Educating advanced midwife practitioners: a collaborative venture

A narrative review of Master's programs in midwifery across selected OECD countries: Organizational aspects, competence goals and learning outcomes

Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master's programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master's programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs' aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master's programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems.

Sustaining the quality of midwifery practice in Belgium: Challenges and opportunities for advanced midwife practitioners

BACKGROUND

Midwifery practice is essential in achieving high-quality maternal and newborn care in all settings and countries. However, midwifery practice has become more complex over the past decades. Considerable demands are being placed on midwives to meet increasing epidemiological, socio-economic, and technological challenges. These require a well-trained midwifery workforce ready to shape the care in the near and long-term future.

OBJECTIVE

To discuss advanced midwife practitioner role implementation in Belgium as a possible answer to healthcare-related challenges that impact midwifery practice. Furthermore, to stimulate a debate within the profession at all levels in Belgium and in countries considering advanced midwife practitioner roles.

METHOD

The framework by De Geest et al. (2008) served as a basis for discussing the drivers for advanced midwife practitioner role implementation: the legal, policy and economic context, workforce issues, education, practice patterns, and healthcare needs of the population.

FINDINGS

A legal basis for advanced midwife practitioner role implementation is lacking in Belgium. Remuneration opportunities for the non-clinical part of these roles (e.g. leadership and innovation activities) are missing. It might be challenging for healthcare organisations to support the implementation of such roles, as immediate revenues of non-clinical activities are absent. However, sufficient potential resources are available to fill in future advanced midwife practitioner positions. Additionally, advanced midwife practitioner specific master programmes are being planned in the near future.

CONCLUSIONS

Although several barriers for the implementation of advanced midwife practitioner roles were identified, a discussion should be held on the opportunities of implementing these roles to facilitate the development of new models of care that meet current and future challenges in midwifery practice and healthcare. After initial discussions amongst midwives in academic, managerial, and policy positions, stakeholders such as obstetricians, general practitioners, associations representing healthcare organisations, and policy makers should be involved as a next step.

Study protocol for 'PROMIsE': Implementation of a curriculum to stimulate PROactive behavior in MIdwifery Education

INTRODUCTION

Proactive behavior shows promise in the challenges of midwifery students in adapting quickly and effectively to different clinical settings. The antecedents of rolebreadth self-efficacy, control appraisal and trust in peers have demonstrated a potential for significant benefit to proactive behavior in midwifery education. A new midwifery educational program, 'PROMIsE', was developed to influence these antecedents and so enhance proactive behavior.

METHODS

A pre-test/post-test cohort study of midwifery students' antecedents in proactive behavior will be conducted from September 2018 until June 2022. All new starting midwifery students (n = estimated at 150) at one Belgian University College will be included. Data will be collected using a validated questionnaire at four time points: the entry point in the new midwifery curriculum, after one year, two years and at the end of the curriculum. A proportional odds logistic regression analysis will be used to clarify the association between these antecedents and the probability to observe proactive behavior within this group at different time points.

RESULTS

A historical comparison will be made with this cohort study and two previous cross-sectional studies. With 'PROMIsE' it is assumed that this cohort, which underwent the intervention of 'PROMIsE', will score significantly higher than the cross-sectional study groups.

CONCLUSIONS

'PROMIsE' aims to support the individual guidance of midwifery students towards proactive behavior in midwifery in order to cope with the numerous challenges in reproductive healthcare.

A cross-sectional pilot study of student's proactive behavior in midwifery education: Validation of a developed questionnaire

OBJECTIVES

Midwifery students face major challenges in adapting quickly and effectively to different clinical settings. Proactive behavior, triggered by various individual and/or contextual antecedents, could be a significant added value to cope with these challenges.

DESIGN

A cross-sectional pilot study was conducted to investigate prognostic factors in proactive behavior in a group of midwifery students.

SETTINGS

The setting was a Belgian University College for midwifery education.

PARTICIPANTS

All second and third year midwifery students (n=156).

METHODS

Students were questioned regarding several prognostic factors: four personal characteristics, seven individual antecedents and three contextual antecedents that might trigger proactive behavior. A proportional odds logistic regression analyses was used to describe the association between prognostic factors and the probability to observe proactive behavior within the group. The strength of the newly developed questionnaire was tested.

RESULTS

Of all tested prognostic factors, nationality, role breadth self-efficacy, referring to the self-confidence of a midwifery-student to perform tasks that exceed expectations, and control appraisal, describing the importance attached to one's perceived control, were significantly associated with proactive behavior. The overall strength of the questionnaire was ratified. Two of the original questions were deleted, two re-formulated and for one prognostic factor the answer-options were re-formulated.

CONCLUSIONS

Findings from this pilot study show that midwifery students who have a high role breadth self-efficacy and low control appraisal are more likely to show proactive behavior. Additionally, Dutch students are more likely to show proactive behavior in relation to Belgian students. The questionnaire's feasibility was examined and adjustments were made for future research in a larger study to confirm these outcomes. This study can be a support in the individual guidance of midwifery students towards proactive behavior in midwifery.