproductive, maternal, and newborn care services. While global standards advocate for quality enhancement and accreditation systems, challenges persist, particularly in low-income countries like Bangladesh. AIM To validate and culturally adapt a Quality Assurance Assessment tool aligned with global midwifery education standards for application in Bangladesh. The goal of the tool is to guide and assess an internal quality education assurance process tailored to meet the national accreditation standards. METHODS A modified Delphi technique was conducted with a panel of 55 experts, including educators, principals, and researchers from Bangladesh, India, and Sweden. The study underwent three rounds: tool development, field testing, and consensus building. RESULTS The first round was completed by 25 workshop panel members, the second was completed by 30 participants during field testing, and the third was completed by the 25 workshop panel members from the first round. The developed Quality Assurance Assessment Tool demonstrated face and content validity through expert consultation and field testing, aligning with both global education and national accreditation standards. Minor revisions enhanced clarity and feasibility. CONCLUSION The Delphi rounds resulted in a validated Quality Assurance Assessment Tool that offers a robust framework for assessing and enhancing midwifery education quality, aiding progress towards meeting national accreditation standards. This study provides a valuable resource for countries seeking to develop similar tools aligned with global and national education priorities.
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Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, Gothenburg 413 46, Sweden.
| | - Paridhi Jha
- Foundation for Research in Health Systems, Bangalore, Karnataka, India
| | - Bharati Sharma
- Indian Institute of Public Health, Gandhinagar, Gujarat, India
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Baran L, Yeşil Y. Midwifery Students' Views on NANDA-I Diagnoses and Care Plans Used in Clinical Practice. Healthcare (Basel) 2024; 12:1196. [PMID: 38921310 PMCID: PMC11203283 DOI: 10.3390/healthcare12121196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/12/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Developing a care plan for patients is not specific to nursing or midwifery; it is the case in every situation where patients seek help from care providers. Midwifery students draw upon NANDA-I diagnoses while developing care plans (CPs) in clinical practices, and plan and apply their care accordingly. This study aims to identify the views of midwifery students on the NANDA-I diagnoses and CPs that they use in clinical practice. METHODS This descriptive and cross-sectional study was conducted with 222 students between September and December 2022. The research data were collected through face-to-face interviews using a questionnaire based on NANDA-I diagnoses and CPs. In line with the existing literature, the questionnaire was designed by two academicians who specialized in nursing fundamentals and midwifery. The questionnaire consisted of closed-ended (8 questions) and open-ended (7 questions) questions. Data analysis was performed with descriptive statistics and Pearson's chi-square test. RESULTS Of 222 students, 57.7% stated that they did not know the definition of a CP. It was found that 46.8% of the students felt inadequate at developing CPs. Furthermore, the students stated that they found the CP training provided during their undergraduate study partially sufficient, with a rate of 52.7%, and 16.7% of midwifery students offered suggestions about CP teaching. The number of midwifery-related diagnoses of which the students were aware was 19. CONCLUSIONS The study was beneficial in terms of identifying the deficiencies of the students related to NANDA-I diagnoses and developing CPs that might be overcome through education and observing the midwifery-related diagnoses that they used. It is of critical importance to educate midwifery students about midwifery-related NANDA-I diagnoses in order that they embrace midwifery diagnoses and CP learning.
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Affiliation(s)
- Leyla Baran
- Faculty of Health Sciences, Mardin Artuklu University, 47100 Mardin, Turkey
| | - Yeşim Yeşil
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, 47100 Mardin, Turkey;
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Kubota S, Ando M, Khambounheuang S, Theppanya K, Nanthavong P, Tengbriacheu C, Sisavanh M, Khattiyod T, Asai D, Murray J, Sobel H. A gap analysis of midwifery competency, pre- and in-service education for reproductive, maternal, newborn, child and, adolescent health in Lao People's Democratic Republic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100959. [PMID: 38144445 PMCID: PMC10746507 DOI: 10.1016/j.lanwpc.2023.100959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/15/2023] [Accepted: 10/22/2023] [Indexed: 12/26/2023]
Abstract
Background Ensuring midwives deliver quality essential services requires systematic and timely updates to midwifery education based on constantly evolving global evidence and local needs. However, midwifery curricula are often not updated to incorporate new evidence, consistent with national standards. This study supported the Ministry of Health of Lao People's Democratic Republic to identify gaps in the midwifery competency framework and training packages. Methods Stakeholder consultations and a document review were conducted to define a core package of RMNCAH interventions and care tasks that midwives should provide based on the national Essential Health Service Package (EHSP). Nationally defined midwifery competencies, the higher diploma midwifery curriculum, and in-service training packages were mapped against required interventions and care tasks. Data were used to revise midwifery education standards. Findings Midwives were expected to provide 47 RMNCAH interventions based on the EHSP. At baseline, 7 (14.9%), 11 (23.4%) and 35 (74.5%) of the 47 interventions were included in the midwifery competency, higher diploma in midwifery curriculum, and in-service training materials, respectively. After revision, the midwifery competency framework included 42 of 47 interventions (89.4%). The data are currently being used to review and update the national midwifery pre-service diploma curriculum. Interpretation This analysis enabled the Ministry to identify RMNCAH content gaps in national midwifery education standards and align them with the EHSP. Regular use of a quantitative approach to review educational content is essential to ensure standards are consistent with changing evidence. The approach has potential application to other service areas, cadres, and countries. Funding Korea Foundation for International Healthcare (KOFIH) supported research operation.
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Affiliation(s)
| | | | | | | | | | - Chankham Tengbriacheu
- National Mother and Child Health Center, Department of Hygiene and Health Promotion, Ministry of Health, Vientiane, Lao PDR
| | | | | | | | - John Murray
- WHO Western Pacific Region, Manilla, Philippines
| | - Howard Sobel
- WHO Western Pacific Region, Manilla, Philippines
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Smith RM, Calvert B, Kata E, Hataogo S, Ioane TR, Tarabo M, Kiritome M, Abraham J, Lees T, Devi C, Ross L, Mafi LL, Tuitupou T, Blackburn K, Homer CS. Midwifery education in Pacific Island countries: A discussion paper. Women Birth 2023; 36:e605-e612. [PMID: 37263877 DOI: 10.1016/j.wombi.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The aim for 95% maternal health care coverage and zero-unmet need for family planning in Pacific Island countries by 2030 could be achieved by strengthening the midwifery workforce. To enable health services to provide accessible, locally acceptable, and high-quality care, the midwifery workforce must be regulated and educated to global standards and supported to practice in enabling environments. In 2019, around 64,000 live births occurred in Pacific Island countries, yet information regarding the state the midwifery workforce and midwifery education is limited. AIM Using data from recent reports and country case studies, this paper provides an overview of the current midwifery education situation in Pacific Island countries and discusses strategic directions for strengthening quality midwifery education and therefore quality midwifery care provision in Pacific Island countries. DISCUSSION Six Pacific Island countries have midwifery curricula, all post-nursing programs, although few offer midwifery education programs on a regular annual basis. Current programs do not meet ICM Global Standards for Midwifery Education. Critical areas for strengthening include making underpinning philosophical frameworks, the vision for midwifery education, and program intended learning outcomes explicit in curricula documents and ensuring integration of these in program implementation. Fortunately, five of six midwifery education programs are under processes of renewal and strengthening against global, regional, and national standards. CONCLUSION Strengthening the midwifery workforce in the Pacific to meet maternal and newborn health targets can be achieved through supporting the existing midwifery education programs to meet global standards. Strengthened midwifery education programs in Pacific Island countries offer an opportunity to meet each country's maternal and newborn health targets.
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Affiliation(s)
| | | | | | | | | | - Monica Tarabo
- School of Midwifery, Kiribati Institute of Technology, Kiribati
| | - Maile Kiritome
- School of Midwifery, Kiribati Institute of Technology, Kiribati
| | | | | | - Clara Devi
- Solomon Islands National University, Solomon Islands
| | - Leila Ross
- Solomon Islands National University, Solomon Islands
| | | | - Telesia Tuitupou
- Queen Salote Institute of Nursing and Allied Health, Kingdom of Tonga
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Warren N, Gresh A, Mkhonta NR, Kazembe A, Engelbrecht S, Feraud J, Patel K, Adandogou-d'Almeida H, Marole P, Reynolds N, Johnson P. Pre-service midwifery education in sub-Saharan Africa: A scoping review. Nurse Educ Pract 2023; 71:103678. [PMID: 37413740 DOI: 10.1016/j.nepr.2023.103678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND In response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence. METHODS We conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus). RESULTS The search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited. CONCLUSION Schools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.
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Affiliation(s)
- Nicole Warren
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Ashley Gresh
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | | | - Abigail Kazembe
- African Forum for Research and Education in Health, PMB, University Post Office, KNUST, Kumasi, Ghana.
| | | | - Jenna Feraud
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Kalin Patel
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Heloise Adandogou-d'Almeida
- La Fédération des Associations des Sages-Femmes d'Afrique Francophone (FASFAF), 229 Rue Sagouda Tokoin Wuiti, Lome, Togo.
| | - Phelelo Marole
- Jhpiego, Plot 155, Unit 4 Kgale Mews, Baborone International Financial Park, Baorone, Botswana.
| | - Nancy Reynolds
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Peter Johnson
- Jhpiego, 1615 Thames Street, Baltimore, MD 21231, USA.
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İsbir GG, Guner S, Beşen MA, Thomson G. Evaluation of labour and birth education by midwifery educators: A qualitative study from Turkey. Nurse Educ Pract 2023; 66:103515. [PMID: 36481496 DOI: 10.1016/j.nepr.2022.103515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Midwifery students' education regarding labor and birth is crucial because it directly affects the quality of care provided to women in labor. AIMS Exploring educators' experiences of delivering labor and birth education to midwifery students and evaluating the circumstances that affect the quality of labor and birth education METHODS: This was a qualitative study. Semi-structured interviews were conducted with 16 educators teaching midwifery in 16 midwifery departments at universities in Turkey. Inductive thematic analysis was conducted. All transcripts were evaluated by two researchers, and codes were created. The codes formed the subthemes in terms of similarities and differences; themes were created based on combining subthemes. FINDINGS Three themes were identified. The first - "impacts of global changes on labor and birth education"- shows how labor and birth is affected by changing policies, philosophies, individuals, and cultures. The second theme - "opportunities/obstacles in labor and birth education"- shows how sources of information, as well as individual and systemic factors, create opportunities or obstacles for the quality of labor and birth education. The final theme - "recommendations for quality labor and birth education"- presents participants' suggestions for the effective integration of courses, use of sources of information, and updating of curriculum. DISCUSSION Changing policies, philosophies, individuals, and cultures affect labor and birth education. Individual and systemic factors and information sources create opportunities or barriers for the quality of labor and birth education. CONCLUSION A positive childbirth experience is a basic human right for both women and newborns. This can be made possible by professionals who have received quality labor and birth education. Thus, investment in midwifery education is an important cost-effective approach to improving health outcomes.
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Affiliation(s)
| | - Sevil Guner
- Mersin University, School of Health, Midwifery Department, Turkey.
| | | | - Gillian Thomson
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston PR1 2NE, UK.
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Abedian S, Javadnoori M, Montazeri S, Khosravi S, Ebadi A, Nikbakht R. Development of accreditation standards for midwifery clinical education in Iran. BMC MEDICAL EDUCATION 2022; 22:750. [PMID: 36320035 PMCID: PMC9624006 DOI: 10.1186/s12909-022-03823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Accreditation is one of the most important methods of quality assurance and improvement in medical education. In Iran, there are no specific midwifery education accreditation standards. This study was designed to develop accreditation standards for midwifery clinical education in Iran. METHODS This study was performed in Iran in 2021. It consisted of two phases. In the first phase, accreditation standards for midwifery education in the United Kingdom, the United States, Australia and the International Confederation of Midwives were thoroughly examined through a narrative review. The domains obtained from this phase were used as a framework for coding in the second phase. In the second phase, a qualitative study was conducted with a directed content analysis approach to determine standards and criteria for clinical midwifery education accreditation in Iran. Participants were policymakers and senior managers of midwifery education, faculty members of midwifery departments with clinical teaching experience, and final year undergraduate midwifery students. The participants were selected by purposive sampling method, and data collection continued until data saturation. RESULTS The standards and accreditation criteria of midwifery education from the review study were formed 6 domains: Mission and goals; Curricula; Clinical instructors; Students, Clinical setting; and Assessment. In the second phase, data analysis led to the extraction of 131 codes, which were divided into 35 sub-subcategories, 15 sub-categories, and 6 main categories. CONCLUSION Implementing the specific and localized standards of clinical midwifery education in Iran can lead to improved quality of clinical education programs.
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Affiliation(s)
- Sara Abedian
- Midwifery Department, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Reproductive Health Promotion Research Center, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Simin Montazeri
- Reproductive Health Promotion Research Center, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Khosravi
- Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Teheran, Iran
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Teheran, Iran
| | - Roshan Nikbakht
- Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hunter CBE B, Thomas G, Wilhelmová R, Trendafilova P, Blaževičienė A, Lynch L, Jokinen M. Strengthening global midwifery education to improve quality maternity care: Co-designing the World Health Organization Midwifery Assessment Tool for Education (MATE). Nurse Educ Pract 2022; 63:103376. [DOI: 10.1016/j.nepr.2022.103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/06/2022] [Accepted: 06/03/2022] [Indexed: 11/27/2022]
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Adnani QES, Gilkison A, McAra-Couper J. The interplay of structural and external factors for strengthening midwifery education in Indonesia. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 33:100734. [PMID: 35640525 DOI: 10.1016/j.srhc.2022.100734] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to identify the barriers to and enablers of the strengthening of midwifery education in Indonesia. Indonesia has a long history of midwifery education. In 1996, midwifery education in Indonesia had a three-year direct-entry pathway leading to a higher education level to meet international standards. The quality of midwifery education is deemed essential for preparing competent midwives. METHODS A qualitative design was undertaken in 12 midwifery schools in eight cities in six provinces involving 37 participants. Data were gathered using in-depth interviews. Data were analysed using thematic analysis. RESULTS Several intertwined factors were found to play a vital role in midwifery education. This article focuses on results on "structural and external factors", a theme which contained three sub-themes: "the structures of midwifery programmes", "midwifery accreditation impacts on midwifery education", and "the Midwifery Act". CONCLUSION The structure of midwifery programmes, the accreditation of midwifery programmes, and establishment of the Midwifery Act contribute to the strengthening of midwifery education in Indonesia. This study highlights the challenges faced and the scheme required to strengthen midwifery education in producing competent newly graduated midwives who improve the midwifery workforce in Indonesia.
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Affiliation(s)
| | - Andrea Gilkison
- Department of Midwifery, Faculty of Health and Environmental Sciences, Auckland University of Technology, North Campus, Auckland 0627, New Zealand
| | - Judith McAra-Couper
- Department of Midwifery, Faculty of Health and Environmental Sciences, Auckland University of Technology, South Campus, Auckland 2104, New Zealand
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Bogren M, Alesö A, Teklemariam M, Sjöblom H, Hammarbäck L, Erlandsson K. Facilitators of and barriers to providing high-quality midwifery education in South-East Asia-An integrative review. Women Birth 2021; 35:e199-e210. [PMID: 34217676 DOI: 10.1016/j.wombi.2021.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND With a diversity in midwifery education across the South-East Asia region, and with the knowledge about the lifesaving competency of the midwife profession, this study's aim is to describe facilitators of and barriers to providing high-quality midwifery education in South-East Asia. METHODS Inspired by Whittemore and Knafl, we conducted a systematic integrative literature review including the five key stages of problem identification, literature search, data evaluation, data analysis, and presentation of results. The literature searches were conducted in October 2020 in the databases CINAHL, PubMed, and Scopus. A deductive data analysis based on global standards was performed. RESULTS The search identified 1257 articles, 34 of which were included. Countries in South-East Asia did not fully comply with the ICM global standards. Midwifery education was not separated from that of nursing, and educators lacked formal qualifications in midwifery. Curriculum implementation in the clinical area was a key barrier to achieving learning outcomes. Higher academic education for midwifery educators and mentorship programs facilitated the pedagogic and assessment process, focusing on the abilities of critical thinking, reflection, and decision-making. CONCLUSIONS Countries in South-East Asia still have a long way to go before they can provide high-quality midwifery education. The identified facilitators can lead to a difference in students' academic achievement and confidence in their clinical work. Coordinated actions will enable the progress in achieving competent midwives matching national health priorities. The findings highlight a need for more research on midwifery education in both theory and practice across the region.
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Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden.
| | - Anna Alesö
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
| | - Milena Teklemariam
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
| | - Helen Sjöblom
- Biomedical Library, Gothenburg University Library, University of Gothenburg, Gothenburg, Sweden
| | - Linda Hammarbäck
- Biomedical Library, Gothenburg University Library, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Department of Women's and Children's Health, Karolinska Institute, Solna, Sweden. https://www.twitter.com/erlandsson_kerstin
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Bogren M, Banu A, Parvin S, Chowdhury M, Erlandsson K. Findings from a context specific accreditation assessment at 38 public midwifery education institutions in Bangladesh. Women Birth 2021; 34:e76-e83. [DOI: 10.1016/j.wombi.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/30/2020] [Accepted: 06/25/2020] [Indexed: 01/05/2023]
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Bogren M, Banu A, Parvin S, Chowdhury M, Erlandsson K. Implementation of a context-specific accreditation assessment tool for affirming quality midwifery education in Bangladesh: a qualitative research study. Glob Health Action 2020; 13:1761642. [PMID: 32429821 PMCID: PMC7301700 DOI: 10.1080/16549716.2020.1761642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/07/2020] [Indexed: 11/03/2022] Open
Abstract
Background: Only recently did midwifery become a profession in Bangladesh. As such, sufficient quality education, both theory and practice, remains a challenge. In 2018, a context-specific accreditation assessment tool for affirming quality midwifery education was therefore developed and implemented.Objectives: To describe both the positive and negative aspects of the implementation of an accreditation process at midwifery education institutions in Bangladesh and to sketch out areas for possible improvement.Method: Forty focus group discussions were conducted with 276 policymakers, regulatory authorities and educators involved in midwifery education and services in Bangladesh. The Consolidated Framework for Implementation Research (CFIR) was used in a directed content analysis approach.Results: The accreditation assessment tool was developed using a participatory and consensus-building approach, building on existing policies, which resulted in the national ownership of its implementation. Staff from clinical sites were not included in the accreditation process; unless this changes, this will make it difficult for Bangladesh to achieve the set accreditation standards. The accreditation process has improved communication between the midwifery teaching institutions, policymakers and regulatory authorities. Educators started to visit the clinical sites more frequently. The planning process was complex and time-consuming, and emphasis was put on the importance of developing a plan of action for measuring improvements.Conclusion: In the move from the initial assessment of an accreditation process to its implementation, it is essential to make public the results found at all educational institutions. This encourages acceptance, while soliciting feedback and suggestions for future action. Only then can an accreditation process have an impact on the provision of high-quality midwifery education and services. This paper aims to encourage and guide other countries in their development, planning and implementation of a national accreditation process for midwifery education.
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Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Afroza Banu
- Directorate General of Nursing and Midwifery, Sher-E-Bangla Nagar Nursing College, Dhaka, Bangladesh
| | - Shahanaj Parvin
- Directorate General of Nursing and Midwifery, Sher-E-Bangla Nagar Nursing College, Dhaka, Bangladesh
| | - Merry Chowdhury
- Chattogram Nursing College, Chattogram Nursing College, Chattogram, Bangladesh
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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Yarmohammadian MH, Khorsani E, Norouzinia R, Mirzaei S, Ehsanpour S, Yamani N, Rezaei F. Institutional Accreditation in Medical Education: The Experience of The Survey Visit Teams. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:39. [PMID: 32318607 PMCID: PMC7161652 DOI: 10.4103/jehp.jehp_518_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 11/12/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study discussed about challenges and opportunities of institutional accreditation in Iranian medical universities. The lesson learned of the first round of the accreditation would direct initiatives and solutions for future accreditation. METHODOLOGY This research is a qualitative content analysis research that studied the experience of the survey visit teams. Semistructured interviews with a purposive sampling approach were done to reach data saturation. Constant comparative method was used to analyze the data. RESULTS The emergent themes were incompatible scheduling with accreditation workload, accreditation sustainability, the weakness of the survey instrument, advantage of the survey instrument, the quality of evaluators' survey, the opportunity of progress for universities, accreditation perspective, defendable cost opportunity, perceived injustice, and the leading strategies. In this study, the relationship between categories and themes was shown with a systematic approach. CONCLUSION In medical education systems, it is necessary to continue the research and development studies using the findings in each accreditation period to achieve the prospect of international accreditation.
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Affiliation(s)
- Mohammad H Yarmohammadian
- Professor, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Khorsani
- Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Roohangiz Norouzinia
- PhD Candidate, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Faculty Member, School of Paramedical Science, Alborz University of Medical Science, Karaj, Iran
| | - Samaneh Mirzaei
- Department of Health in Emergency and Disaster, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Soheila Ehsanpour
- Medical Education Department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nikoo Yamani
- Medical Education Department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Rezaei
- Associate Professor, Medical Education Department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Barger MK, Hackley B, Bharj KK, Luyben A, Thompson JB. Knowledge and use of the ICM global standards for midwifery education. Midwifery 2019; 79:102534. [DOI: 10.1016/j.midw.2019.102534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/28/2019] [Accepted: 08/31/2019] [Indexed: 11/28/2022]
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