Turkish adaptation and psychometric characteristics of the Nursing Authority and Autonomy Scale

Challenges facing clinical midwifery education in Iran

BACKGROUND

Delivering high-quality midwifery services requires a professional, educated and competent workforce. The challenges of clinical training and education for midwives in Iran have prevented midwifery students from fully gaining the clinical competency required of midwifery graduates.

METHODS

This qualitative study was conducted to identify and explain the challenges of clinical training for midwives in Iran and to determine their underlying factors within the sociocultural and educational context of this country. Data were collected from a purposive sample in a western province of Iran, which included clinical midwives working in public and private maternity units, midwifery instructors working at educational institutes, and midwifery students. After receiving an ethics approval for the project and informed consent from the participants, data were collected through focus group interviews held with midwifery students (n = 9) and semi-structured interviews held with midwifery instructors (n = 6) and clinical midwives (n = 7). Data were then analyzed using the framework proposed by Graneheim and Lundman using MAXQDA-10.

FINDINGS

The analysis of the data led to two themes: "Discriminatory approach in the health system" and "Professional nature of midwifery". The noted discrimination was caused by the insecure position of midwives in the health system, inequalities related to education and training opportunities, and the demotivation of midwives. The professional nature of midwifery discussed the community in transition, functional paradoxes and high-risk labor.

CONCLUSION

The findings revealed numerous challenges facing clinical midwifery education and training in the study setting, which may in part be explained by the sociocultural context of maternity services in Iran. The learning opportunities provided to midwifery students should be improved by making significant revisions to the structure of clinical settings where students are placed. Tackling discrimination against a profession and its students is essential, and it is equally important to value the contributions of midwifery students and midwives to their practice and their efforts to ensure safe maternity care for women and newborns. The quality of the clinical learning environment must therefore be improved for this group, and the active participation of competent and autonomous midwifery instructors in this environment can have a facilitatory role.

Clinical placements as a challenging opportunity in midwifery education: A qualitative study

AIM

The aim of this qualitative study was to explore some of the existing statuses of clinical education and examine the strengths and weaknesses of the clinical faculty programme.

DESIGN

A qualitative study.

METHODS

This qualitative study was designed through the directed content analysis approach, which was completed according to the Context, Input, Process, and Product evaluation model. The purposeful sampling method of maximum variation was employed to select 33 participants, and the data were collected through in-depth individual interviews and focus group discussion.

RESULTS

After the interview transcripts were analysed, the participants' opinions of the clinical faculty programme and the relevant challenges, dimensions and factors were classified into four categories and sixteen subcategories. The categories were compiled in the CIPP evaluation model, including context, input, process and product. Based on the content analysis results, appropriate planning was recommended for teaching effective clinical skills to students.

Development and Validation of the Turkish Version of the Attitude Toward Professional Autonomy Scale for Nurses

Autonomy in nursing practice is one of the recurring fields in literature of research. For nurses to be autonomous is considered to have a great importance on the quality of healthcare services. This study aimed to examine the validity and reliability of the Turkish version of the Attitude Toward Professional Autonomy Scale for Nurses. This methodological study adopted a descriptive cross-sectional design. The study was done in a secondary care hospital. Sample group includes 199 nurses that work at a secondary care hospitals. It was carried out while culturally adjusted and it also included two-way translations of English version of the Attitude Toward Professional Autonomy Scale for Nurses. To evaluate its validity, LISREL statistics software was used to make confirmatory factor analysis. Internal consistency was evaluated by using Cronbach's α and total-item correlations. Average age of the sample group was found 28.35 ± 6.16. Confirmatory factor analysis yielded t-scores, which were significant for all the 18 items (p < .05). Fit indices of the model, resemblance rate chi-square statistics were identified as 𝜒 2/df = 198.01/132 = 1.50. The Cronbach's alpha of the scale (.918) was indicative of strong internal consistency. The scale demonstrated strong validity and internal consistency. This scale can be used to assess perceptions of nursing practices that enhance the quality of nursing care.

Autonomy Levels and Professional Attitudes of Nurse Educators

AIM

This study aimed to determine the autonomy levels and the professional attitudes of nurse educators.

METHODS

This study was a descriptive, cross-sectional design. Total of 486 people, including 172 faculty members, 103 lecturers, and 211 research assistants were included in this study. The individual information form, Sociotropy-Autonomy Scale autonomy subscale, and the inventory of professional attitude at occupation were used to collect the research data.

RESULTS

The mean age of academics participating in the study was 35.14±8.39. In total, 94.2% of them were women. Of the academics, 35.5% were faculty members, 21.2% were lecturers, and 43.4% were research assistants. The mean autonomy score was 80.04±15.69 and the mean score of the professional attitude inventory was 146±10.59. The mean autonomy score was found to be the highest among professors, the mean score of professional attitudes inventory was highest among associate professors, while the mean value of both scale scores was the lowest in research assistants.

CONCLUSION

According to the research findings, it was concluded that the autonomy levels of the nurse educators were above average, their professionalism was at a high level, and they developed more professional attitude as the professional experience increased.