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Niemczyk NA, Sokunbi A, Reale B. Decolonizing the midwifery curriculum: Jettisoning the Caldwell-Moloy pelvic types. Birth 2024. [PMID: 38268381 DOI: 10.1111/birt.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/17/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
As faculty in two different midwifery education programs, we have stopped teaching the Caldwell-Moloy classifications of the female pelvis, as have faculty in several other US midwifery programs. In this commentary, we explain the rationale for this change. We review the roots of the Caldwell-Moloy pelvic classification and the lack of contemporary scientific support for either classifying pelvic types or using such a classification for clinical decision-making, and propose an alternative approach to teaching assessment of the bony pelvis.
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Affiliation(s)
- Nancy A Niemczyk
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adeyinka Sokunbi
- Midwifery Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Barbara Reale
- Midwifery Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Arbour M, Walker K, Houston J. Trauma-Informed Pedagogy: Instructional Strategies to Support Student Success. J Midwifery Womens Health 2024; 69:25-32. [PMID: 37358392 DOI: 10.1111/jmwh.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2023] [Indexed: 06/27/2023]
Abstract
Over the past several years, the ongoing coronavirus disease 2019 pandemic has contributed to challenging working and life conditions. As a result, the midwifery and health care workforce has faced significant shortages due to burnout. Increased societal awareness of historical trauma and systemic racism embedded within US culture has also led to increased anxiety and signs of trauma among midwifery and health profession students. Now more than ever, innovative teaching strategies are needed to support students, reduce the risks of burnout, and increase diversity in the workforce. One strategy is to adopt a trauma-informed pedagogy within midwifery education. Trauma-informed pedagogy is founded on core assumptions of trauma-informed care and thus supports student success by recognizing that the student cannot be separated from their own life experiences. Faculty and preceptors can develop empathetic, flexible supports that communicate care and concern regarding students' personal and social situations, and emotions. Empathetic behavior from teachers also increases student learning motivation, making it easier for students to actively engage in learning thereby reducing their distress. The purpose of this State of the Science review, therefore, was to describe the literature surrounding trauma-informed pedagogy and to offer concrete educational strategies that faculty members and educational programs can employ to increase the success of a diverse student body. This can be accomplished through flexibility in curriculum design and outcome measurement to ensure attainment of end of program learning outcomes. Institutional and administrative support are essential to develop a faculty who realize the benefit and value of trauma-informed pedagogy underpinning student success.
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Affiliation(s)
- Megan Arbour
- Department of Midwifery and Women's Health, Frontier Nursing University, Hyden, Kentucky
| | - Kelly Walker
- School of Nursing, Georgetown University, Washington, District of Columbia
| | - Jane Houston
- Obstetrics and Gynecology Residency Program, University of Central Florida, Orlando, Florida
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Murdock M. Providing Inclusive Midwifery Care for 2SLGBTQQIA+ People: Supporting Inclusion in Ontario's Midwifery Education Program. J Midwifery Womens Health 2024; 69:91-100. [PMID: 37708221 DOI: 10.1111/jmwh.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Research on how midwives in North America are trained to provide inclusive care to Two Spirited, Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, or Asexual (2SLGBTQQIA+) clients is limited. The objective of this study was to define 2SLGBTQQIA+ inclusive midwifery care in the Canadian context and to explore the experiences of graduates of Ontario's Midwifery Education Program (MEP) to determine how midwives are trained to provide inclusive care. METHODS Ethics approval was obtained for this qualitative study to perform semistructured interviews with graduates from the MEP hosted by McMaster, Toronto Metropolitan, and Laurentian University. Eleven midwives were recruited and were required to be (1) graduates of Ontario's MEP, (2) registered midwives under the College of Midwives of Ontario or elsewhere, (3) currently practicing or on leave, and (4) self-identified advocates for 2SLGBTQQIA+ individuals. RESULTS When defining 2SLGBTQQIA+ inclusive care, midwives described the following principles: using inclusive language, changing the clinical environment, amending documents and websites, and tailoring care for each client. Participants recognized recent efforts by Ontario's MEP to provide 2SLGBTQQIA+ inclusive education while highlighting the need to expand 2SLGBTQQIA+ content across all courses, practicing inclusive care during placement, and ensuring an inclusive environment in the program. DISCUSSION Midwives in this study helped conceptualize inclusive midwifery care for 2SLGBTQQIA+ clients and underlined remaining gaps in Ontario's MEP toward providing student midwives with this competency by graduation. This study helped to fill a gap in the literature on how Canadian midwives are trained to provide 2SLGBTQQIA+ inclusive care and generated recommendations for Ontario's MEP to support prelicensure education that trains inclusive midwives. Having demonstrated gaps in how birth workers are trained to provide 2SLGBTQQIA+ inclusive care, this study points to the need for other prelicensure health professional programs to evaluate their training and to support 2SLGBTQQIA+ inclusive practice.
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Affiliation(s)
- Melanie Murdock
- Department of Gender Studies, Queen's University, Kingston, Ontario, Canada
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Weintraub SA, Versace A, Winston L, Graff B, Kattan D. Midwives Safeguarding Abortion Access: Establishing Medication Abortion Services. J Midwifery Womens Health 2023; 68:764-768. [PMID: 37708214 DOI: 10.1111/jmwh.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/07/2023] [Indexed: 09/16/2023]
Abstract
The abortion access landscape for patients has changed dramatically in the wake of the US Supreme Court Dobbs v. Jackson Women's Health Organization decision in June of 2022. In response, the Division of Midwifery at Baystate Medical Center in Springfield, Massachusetts, began a medication abortion service for both established patients and those who may seek care from out of state. This service increases access to abortion care now while also providing the clinical experience needed for student nurse-midwives to become future abortion providers. This article outlines the steps taken to implement a medication abortion service and ways it can be adopted by other midwifery practices. Strategies to address possible clinical, administrative, and logistical challenges are addressed. Finally, this article is a call to action because midwives are well qualified to provide high quality, safe, and comprehensive medication abortion within the midwifery model of care.
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Affiliation(s)
- Sharon A Weintraub
- Division of Midwifery, Baystate Medical Center, Springfield, Massachusetts
| | - Autumn Versace
- Division of Midwifery, Baystate Medical Center, Springfield, Massachusetts
| | - Liza Winston
- Division of Midwifery, Baystate Medical Center, Springfield, Massachusetts
| | - Brianna Graff
- Baystate Medical Education Program, Springfield, Massachusetts
| | - David Kattan
- Baystate Medical Center, Springfield, Massachusetts
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Sun K, Qi J, Luo B, Yang L, Shu C, Tang H, Qin Y, Zang Y. Study on core competencies of midwives in China. Medicine (Baltimore) 2023; 102:e34246. [PMID: 37904464 PMCID: PMC10615511 DOI: 10.1097/md.0000000000034246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/16/2023] [Indexed: 11/01/2023] Open
Abstract
The aim of this study is to investigate the core competencies of midwives in China. Combination of qualitative research and quantitative research. A total of 100 midwives in 3 tertiary (Grade 3) hospitals in Shijiazhuang were investigated by using the Midwife Core Competency Scale, and simultaneously followed by semi-structured interviews with 12 midwives. The questionnaire survey showed that the average score of core competencies of midwives was 4.17 ± 0.17. The scores of midwives' competency for labor and delivery care (4.31 ± 0.09), new-born care (4.29 ± 0.04), and postpartum care (4.25 ± 0.13) were relatively high, while the prepregnancy care had the lowest score (3.88 ± 0.07). The interview results showed that the self-perception of core midwifery competencies was not bad, the limitations of midwives' work scope affect the core competencies, and midwifery education needs to strengthen the humanistic care and the training of obstetric knowledge and technology.
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Affiliation(s)
- Kejuan Sun
- Department of Nursing, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jinghan Qi
- School of Nursing, China Medical University, Shenyang, China
| | - Bin Luo
- Hebei Province Key Laboratory of Nutrition and Health, Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lisha Yang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Chang Shu
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Huijun Tang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Yanyue Qin
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Yu Zang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
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Baluwa MA, Mndolo NCM, Yeboa NK, Mpeta-Phiri C, Haruzivishe C, Chirwa E. Clinical Competency During Undergraduate Midwifery Training in Malawi: A Concept Analysis. Adv Med Educ Pract 2023; 14:1067-1075. [PMID: 37789928 PMCID: PMC10543071 DOI: 10.2147/amep.s426347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
Background The purpose of midwifery education is to produce clinically competent midwives. However, clinical training in Malawi faces multiple challenges, and the concept of Clinical Competency (CC) has not been analysed in this context. This article analyses CC during undergraduate midwifery training in Malawi to elucidate its attributes, antecedents, consequences, and empirical referents. Methods A literature search was performed on data bases, Google Scholar, PubMed, and CINAHL, using the following terms: clinical competency, midwifery competency, nursing competency, nursing and midwifery competency. Published articles were retrieved and clinical competency analysis was guided by Walker and Avant's strategy. Results CC attributes were knowledge, skills, attitudes, performance level, professionalism, and entrustable professional activity. Antecedents included motivation, role models, learning environment and personal traits. The consequences of CC include confidence, client safety, and quality of care. CC can be measured through a combination of four strategies: observing a student practising it in clinical area, simulation or Objective Structured Clinical Examination (OSCE), application through written essays or case presentations, and knowledge-based assessment. Conclusion CC is a multidimensional concept and its definition and defining attributes are contextual. Similarly, clinical competencies are a major determinant of educational decisions such as curriculum nucleus, length of clinical placement, teaching strategies, and student assessment methods. However, CC and its attributes have not been fully utilised in Malawi, especially in clinical teaching and student clinical assessments. There is a need to adequately prepare midwifery educators, clinical staff, and students to deliver quality clinical competencies consistent with competency-based education. Adoption of different assessment strategies and development of valid and reliable tools is necessary to comprehensively measure CC among midwifery students in Malawi.
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Affiliation(s)
- Masumbuko Albert Baluwa
- School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Nursing and Midwifery, Mzuzu University, Mzuzu, Malawi
| | | | - Naomi Kyeremaa Yeboa
- School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Cynthia Mpeta-Phiri
- School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Clara Haruzivishe
- Departments of Primary Healthcare Services/Health Professions Education, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Ellen Chirwa
- School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi
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Thumm EB, Emeis CL, Snapp C, Doublestein L, Rees R, Vanderlaan J, Tanner T. American Midwifery Certification Board Certification Demographic and Employment Data, 2016 to 2020: The Certified Nurse-Midwife and Certified Midwife Workforce. J Midwifery Womens Health 2023; 68:563-574. [PMID: 37283414 DOI: 10.1111/jmwh.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Expansion and diversification of the midwifery workforce is a federal strategy to address the maternal health crisis in the United States. Understanding characteristics of the current midwifery workforce is essential to creating approaches to its development. Certified nurse-midwives and certified midwives (CNMs/CMs) certified by the American Midwifery Certification Board (AMCB) constitute the largest portion of the US midwifery workforce. This article aims to describe the current midwifery workforce based on data collected from all AMCB-certified midwives at the time of certification. METHODS Midwife initial certificants and recertificants were administered an electronic survey about personal and practice characteristics at the time of certification by AMCB between 2016 and 2020 for administrative purposes. Given the standard 5-year certification cycle, every midwife certified during this period completed the survey once. The AMCB Research Committee conducted a secondary data analysis of deidentified data to describe the CNM/CM workforce. RESULTS In 2020 there were 12,997 CNMs/CMs in the United States. The workforce was largely White and female with an average age of 49. There has been a slow increase (15% to 21%) of initial certificants identifying as midwives of color. The proportion of CMs to all AMCB-certified midwives remained less than 2%. Physician-owned practices were the most common employer. Approximately 60% of midwives attend births, and hospitals were the most common birth setting. Over 10% of those certified to practice reported not working within the discipline of midwifery. DISCUSSION Targeted recruitment and retention of midwives must take into consideration not just expansion but dispersion, scope of practice, and diversification. The proportion of midwives attending births was lower than reported in previous years. Expansion of the CM credential and accessible educational pathways are 2 potential solutions to workforce growth. Developing strategies to retain those who are trained but not practicing presents an opportunity for workforce maintenance.
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Affiliation(s)
- E Brie Thumm
- American Midwifery Certification Board Research Committee, College of Nursing, University of Colorado, Aurora, Colorado
| | - Cathy L Emeis
- School of Nursing, Oregon Health & Science University, Portland, Oregon
- College of Nursing and Public Health, Chamberlain University, Addison, Illinois
| | - Carol Snapp
- College of Nursing and Public Health, Chamberlain University, Addison, Illinois
- School of Nursing, University of Nevada, Las Vegas, Nevada
| | | | - Rebecca Rees
- American Midwifery Certification Board Research Committee, College of Nursing, University of Colorado, Aurora, Colorado
| | | | - Tanya Tanner
- American Midwifery Certification Board Research Committee, College of Nursing, University of Colorado, Aurora, Colorado
- Frontier Nursing University, Versailles, Kentucky
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Perera SM, Isa GP, Sebushishe A, Sundararaj P, Piccirillo M, Xia S, Langaigne A, Ali J, Casey SE. "Midwives are heroes of the country": qualitative evaluation of a midwifery education program in South Sudan. Front Glob Womens Health 2023; 4:1215405. [PMID: 37705530 PMCID: PMC10497107 DOI: 10.3389/fgwh.2023.1215405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023] Open
Abstract
Background Countries affected by armed conflict have higher maternal mortality than stable settings. South Sudan has one of the highest maternal mortality ratios in the world, with an estimated 789 maternal deaths per 100,000 live births. Long-term socio-political instability has contributed to significant challenges in its health system. To reduce maternal and newborn morbidity and mortality, South Sudan must increase the number of skilled midwives. Methods A cross-sectional mixed methods study was conducted in 2022 to assess the midwifery education program at three schools receiving support from International Medical Corps in South Sudan, including in-depth interviews with 15 midwifery school graduates currently working as midwives, their supervisors, 16 school faculty (in dyads), and two Ministry of Health officials; and nine focus group discussions with women clients of graduate midwives. Results Participants identified strengths of the schools, including being well equipped with trained and competent teaching staff, competency-based curriculum, including practical training which prepared graduate midwives to apply their skills in practice. Weaknesses of the program included its dependence on donor funding, inadequate mentorship and number of tutors, and insufficient practice for some services due to low client load at clinical sites. Additionally, participants identified challenges affecting midwives' ability to provide good quality care, including lack of equipment and supplies, low client load, low salaries, and insecurity due to conflict. Nevertheless, women in the community appreciated the immense work that midwives do. Midwives were respected by the community at large, and graduates expressed pride and satisfaction in their job, as well as the positive impact they have had in providing critical services to communities. Discussion Overall, the quality of the midwifery education program appears to be strong, however gaps in the program and the provision of quality care remain. The findings highlight the need to ensure sustained funding for midwifery education, as well as health system strengthening to ensure midwives can practice their skills. Continued investment in midwifery education and training is critical to reduce high maternal mortality and morbidity in South Sudan.
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Affiliation(s)
| | | | | | - Preethika Sundararaj
- RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Megan Piccirillo
- RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Shanell Xia
- RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Amaya Langaigne
- RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Javed Ali
- International Medical Corps, Washington, DC, United States
| | - Sara E. Casey
- RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States
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Altman SD, Tilley CP, Feldman R, Brennan M, Wholihan D. Curricular Quality Improvement in Midwifery: Simulating Unexpected Perinatal Loss. J Midwifery Womens Health 2023; 68:523-530. [PMID: 37092842 DOI: 10.1111/jmwh.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/27/2023] [Accepted: 02/27/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Caring for families experiencing perinatal loss is a fundamental component of midwifery practice, but little attention is paid to perinatal palliative care in midwifery curricula. Lack of educational preparation and self-care resources negatively impacts midwifery students and health care teams caring for families experiencing stillbirth. PROCESS A private, urban university conducted a curricular quality improvement project to integrate perinatal palliative care into the midwifery curriculum using a high-fidelity, branching simulation pedagogy. Simulation objectives were developed from curricular gap analyses and the Core Competencies for Basic Midwifery Practice. Development of the Unexpected Perinatal Loss Simulation was guided by the International Nursing Association for Clinical Simulation and Learning Outcomes and Objectives and Design Standards. The Unexpected Perinatal Loss Simulation was revised based on qualitative data from student focus groups and expert content validation. OUTCOMES Qualitative data yielded 4 key domains: presimulation, simulation skills, prior experience/personal reflections, and recommendations. Simulation procedures and scenario content were revised, after which 8 expert clinicians in the fields of midwifery, palliative care, and psychiatry validated the scenario content using the Lynn method. Two items did not meet the content validity index (CVI) threshold of 0.78, necessitating review by stakeholders; however, the overall scenario CVI threshold was met (0.82). DISCUSSION Through this project, faculty integrated perinatal palliative care into the midwifery program using a novel approach of high-fidelity, branching simulation, structured debriefing, and an introductory self-care skills workshop. Potential clinical impact includes skillful perinatal palliative care with effective communication skills to mitigate how families experience and remember a traumatic loss and facilitate the grieving process. Students voiced insights into how they would process loss and seek support to mitigate their own grief as future midwives.
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Affiliation(s)
| | | | | | - Mary Brennan
- NYU Rory Meyers College of Nursing, New York, New York
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Novello S, Pailleau M, Le Dévéhat P, Jeanne S. Periodontal Diseases and Pregnancy: Knowledge and Clinical Practice Habits of French Midwives. ORAL HEALTH & PREVENTIVE DENTISTRY 2022; 20:525-532. [PMID: 36511760 DOI: 10.3290/j.ohpd.b3680323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Several studies have demonstrated the role of periodontal disease as risk factor of adverse pregnancy outcomes, including preterm birth, low birthweight and pre-eclampsia. As such, midwives can play an essential role in prevention and early screening as the preferred intermediary of pregnant women. The purpose of this study was to assess the knowledge, training and daily practice habits of midwives to determine if they fulfill their role in oral health prevention. MATERIALS AND METHODS A questionnaire was sent by e-mail to practicing midwives and fifth-year midwifery students in the Brittany region of France. Data were collected online and descriptive data analyses were conducted. RESULTS A total of 192 practicing midwives and 13 students participated in the survey. The results showed that the majority of midwives were not familiar with the correlation between periodontal disease and adverse pregnancy outcomes and did not implement screening and prevention to a sufficient extent. CONCLUSION The explanation for this lack of knowledge seems to come from the initial training, since the topic of oral health is almost never discussed during midwives' studies. Most agreed they needed more training on periodontal disease and adverse pregnancy outcomes. Improving and integrating oral health education into the midwife academic curriculum can enhance midwives' engagement in oral health.
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Gresh A, Abrams ET, Chirwa E, Jere DL, Chodzaza E, Chorwe-Sungani G, Kafulafula U, Kapito E, Patel DR, Jeremiah RD, Klima CS, MacDonald A, Norr KF, Patil CL. Experiential Training Workshops for Group Antenatal Care in Malawi. J Midwifery Womens Health 2022; 67:759-769. [PMID: 36433698 PMCID: PMC10239291 DOI: 10.1111/jmwh.13436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/27/2022]
Abstract
The positive effects of the CenteringPregnancy group antenatal care (ANC) model on perinatal outcomes in the United States has led to its adaptation and implementation in many low- and middle-income countries. Facilitative discussions are a core component of this group ANC model. Facilitator training lays a critical foundation for delivery of this paradigm-shifting model as practitioners learn to adapt their approach to health education from didactive to facilitative. However, there is little rigorous research focused on best practices for training group health care facilitators and none that is guided by a theoretical framework. Kolb's experiential learning theory offers a theoretical framework to guide the development of training workshops that allow trainees to experience, reflect on, and practice the facilitation skills needed to deliver this evidence-based intervention. This article describes an experiential learning-based training workshop that was implemented as part of an ongoing effectiveness-implementation trial of a Centering-based group ANC model in Blantyre District, Malawi. We provide a blueprint for conducting group ANC facilitator trainings that, in addition to imparting knowledge, effectively builds confidence and buy-in to this paradigm-changing approach to ANC delivery. This blueprint can be adapted for use in designing and implementing group health care across settings in the United States and globally.
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Affiliation(s)
- Ashley Gresh
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Elizabeth T Abrams
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
| | - Ellen Chirwa
- Department of Midwifery, School of Maternal, Neonatal and Reproductive Health Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Diana L Jere
- School of Maternal, Neonatal and Reproductive Health Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Elizabeth Chodzaza
- Department of Midwifery, School of Maternal, Neonatal and Reproductive Health Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Genesis Chorwe-Sungani
- Institute of Postgraduate Studies and Research, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Ursula Kafulafula
- School of Maternal, Neonatal and Reproductive Health Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Esnath Kapito
- School of Maternal, Neonatal and Reproductive Health Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Dhruvi R Patel
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
| | - Rohan D Jeremiah
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
| | - Carrie S Klima
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
| | - Amy MacDonald
- Group Care Programs, Pomelo Care, Hillsborough, North Carolina
- Group Care Global, Philadelphia, Pennsylvania
| | - Kathleen F Norr
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
| | - Crystal L Patil
- Department of Human Development Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, Illinois
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Avery MD. Evidence-Based Guidelines Collection from the Collège National des Sages-Femmes de France (French National College of Midwives). J Midwifery Womens Health 2022; 67 Suppl 1:S1. [PMID: 36480669 DOI: 10.1111/jmwh.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/12/1912] [Accepted: 07/27/2022] [Indexed: 12/13/2022]
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Urbanová E, Bašková M, Maskálová E, Mazúchová L, Škodová Z. Virtual patients: an option for future distance midwifery education? Int J Nurs Educ Scholarsh 2022; 19:ijnes-2021-0096. [PMID: 35822716 DOI: 10.1515/ijnes-2021-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/23/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The objective is to introduce the creating a set of virtual patients (VPs) to support distance midwifery education as well as the impact of distance education by means of VPs on knowledge, skills, motivation, clinical practice, and student satisfaction. METHODS VPs were created using OpenLabyrinth (OL). The impact of the distance education was assessed using a feedback questionnaire. RESULTS When creating our own VPs, the design and development phase can be considered the most difficult. On a scale of 1 (agree) to 4 (disagree), the student feedback rates were mostly positive (1.04-2.13). A high degree of agreement was associated with the acquisition of theoretical knowledge (1.15-1.28) and skills (1.43). CONCLUSIONS The creation of our own VPs is challenging for teachers due to its unconventional character. The students expressed great satisfaction with distance learning, but lacked face-to-face contact with the patient.
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Affiliation(s)
- Eva Urbanová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Martina Bašková
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Erika Maskálová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Lucia Mazúchová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Zuzana Škodová
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
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Beckingham A, Downe S, Fernandez E, Reed B, Kaur I, Aziz N, Kingdon C. Implementing Professional Midwife-Led Maternity Care in India for Healthy Pregnant Women: A Community Case Study. Front Public Health 2022; 10:875595. [PMID: 35757640 PMCID: PMC9221983 DOI: 10.3389/fpubh.2022.875595] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022] Open
Abstract
More women and neonates die each year in India than in almost every other country of the world. Since 1947, India has in principle provided free medical maternal health care to all pregnant and childbearing women. Although rates of maternal and neonatal deaths have fallen since the 1990s, major inequalities remain. Some Indian States have very high rates of interventions, (e.g., cesarean section), while others have intervention and care rates that are too low. Disrespectful treatment of women in labor and lack of evidence-based practice have also been reported. The World Health Organization and others have strongly recommended that professional midwives (trained in a woman-centered philosophy and to international standards) have a key role for reducing mortality and morbidity, minimizing unnecessary interventions in pregnancy and labor, and improving maternal care quality in low- and medium-income countries. This paper provides a community case-report of the first professional midwifery programme in India designed to international standards, implemented in 2011 in Hyderabad. We describe the design and implementation in the programme's first eleven years, as a basis for further scale-up and testing in India, and in other low- or medium-income countries. The ultimate aim is to improve maternal care quality, choice and outcomes in India and in similar socio-economic and cultural settings.
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Affiliation(s)
| | - Soo Downe
- UCLan THRIVE Centre, Research in Childbirth and Health (ReaCH) Unit, University of Central Lancashire, Preston, United Kingdom
| | | | | | | | | | - Carol Kingdon
- UCLan THRIVE Centre, Research in Childbirth and Health (ReaCH) Unit, University of Central Lancashire, Preston, United Kingdom
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La Rosa VL, Ciebiera M, Zaręba K, Reyes-Muñoz E, Marques Cerentini T, Barra F, Garzon S, Riemma G, De Franciscis P, Laganà AS, Vitale SG. The Medical Training Evaluation Questionnaire (MeTrE-Q): a multidimensional self-report instrument for assessing the quality of midwifery students' education. J OBSTET GYNAECOL 2021; 42:968-975. [PMID: 34927522 DOI: 10.1080/01443615.2021.1980511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aims to understand the factors that can hinder Italian midwifery students' educational process, what messages are given to students during their clinical practice, and how students interact with tutors and other professionals. Seven hundred and eighty Italian students of midwifery were asked to answer an Internet-based questionnaire regarding their own opinions concerning their theoretical-practical formative path. For male Italian students, satisfaction is lower than female students as well as for students from Southern than Northern Italy. Students are dissatisfied with the quality of their academic and practical training, particularly regarding recognising their professional role and their relationship with tutors. Based on these data, it is essential to design a formative path for midwives that considers students' opinions and the positive experiences of other countries.Impact StatementWhat is already known on this subject? Several studies underscore the poor preparation of students for learning in clinical settings. The current reality of the Italian academic path in most universities disregards midwifery students' expectations and formative needs.What do the results of this study add? For male Italian students, satisfaction is lower than for female students and students from Southern than Northern Italy. Students are dissatisfied with the quality of their academic and practical training, particularly regarding recognising their professional role and their relationship with tutors.What are the implications of these findings for clinical practice and/or further research? It is essential to design a formative path for midwives that considers students' opinions and other countries' positive experiences.
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Affiliation(s)
| | - Michał Ciebiera
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Kornelia Zaręba
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Enrique Reyes-Muñoz
- Coordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Tais Marques Cerentini
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, University of Insubria, "Filippo Del Ponte" Hospital, Varese, Italy
| | - Gaetano Riemma
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, University of Insubria, "Filippo Del Ponte" Hospital, Varese, Italy
| | - Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Guner S, Ocak Akturk S, Oner Aydın S, Karaca Saydam B. Investigation of Intercultural Sensitivity and Ethnocentrism Levels of Midwife Candidates in Turkey Sample: A Cross-Sectional Study. J Transcult Nurs 2021; 33:208-218. [PMID: 34865576 DOI: 10.1177/10436596211057914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION As women experience cultural practices during their lifespan, midwives' displaying a culture-specific approach from the school years is of great importance for the quality of care. This study was conducted to determine the intercultural sensitivity and ethnocentrism levels of midwife candidates in Turkey. METHOD This cross-sectional study was conducted with 1,616 midwifery students who studied in seven different regions of Turkey in the 2018-2019 academic year. Data were collected through a questionnaire, Intercultural Sensitivity Scale, and Ethnocentrism Scale. RESULTS It was determined that the variables such as the region where the midwife candidates grew up and location of the university, their years at school, and having friends from different cultures were effective on their intercultural sensitivity and ethnocentrism levels (p < .05). DISCUSSION Consequently, it is concluded that international student exchange programs and culture-sensitive-based care approaches during midwifery education will increase the intercultural sensitivity levels of students and contribute to reducing ethnocentrism levels.
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Adnani QES. Progress and challenges of midwifery education in Indonesia. Eur J Midwifery 2021; 5:50. [PMID: 34782890 PMCID: PMC8559270 DOI: 10.18332/ejm/142496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
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Öztürk S. Evaluation of the opinions of midwifery students on adolescent pregnancy: A phenomenological qualitative study in eastern Turkey. Eur J Midwifery 2021; 5:49. [PMID: 34734170 PMCID: PMC8544601 DOI: 10.18332/ejm/138593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/09/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Adolescent pregnancy is a major health problem that is significantly associated with adverse impacts on the health of both teenage mothers and their newborns. This study was conducted to evaluate the opinions of midwifery students on adolescent pregnancy. METHODS The participants were selected using a purposeful sampling method. Thirty-seven students studying at the final year of the midwifery department were interviewed in the study in Erzurum, Turkey, in 2018. The interviews were analyzed by the phenomenological qualitative method. RESULTS Students thought that adolescent pregnancy was a social problem in addition to its maternal and fetal risks. The students indicated that adolescent pregnancy was perceived as normal in a family in which cultural values were important (especially in those families that live in the Eastern and South-Eastern regions). Only one student attracted attention to the effect of the media in this respect. The students stated that adolescent pregnancy was a social problem, and a multidisciplinary approach was required for its solution. CONCLUSIONS Our qualitative study provides insight into the role of adolescent pregnancy in Turkey. Participants expressed the idea that increasing the education level of girls and raising awareness among mothers may be an effective solution to the problem. The students were aware that adolescent pregnancy was an important social problem.
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Affiliation(s)
- Sibel Öztürk
- Department of Midwifery, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey
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Di Marco L. User-centered evaluation of Discord in midwifery education during the COVID-19 pandemic: Analysis of the adaptation of the tool to student needs. Eur J Midwifery 2021; 5:51. [PMID: 34782891 PMCID: PMC8562159 DOI: 10.18332/ejm/142638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In the context of the COVID-19 pandemic in 2020, and in order to overcome the lack of face-to-face contact between students and teachers, the midwifery department of Grenoble (France) decided to use the Discord tool in the training of midwifery students. In order to evaluate the relevance of using instant messaging software for the education of future midwives, the tool was evaluated by the students. METHODS We conducted, in January 2021, a user-centered online study with all midwifery students in training for the classes of 2020-2021, using the French translation of Anstey and Watson's Rubric for the Evaluation of eLearning Tools. This evaluation analyzed the different dimensions of Discord in the context of training: functionality, accessibility, technology, design, privacy and data protection, social presence, pedagogical presence, and cognitive presence. RESULTS Discord had a good functionality for 75% of the students surveyed. They found Discord to be suitable for maintaining social links and creating serious games. But they did not find it useful for following courses or practical work. More than 80% of the midwifery students interviewed agreed that Discord can be adapted to different learning contexts. CONCLUSIONS The department can continue to use Discord without reservation for the creation of serious games, as well as for maintaining links between students and teaching staff in the department. Discord has the characteristics of a social network, allowing students to connect with each other.
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Affiliation(s)
- Lionel Di Marco
- Midwifery Department, Faculty of Medicine, Grenoble-Alpes University, Grenoble, France
- TIMC-IMAG Lab, UMR 5525, ThEMAS Team, CNRS, Public Health Department, Grenoble-Alpes University, Grenoble, France
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20
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Jenkins J, Woodside F, Lipinsky K, Simmonds K, Coplon L. Abortion With Pills: Review of Current Options in The United States. J Midwifery Womens Health 2021; 66:749-757. [PMID: 34699129 DOI: 10.1111/jmwh.13291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
Interest in self-management approaches to abortion with pills in the United States preceded the coronavirus disease 2019 (COVID-19) pandemic and has accelerated during this global health crisis. Coupled with the unclear future of legal abortion in the United States, clinical care providers need to be aware of the range of self-managed abortion approaches and of the varying levels of engagement with the formal health care system they entail. This article is intended to serve as a resource to inform providers of the current landscape of abortion with pills in the United States, while also describing possible shifts in the future that may result due to the ongoing pandemic and the continuing erosion of access to abortion care and services.
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Affiliation(s)
- Julie Jenkins
- Johns Hopkins School of Nursing, Baltimore, Maryland
| | | | | | - Katherine Simmonds
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
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Kul Uçtu A, Karahan N. The impact of communication education provided with creative drama method on midwifery undergraduates. Eur J Midwifery 2021; 5:42. [PMID: 34632325 PMCID: PMC8462520 DOI: 10.18332/ejm/138592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/15/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This study was carried out to evaluate the impact of communication education provided by using creative drama method on the communication skills, selfesteem, and organizational conflict resolution skills of midwifery undergraduates. METHODS The research was conducted as a semi-experimental 'controlled pretest-posttest' method. The study was carried out with freshmen studying midwifery at a public university in Western Turkey (n=52) between 30 September and 30 December 2017. Data were collected by means of the Communication Skills Inventory, Rosenberg Self-Esteem Scale, and Rahim Organizational Conflict Inventory-II. Throughout the research process, a 12-week lesson plan covering the stages of the creative drama method was applied. During the collection of the data, the scales were applied to the group as pretest, posttest while dependent t-test was applied for analyzing purposes. RESULTS Communication Skills Inventory behavioral communication skills created a significant difference between Rosenberg Self-Esteem Scale self-esteem subscale scores (p>0.05). No significant difference was detected among the Rahim Organizational Conflict Inventory sub-dimension mean scores (p>0.05). CONCLUSIONS Findings obtained from the research reveal that the creative drama method effectively develops communication skills, self-esteem, and conflict resolution skills for midwifery undergraduates.
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Affiliation(s)
- Arzu Kul Uçtu
- Midwifery Department, Gulhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Nazan Karahan
- Midwifery Department, Gulhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
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22
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Esegbona-Adeigbe S. The impact of a Eurocentric curriculum on racial disparities in maternal health. Eur J Midwifery 2021; 5:36. [PMID: 34568777 PMCID: PMC8419870 DOI: 10.18332/ejm/140086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sarah Esegbona-Adeigbe
- Adult Nursing and Midwifery Studies, School of Nursing and Midwifery, Institute of Health and Social Care, London South Bank University, London, United Kingdom
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Garbelli L, Lira V. Maternal positions during labor: Midwives' knowledge and educational needs in northern Italy. Eur J Midwifery 2021; 5:15. [PMID: 34046561 PMCID: PMC8138948 DOI: 10.18332/ejm/136423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Maternal positions and mobility during childbirth can have different and specific effects on labor and affect some birth outcomes. The aim of the survey is to investigate the knowledge and skills regarding maternal positions in labor among midwives and to consider the need of training. METHODS A semi-structured questionnaire was distributed in August and September 2020 among midwives working in eight hospitals of Brescia, Northern Italy. The sample consisted of 115 midwives and data were analyzed using a quantitative, descriptive approach. RESULTS The majority of the sample identified the general and specific benefits of maternal positions. Factors limiting the proposal of maternal positions were the context, the relationships with healthcare providers, the woman features, the fetal heart rate registration, continuous cardiotocography, amniotomy, episiotomy, operative vaginal birth, and epidural analgesia. Vaginal examination, the detection of uterine contractions, intrapartum ultrasounds, and ‘hands-on’ perineum technique were considered irrelevant by the participating midwives. The promoting factors were the presence of the partner, the telemetry, and the partogram with a section dedicated to positions. Nearly the totality of the sample considered appropriate to deepen the topic with training. CONCLUSIONS Post-graduate courses are desirable to improve midwives’ skills. An educational toolkit is proposed to make the promotion of maternal positions more effective and appropriate. In order to improve midwifery intrapartum care, further research addressed to midwives of other settings appears essential to compare different training contexts, to expand the proposed toolkit, and to invest on midwifery practice and education.
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Affiliation(s)
- Laura Garbelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Viviana Lira
- Department of Obstetrics and Gynaecology, ASST Spedali Civili Hospital, Brescia, Italy
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de Pierrepont C, Brassard A, Lessard I, Gingras AS, Péloquin K. Testing an Online Training Session on Couples' Perinatal Sexual Changes Among Health Care Professionals and Paraprofessionals. J Midwifery Womens Health 2021; 66:218-226. [PMID: 33650785 DOI: 10.1111/jmwh.13206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 10/16/2020] [Accepted: 10/28/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION During and after pregnancy, couples have to adapt to sexual changes. Although many couples have questions and preoccupations regarding those changes, they are rarely addressed by professionals and paraprofessionals in perinatal health care, mainly because of lack of knowledge and training. An online training session that addressed couples' perinatal sexual changes tailored for health care perinatal professionals (nurses and midwives) and paraprofessionals (doulas) was developed, implemented, and evaluated. METHODS Participants completed 4 steps: (1) a baseline online questionnaire assessing training needs and measures on knowledge, attitudes, and perceived counseling skills regarding couples' perinatal sexual changes; (2) a 2-hour online training session on the topic with theoretical and practical content; (3) an online post-training satisfaction questionnaire; and (4) a one-month follow-up assessment using the same measures as at baseline. RESULTS Of the 74 participants (20 nurses, 20 midwives, 34 doulas) who completed the study, 37.8% had previous training in sexuality and 18.9% in perinatal sexuality. Results showed pre- to post-training significant increases in knowledge and attitudes toward couples' perinatal sexual changes, characterized by more positivity, flexibility, openness, and sense of competence regarding the topic. There were also significant pre- to post-training increases in perceived utility, comfort, intention, and sense of self-efficacy related to counseling skills regarding couples' perinatal sexual changes. After training, more participants discussed couples' sexual changes with couples during and after pregnancy. After training, significantly fewer participants reported lack of knowledge, lack of training, and lack of discomfort as barriers to discussions on couples' perinatal sexual changes, whereas more reported lack of time as a barrier. Global satisfaction with the training was high. DISCUSSION This training can help foster more discussions on the topic from perinatal professionals and paraprofessionals to better meet couples' needs for information and support.
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Affiliation(s)
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Isabelle Lessard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anne-Sophie Gingras
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
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Thackrah RD, Wood J, Thompson SC. Longitudinal Follow Up of Early Career Midwives: Insights Related to Racism Show the Need for Increased Commitment to Cultural Safety in Aboriginal Maternity Care. Int J Environ Res Public Health 2021; 18:1276. [PMID: 33572624 DOI: 10.3390/ijerph18031276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/04/2022]
Abstract
Racism in health care undermines equitable service delivery, contributes to poorer health outcomes and has a detrimental effect on the Aboriginal workforce. In maternity care settings, Aboriginal women’s perceptions of discrimination are widespread, with the importance of cultural practices surrounding childbirth often not recognised. Efforts to build midwives’ cultural capabilities and address health disparities have seen Aboriginal content included in training programs but little is known about its application to clinical practice. This study reinterviewed midwives who had previously completed university midwifery training that aimed to increase understanding of Aboriginal people and cultural safety in health care. Participants were 14 non-Indigenous midwives and two Aboriginal midwives. Interviews explored the legacy of program initiatives on cultural capabilities and observations and experiences of racism in maternity care settings. Methods followed qualitative approaches for research rigour, with thematic analysis of transcribed interviews. Findings revealed the positive impact of well-designed content and placements, with non-Indigenous participants cognisant and responsive to casual racism but largely not recognising institutional racism. The Aboriginal midwives had experienced and were attuned to racism in all its guises and suggested initiatives to heighten awareness and dispel stereotypes. It is evident that greater attention must be paid to institutional racism in educational programs to increase its recognition and appropriate actions within health care settings.
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Dole D, Farley CL, Sokas RK, Kessler JL. Partnering to Support Education for Midwives and Nurses in Liberia. Nurs Womens Health 2021; 25:82-92. [PMID: 33453157 DOI: 10.1016/j.nwh.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/10/2020] [Accepted: 11/01/2020] [Indexed: 11/18/2022]
Abstract
The midwifery and occupational health faculty of a U.S. university were approached by parish and health care leaders from Caldwell, Liberia, for assistance in addressing critical maternal health care needs in their community. Liberia has suffered setbacks in its efforts to improve health care for its people due to recent civil wars and the Ebola epidemic of 2014 to 2016. Initial discussions among international groups centered around realistic ways to help in the face of multiple compelling needs. Grant support for U.S. faculty to conduct exploratory meetings and educational workshops in Liberia was secured. Ethical principles and best practices in partnering across borders guided this partnership and include reciprocity, equity, and empowerment of health care workers, including nurses, midwives, community workers, and health center staff. Here, we describe the preparation for and implementation of these workshops, as well as plans for continuing collaborations that emerged from these workshops.
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Mrayan L, Al-Motlaq M, Abuidhail J, Abujilban S. Teaching Midwifery Module to Male Undergraduate Nursing Students: Case Report in Jordan. Florence Nightingale Hemsire Derg 2020; 28:359-363. [PMID: 34263215 PMCID: PMC8134020 DOI: 10.5152/fnjn.2020.19192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/28/2020] [Indexed: 11/22/2022] Open
Abstract
This case report presented our experience of teaching male student nurses a midwifery course. The aim was to present the teaching experience of midwifery module to male undergraduate nursing students at the School of Nursing at The Hashemite University. In teaching a midwifery course, an educational approach has been adopted, focusing on a more holistic perspective of the problem in its own contextual nursing environment. Using Problem Based Learning (PBL) as a model of education instead of the traditional way of teaching played a major role in overcoming the challenges of involving male students in midwifery module education in Jordanian conservative culture.
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Affiliation(s)
- Lina Mrayan
- Department of Maternal, Child and Family Health Care Nursing, The Hashemite University Faculty of Nursing, Zarqa, Jordan
| | - Mohammad Al-Motlaq
- Department of Maternal, Child and Family Health Care Nursing, The Hashemite University Faculty of Nursing, Zarqa, Jordan
| | - Jamila Abuidhail
- Department of Maternal, Child and Family Health Care Nursing, The Hashemite University Faculty of Nursing, Zarqa, Jordan
| | - Sanaa Abujilban
- Department of Maternal, Child and Family Health Care Nursing, The Hashemite University Faculty of Nursing, Zarqa, Jordan
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Othman SME, Steen M, Fleet JA, Jayasekara R. Healthy eating in pregnancy, education for midwives: A pre-post intervention study. Eur J Midwifery 2020; 4:20. [PMID: 33537622 PMCID: PMC7839119 DOI: 10.18332/ejm/120004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/25/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Midwives have an important role in providing education in healthy eating to pregnant women, which is essential for maternal and foetal health and wellbeing. Importantly, midwives require continual professional development to ensure they provide up-to-date education. METHODS A pre-post intervention study utilised a purpose-designed questionnaire to collect data at three time points. Forty-four midwives completed the pre education questionnaire, 29 of these midwives attended the education intervention (workshop/webinar) and completed the immediately after questionnaire. Nineteen midwives then completed a questionnaire at 6–8 weeks follow-up. The study aimed to evaluate midwives’ knowledge and level of confidence to discuss healthy eating in pregnancy. RESULTS Education in healthy eating improved midwives’ knowledge and level of confidence, which were maintained for six to eight weeks. The mean difference of total scores on knowledge and confidence between pre and immediately after education questionnaires showed a statistically significant improvement in nutrition knowledge (4.93 ± 1.62 vs 7.55 ± 1.55; p<0.001) and confidence level (22.05 ± 6.87 vs 31.48 ± 7.47; p<0.001). In terms of the mode of education, there was a significant increase in total knowledge scores for midwives who attended a workshop compared to a webinar. CONCLUSIONS Overall, healthy eating education improved midwives’ knowledge and confidence immediately after receiving education and also at 6–8 weeks follow-up. This study is unique as it evaluated midwives’ knowledge and level of confidence at 6–8 weeks post education. This study concludes that midwives benefited from receiving further knowledge on cultural food choices, eating behaviours, and dental care.
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Affiliation(s)
- Shwikar M E Othman
- Obstetrics and Gynaecology Nursing Department, Faculty of Nursing, South Valley University, Luxor, Egypt.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Mary Steen
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Julie-Anne Fleet
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Rasika Jayasekara
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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Nacht A, Martin J. An Academic Midwifery Fellowship: Addressing a Need for Junior Faculty Development and Interprofessional Education. J Midwifery Womens Health 2020; 65:370-375. [PMID: 32424912 DOI: 10.1111/jmwh.13116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 11/30/2022]
Abstract
The University of Colorado College of Nursing crafted a midwifery fellowship to address a local need to recruit junior faculty into a large practice caring primarily for an underserved, at-risk population. Additional goals for the fellowship included promoting retention and development of interprofessional education teams. The curriculum design drew heavily from 2 national initiatives: (1) the Institute of Medicine's call for nursing residencies to support the transition to advanced practice and build expertise in navigating health systems and caring for patients with complex needs and (2) the American College of Obstetricians and Gynecologists and American College of Nurse-Midwives collaboration to address maternity care workforce shortages by building clinically-based interprofessional teams. The fellowship uses Melei's transitions theory and Jean Watson's Theory of Human Caring as frameworks to understand the fellows experience in the 12-month program. Fellow competencies concentrate on 7 core components: clinical, professional, intrapersonal, mentorship, interprofessional, low-resource setting, and leadership. Program evaluation is in process with the aim of understanding if the fellowship improves confidence and competence for the newly graduated nurse-midwife, and a change in attitude toward interprofessional teams. Of the 5 fellows who completed the midwifery fellowship over 4 years, 2 now have faculty positions within the practice and 4 of the 5 were offered positions. Common themes from the fellows' reflection journals and mentorship meetings include the importance of mentorship in clinical and professional growth. Further program evaluation is needed to better understand the efficacy of program components in meeting the objectives to recruit and retain faculty and promote interprofessional education. Academic midwifery fellowships with interprofessional components may be an innovative recruitment technique for clinical faculty.
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Affiliation(s)
- Amy Nacht
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, and University of Colorado College of Nursing Office of Clinical and Community Affairs, Aurora, Colorado
| | - Julia Martin
- University of Colorado College of Nursing Office of Clinical and Community Affairs, Aurora, Colorado
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Avery MD, Jennings JC, Germano E, Andrighetti T, Autry AM, Dau KQ, Krause SA, Montgomery OC, Nicholson TB, Perry A, Rauk PN, Sankey HZ, Woodland MB. Interprofessional Education Between Midwifery Students and Obstetrics and Gynecology Residents: An American College of Nurse-Midwives and American College of Obstetricians and Gynecologists Collaboration. J Midwifery Womens Health 2020; 65:257-264. [PMID: 31965745 PMCID: PMC7187383 DOI: 10.1111/jmwh.13057] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 01/17/2023]
Abstract
Despite areas of excellence, US perinatal care outcomes lag behind most developed countries. In addition, a shortage and maldistribution of health care providers exists. The American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists (ACOG) partnered to obtain funding to develop interprofessional education modules and other learning activities for midwifery students and obstetrics and gynecology residents in 4 demonstration sites. The multidisciplinary 2016 ACOG document Collaboration in Practice: Implementing Team-Based Care was adopted as a framework. Core competencies of values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork developed by the Interprofessional Education Collaborative were used to guide the work. Seven modules have been developed including guiding principles, patient-centered care, role clarification, collaborative practice, history and culture, care transition, and difficult conversations. Learners participate in laboratory and simulation activities and work together in clinical care settings. Stakeholder experiences as well as barriers to implementation are discussed. Learning materials and activity descriptions are open resourced and shared on a project website for use by programs interested in implementing an interprofessional curriculum. Ongoing formal evaluation including pilot testing of a program evaluation method is described.
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Affiliation(s)
| | - John C. Jennings
- Texas Tech University Health Sciences Center, Permian BasinTexas
| | | | - Tia Andrighetti
- Department of Midwifery and Women's HealthFrontier Nursing UniversityHydenKentucky
| | - Amy M. Autry
- Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of California San Francisco School of MedicineSan FranciscoCalifornia
| | - Kim Q. Dau
- Department of Family Health Care NursingUniversity of California San Francisco School of NursingSan FranciscoCalifornia
| | | | - Owen C. Montgomery
- Drexel University College of Medicine, Philadelphia, Pennsylvania. Dr. Montgomery is now with Thomas Jefferson UniversityPhiladelphiaPennsylvania
| | - Tonya B. Nicholson
- Department of Midwifery and Women's HealthFrontier Nursing UniversityHydenKentucky
| | - Audrey Perry
- Department of Midwifery and Women's HealthFrontier Nursing UniversityHydenKentucky
| | - Phillip N. Rauk
- University of Minnesota School of MedicineMinneapolisMinnesota
| | - Heather Z. Sankey
- Department of Obstetrics and GynecologyUniversity of Massachusetts‐BaystateSpringfieldMassachusetts
| | - Mark B. Woodland
- Drexel University College of MedicineOBGYN Reading Health SystemReadingPennsylvania
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Effland KJ, Hays K, Ortiz FM, Blanco BA. Incorporating an Equity Agenda into Health Professions Education and Training to Build a More Representative Workforce. J Midwifery Womens Health 2020; 65:149-159. [PMID: 31957220 DOI: 10.1111/jmwh.13070] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 09/09/2019] [Accepted: 10/02/2019] [Indexed: 11/30/2022]
Abstract
Efforts to achieve health equity goals in the United States require the recruitment, retention, and graduation of an increasingly diverse student body of aspiring health professionals. Improving access to health care providers who are culturally congruent with the populations served is a related ethical priority that has the potential to improve the health inequities faced by communities of color and others in the United States. Midwifery education program administrators and faculty have responded to this need by acknowledging that creation of a more representative midwifery workforce starts with midwifery education. The Equity Agenda Guideline, related conceptual model, and website resources were developed for the purpose of supporting health professions educators and institutions who recognize a need for change and are seeking answers about how to train and graduate more health care providers from communities that are currently underrepresented. Using a systems approach to outline the transformative multilevel changes required, these resources offer a roadmap for how to address the underlying problems of racism and other differentisms that have limited the growth and diversification of the health and helping professions. This article addresses how health education programs interested in making an impact on this complex and persistent problem can adopt or adapt the Equity Agenda Guideline, originally developed for midwifery education programs in the United States.
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Affiliation(s)
- Kristin J Effland
- Department of Midwifery, Bastyr University, Kenmore, Washington.,Midwives College of Utah, Salt Lake City, UT
| | - Karen Hays
- Department of Midwifery, Bastyr University, Kenmore, Washington
| | - Felina M Ortiz
- Department of Health Sciences, University of New Mexico College of Nursing, Albuquerque, New Mexico
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Vermeulen J, Peersman W, Waegemans M, De Clercq G, Gucciardo L, Laubach M, Swinnen E, Beeckman K, Buyl R, Fobelets M. Learning experiences of final-year student midwives in labor wards: A qualitative exploratory study. Eur J Midwifery 2019; 3:15. [PMID: 33537594 PMCID: PMC7839143 DOI: 10.18332/ejm/111802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/17/2019] [Accepted: 08/17/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for achieving professional competencies. Although students' experiences on placements have been shown to play a meaningful role in their learning, they have received scant attention in the literature. The aim of this paper is to describe the learning experiences of final-year student midwives in labor wards within the Brussels metropolitan region, Belgium. METHODS A qualitative exploratory study was conducted using two focus groups (N=20). Data analysis included: transcription of audio recordings, thematic content analysis with coding into recurrent and common themes, and broader categories. Discussions among researchers were incorporated in all phases of the analysis for integrity and data fit. RESULTS Data analysis identified the following categories as determining student learning experiences in labor wards: 1) managing opportunities, 2) being supported, and 3) dealing with the environment. Overall, respondents were positive and enthusiastic about their learning experiences, although some felt tense and unprepared. Students expressed concerns about differences in learning opportunities between placements and found it challenging to achieve all competencies. Student learning experiences were enhanced when they had placements for longer periods with the same supportive mentors. CONCLUSIONS Factors related to students' functioning, the healthcare professional, midwifery education and hospital environment affected their learning in labor wards. The combination of a more persevered preparation of students and mentors, together with a student-centered organization of placements, is crucial to create a positive learning experience for midwifery students in labor wards.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Wim Peersman
- Social and Community Work, Odisee University College, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Matthias Waegemans
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Gerlinde De Clercq
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Leonardo Gucciardo
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Monika Laubach
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Katrien Beeckman
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department Medical Sociology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Nursing and Midwifery Research Unit, University Hospital Brussels, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), Midwifery Research Education and Policymaking (MIDREP), University of Antwerp, Antwerp, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Krause SA, DeJoy SA, Sankey HZ. Innovations in Midwifery Education: The Academic Medical Center Model. J Midwifery Womens Health 2019; 64:649-656. [PMID: 31264777 DOI: 10.1111/jmwh.12989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/11/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022]
Abstract
Workforce analyses project a need for women's health care providers, especially in maternity care. With a stagnant number of certified nurse-midwife/certified midwife (CNM/CM) education programs, the present production of new CNMs/CMs is not robust enough to meet the growing demand. This article describes an existing but underutilized model for CNM/CM education programs, based in an academic medical center with an existing academic affiliation. Advantages include a federal funding source through the Centers for Medicare and Medicaid Services, lower tuition costs than most current programs, and expanded job satisfaction for CNMs/CMs in clinical practice.
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Affiliation(s)
- Susan A Krause
- Midwifery Education Program, Division of Midwifery and Community Health, Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
| | - Susan A DeJoy
- Division of Midwifery and Community Health, Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
| | - Heather Z Sankey
- Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
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Srisaeng P, Upvall MJ. Looking toward 2030: Strengthening midwifery education through regional partnerships. J Adv Nurs 2019; 76:715-724. [PMID: 30937943 DOI: 10.1111/jan.14015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/21/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Abstract
AIMS The purpose of this paper is to describe the impact of a regional capacity-building project between Thailand and Laos that supports the United Nation's sustainable development goal 3 through midwifery education. DESIGN Discussion paper based on an exemplar. DATA SOURCES The International Confederation of Midwifery's standards of midwifery education and World Health Organization midwifery educator core competencies provided the framework for capacity-building of Lao midwifery educators. IMPLICATIONS FOR NURSING Knowledge gained from this 2-year project (October 2015-November 2017) increased the teaching confidence of midwifery educators while linking international standards and competencies to curriculum revision. In addition, capacity-building projects based on a needs assessment and implementation from regional partners may result in policy changes at the local and national level. CONCLUSION Partnerships are essential to meeting the sustainable development goals. These regional partnerships may be highly effective in creating sustainable capacity-building projects. IMPACT Maternal mortality and preventing deaths of children under 5 years old continues to be a challenge across the globe despite progress made in recent years. Progress toward sustainable development goal 3, requires efforts addressed in sustainable development goal17, partnership. Laos has one of the highest maternal mortality rates in Southeast Asia. A project to increase capacity of midwifery educators demonstrated the benefit of regional partnerships in Laos to have an impact on sustainable development goal 3 ultimately improving maternal outcomes throughout the country. Partnerships especially those between countries in the same region, are crucial to the success of meeting the sustainable development goals.
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Affiliation(s)
- Pakvilai Srisaeng
- Department of Midwifery, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Michele J Upvall
- College of Nursing, University of Central Florida, Orlando, Florida
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Zheng YHE, Palombella A, Salfi J, Wainman B. Dissecting through Barriers: A Follow-up Study on the Long-Term Effects of Interprofessional Education in a Dissection Course with Healthcare Professional Students. Anat Sci Educ 2019; 12:52-60. [PMID: 29659188 DOI: 10.1002/ase.1791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 03/24/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.
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Affiliation(s)
| | - Andrew Palombella
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jenn Salfi
- Department of Nursing, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Bruce Wainman
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Woeber K, Sibley L. The Effect of Prior Work Experiences on the Preparation and Employment of Early-Career Midwives. J Midwifery Womens Health 2018; 63:668-677. [PMID: 30294893 DOI: 10.1111/jmwh.12910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 05/02/2018] [Accepted: 05/28/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Strategic recruitment, preparation, distribution, and retention of US midwives requires a solid body of knowledge about midwives' education and workforce experiences. Although half of US midwifery education programs currently require or prefer prior registered nurse (RN) employment, data are lacking about whether and how these criteria influence efforts to scale up the workforce to meet reproductive care workforce shortages and maldistributions. METHODS This cross-sectional research used an online survey, developed using the framework of Social Cognitive Career Theory. Early-career midwives were contacted through the American College of Nurse-Midwives electronic mailing list and social media during the fall of 2016. Statistical analysis allowed for linkage of data related to the following constructs: personal characteristics, prior RN employment, educational experiences, employment situations, career perceptions, and future plans. RESULTS All participants (N = 244) were certified nurse-midwives. Compared with those without prior RN employment, midwives with prior RN employment were more likely to enroll part-time in distance programs and complete single majors or degrees. During enrollment, the 2 groups experienced the same degree of mentorship and cultural support and were similarly likely to attend 30 births and to pass the certification examination on first attempt. In the workforce, those with prior RN employment were 6 years older and more likely to work full-time. The 2 groups demonstrated no significant differences in their career perspectives or future career plans. DISCUSSION Despite anecdotal concerns about training midwives who lack RN work experience, an individual without prior RN employment offers the workforce an employee who completes midwifery education at a younger age, may be educated more quickly, and is more likely to have earned a dual major or degree. Those with prior RN employment are more likely to work full-time. Both groups may offer benefits to education and the workforce.
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Wadephul F, Jarrett PM, Jomeen J, Martin CR. A mixed methods review to develop and confirm a framework for assessing midwifery practice in perinatal mental health. J Adv Nurs 2018; 74:2258-2272. [PMID: 29989193 DOI: 10.1111/jan.13786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/27/2018] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
AIM To ascertain whether a new framework examining midwifery practice in perinatal mental health (PMH) is supported by the research literature. BACKGROUND The identification and care of women with PMH problems is increasingly considered part of midwifery practice. Research suggests that many midwives lack knowledge, skills and confidence. It would be useful to be able to determine barriers and facilitators to effective clinical practice. The authors propose a framework comprising five potentially measurable domains which have an impact on midwives' ability to identify, assess and care for women with PMH problems. DESIGN This mixed-methods review uses an innovative qualitative convergent design based on framework synthesis. DATA SOURCES Relevant electronic databases were searched for the period from January 2007-December 2016; 33 studies from nine countries met the inclusion criteria. REVIEW METHODS Study quality was assessed using critical appraisal tools. Study findings were mapped onto the five domains of the framework: knowledge, confidence, attitudes, illness perception and infrastructure. Findings were then synthesized for each domain. RESULTS All five domains are substantially represented in the literature, thus supporting the proposed framework. Several sub-domains and relationships between domains were identified. Varying levels of knowledge, confidence, attitudes and illness perceptions were found; evidence suggests that midwives benefit from further training within these domains. Features of organizational infrastructure act as barriers or facilitators to effective care; these need to be addressed at organizational level. CONCLUSION The proposed framework was confirmed and can be used to inform practice, policy and research.
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Affiliation(s)
- Franziska Wadephul
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | | | - Julie Jomeen
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Colin R Martin
- Institute for Clinical and Applied Health Research, Faculty of Health Sciences, University of Hull
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Lawson S, Sacks A. Pelvic Floor Physical Therapy and Women's Health Promotion. J Midwifery Womens Health 2018; 63:410-417. [PMID: 29778086 DOI: 10.1111/jmwh.12736] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 12/02/2017] [Accepted: 12/04/2017] [Indexed: 11/27/2022]
Abstract
Pelvic floor dysfunction is defined as abnormal function of the pelvic floor and includes conditions that can have significant adverse impacts on a woman's quality of life, including urinary incontinence (stress, urge, and mixed), fecal incontinence, pelvic organ prolapse, sexual dysfunction, diastasis recti abdominis, pelvic girdle pain, and chronic pain syndromes. Women's health care providers can screen for, identify, and treat pelvic floor dysfunction. This article examines the case of a woman with multiple pelvic-floor-related problems and presents the evidence for the use of pelvic floor physical therapy (PFPT) for pregnancy-related pelvic floor dysfunction. PFPT is an evidence-based, low-risk, and minimally invasive intervention, and women's health care providers can counsel women about the role that PFPT may play in the prevention, treatment, and/or management of pelvic floor dysfunction.
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Thackrah RD, Thompson SC, Durey A. Promoting women's health in remote Aboriginal settings: Midwifery students' insights for practice. Aust J Rural Health 2017; 23:327-31. [PMID: 26683714 DOI: 10.1111/ajr.12247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe midwifery students' insights on promoting health to Aboriginal women in remote Australia following a supervised clinical placement. DESIGN Semistructured, in-depth interviews were conducted with all midwifery students who undertook the placement between 2010 and 2013. SETTING Aboriginal communities on the Ngaanyatjarra Lands, Western Australia. PARTICIPANTS Undergraduate and postgraduate midwifery students from a Western Australian university. INTERVENTIONS Remote cultural immersion clinical placement. MAIN OUTCOME MEASURES Student learning related to culturally respectful health care delivery and promotion of health. RESULTS Students observed that, despite vast distances, high rates of participation in a breast screening program were achieved due to the informal provision of culturally relevant information and support. Opportunistic encounters in communities also enabled sexual health messages to be delivered more widely and in less formal settings. The role played by Aboriginal Health Workers and female family members was vital. The importance of culturally respectful approaches to sensitive women's business, including discretion, the use of local language and pictorial representations of information, was recognised as was the socio-cultural context and its impact on the health and well-being of the community. CONCLUSIONS Although short in duration, the Ngaanyatjarra Lands clinical placement provided midwifery students with a rare opportunity to observe the importance of local contexts and cultural protocols in Aboriginal communities, and to adapt health promotion strategies to meet local needs and ways of doing things. These strategies embraced the strengths, assets and capacities of communities, yet students also witnessed challenges associated with access, delivery and acceptance of health care in remote settings.
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Affiliation(s)
- Rosalie D Thackrah
- Western Australian Centre for Rural Health, University of Western Australia, Perth, Western Australia.,School of Dentistry, University of Western Australia, Perth, Western Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Perth, Western Australia
| | - Angela Durey
- Faculty of Health Sciences, Curtin University, Perth, Western Australia.,Centre for Aboriginal Studies, Curtin University, Perth, Western Australia
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Floyd BO, Brunk N. Utilizing Task Shifting to Increase Access to Maternal and Infant Health Interventions: A Case Study of Midwives for Haiti. J Midwifery Womens Health 2017; 61:103-11. [PMID: 26824199 DOI: 10.1111/jmwh.12396] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The shortage of health workers worldwide has been identified as a barrier to achieving targeted health goals. Task shifting has been recommended by the World Health Organization to increase access to trained and skilled birth attendants. One example of task shifting is the use of cadres of health care workers, such as nurses and auxiliary nurse-midwives, who can successfully deliver skilled care to women and infants in low-resource areas where women would otherwise lack access to critical health interventions during the childbearing years. Midwives for Haiti is an organization demonstrating the use of task shifting in its education program for auxiliary midwives. Graduates of the Midwives for Haiti education program are employed and working with women in hospitals, birth centers, and clinics across Haiti. This article reviews the Midwives for Haiti education program and presents successes and challenges in task shifting as a strategy to increase access to skilled maternal and newborn care and to meet international health goals to reduce maternal and infant mortality in a low-resource country.
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Abstract
INTRODUCTION There is a shortage of primary care providers in the United States. As more individuals obtain health insurance coverage with the Patient Protection and Affordable Care Act, the number seeking care will increase dramatically. Both the Institute of Medicine and the American College of Nurse-Midwives state that certified nurse-midwives and certified midwives should function at their full scope of practice, which includes primary care services as delineated by the Core Competencies for Basic Midwifery Practice. Nonetheless, the percentage of midwives who self-identify as primary care providers is decreasing. Dedicated primary care educational experiences may increase student confidence and encourage the incorporation of primary care into midwifery practice after graduation. METHODS Midwifery students in 2 cohorts completed questionnaires before and after a dedicated primary care practicum to study changes in the perceived level of confidence in primary care provision. The students in cohort A participated in 45 hours of primary care clinical time, whereas the students in cohort B participated in 88 hours of primary care clinical time. Postclinical focus groups provided qualitative data on student perceptions and attitudes about the clinical experience. Student responses were coded by cohort and analyzed using qualitative descriptive analysis. RESULTS Seventeen midwifery students from 2 cohorts completed questionnaires. Students in both cohorts reported increased perceived confidence in almost all primary care domains. DISCUSSION Participation in a dedicated primary care clinical rotation increased student-perceived confidence in primary care practice. The inclusion of designated primary care clinical education in nurse-midwifery education may contribute to meeting the national need for primary care providers. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
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Dyer JM, Latendresse G. Identifying and Addressing Problems for Student Progression in Midwifery Clinical Education. J Midwifery Womens Health 2016; 61:28-36. [PMID: 27880865 DOI: 10.1111/jmwh.12507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 11/26/2022]
Abstract
Identifying challenges to progression for a health care profession student who is not meeting expectations in a busy clinical practice can be challenging yet can lead to assisting the student toward success. Preceptor preparation includes acquiring knowledge about the student's education program, understanding federal regulations designed to protect students, gathering background information about a student, learning to provide feedback, structuring the clinical experience, and completing student evaluations. Students in health care professions may have difficulties with cognitive, affective, or psychomotor learning, and the clinical preceptor can identify problems for student progression within these learning domains. Subsequently, specific solutions that are tailored to the individual student's needs can be developed, implemented, and evaluated. A structured evaluation of the student's performance by the clinical preceptor, in accordance with the education program's parameters, is essential. Through a structured process, preceptors can assist many students to achieve success, in spite of challenges. This article describes how the preceptor can prepare, identify the type(s) of problem(s), and develop learning solutions for students who are experiencing difficulties in clinical settings.
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Gordon WM, McCarter SAU, Myers SJ. Incorporating Antiracism Coursework into a Cultural Competency Curriculum. J Midwifery Womens Health 2016; 61:721-725. [PMID: 27860251 DOI: 10.1111/jmwh.12552] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 12/01/2022]
Abstract
Creating a socially conscious educational environment is an imperative if health care practitioners are to have a significant impact on health inequities. The effects of practitioner bias, prejudice, and discrimination on health and health outcomes have been well documented in the literature. Individuals being trained to provide health care will be entering into an increasingly diverse world and must be equipped with the appropriate knowledge and skills in order to meet the needs of those seeking their care. Cultural competency training in medical education has evolved over the past 15 years since the Institute of Medicine's 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. As research on the effectiveness of this training has emerged, several authors have called for the integration of antiracism training into the cultural competency curriculum, but few have found effective ways of doing so. This article describes the approach of one midwifery program in order to inform clinical education programs across the spectrum of health care practitioners.
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Tyson H, Wilson-Mitchell K. Diversifying the Midwifery Workforce: Inclusivity, Culturally Sensitive Bridging, and Innovation. J Midwifery Womens Health 2016; 61:752-758. [PMID: 27860141 DOI: 10.1111/jmwh.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 08/23/2016] [Accepted: 08/28/2016] [Indexed: 11/29/2022]
Abstract
Midwifery educators and regulators in Canada have begun to address diversity, equity, and inclusion in admission processes and program curricula. Populations served by midwives value internationally educated midwives from their countries of origin. The International Midwifery Pre-Registration Program at Ryerson University in Toronto, Ontario, provides assessment, midwifery workplace orientation, and accelerated education for internationally educated midwives on behalf of the regulatory College of Midwives of Ontario. Between 2003 and 2015, midwives from 41 countries participated in the bridging program, and 214 (80%) successfully completed the program and qualified for licensure. Of these 214 graduates, 100% passed the Canadian Midwifery Registration Examination and 193 (90%) were employed full time as midwives within 4 months of graduation. The program curriculum enables the integration of these midwives into health care workplaces utilizing innovative approaches to assessment and competency enhancement. Critical to the bridging process are simulation-based practices to develop effective psychomotor learning, virtual and real primary care community placements, and coaching in empathetic, client-centered communication. Cultural sensitivity is embedded into the multiple assessment and learning modalities, and addresses relevant barriers faced by immigrant midwives in the workplace. Findings from the 13 years of the program may be applicable to increase diversity in other North American midwifery settings. This article describes the process, content, outcomes, and findings of the program. Midwifery educators and regulators may consider the utility of these approaches for their settings.
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Abstract
Eighteen identified motivations for attending a birth doula training workshop were ranked by 467 participants (466 females, 1 male) in 2010 and 2013. Participants selected a variety of reasons but only 30% chose to "become a professional doula" as their main reason. Another 20% wanted to "become a midwife." Remaining participants selected 16 other professional and personal motivations, such as "increase birth knowledge," "understand my own births," "make future births better," and "help women have better births (not as a professional)." One quarter had not attended a birth or had a child. Besides career training, these workshops are filling a cultural gap in childbirth education for people who are not expectant parents, and who intend to use this knowledge in unanticipated ways.
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Abstract
Scheduling interprofessional team-based activities for health sciences students who are geographically dispersed, with divergent and often competing schedules, can be challenging. The use of Web-based technologies such as 3-dimensional (3D) virtual learning environments in interprofessional education is a relatively new phenomenon, which offers promise in helping students come together in online teams when face-to-face encounters are not possible. The purpose of this article is to present the experience of a nurse-midwifery education program in a Southeastern US university in delivering Web-based interprofessional education for nurse-midwifery and third-year medical students utilizing the Virtual Community Clinic Learning Environment (VCCLE). The VCCLE is a 3D, Web-based, asynchronous, immersive clinic environment into which students enter to meet and interact with instructor-controlled virtual patient and virtual preceptor avatars and then move through a classic diagnostic sequence in arriving at a plan of care for women throughout the lifespan. By participating in the problem-based management of virtual patients within the VCCLE, students learn both clinical competencies and competencies for interprofessional collaborative practice, as described by the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
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Fernandes AR, Palombella A, Salfi J, Wainman B. Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students. Anat Sci Educ 2015; 8:305-16. [PMID: 25641912 DOI: 10.1002/ase.1517] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/12/2014] [Accepted: 12/22/2014] [Indexed: 05/25/2023]
Abstract
Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions.
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Affiliation(s)
- Alisha Rebecca Fernandes
- Faculty of Health Sciences, Department of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Palombella
- Faculty of Health Sciences, Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Jenn Salfi
- Faculty of Applied Health Sciences, Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | - Bruce Wainman
- Faculty of Health Sciences, Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Abstract
One of the challenges in teaching clinicians is helping health care provider students, including midwives, develop the critical thinking and clinical decision-making skills needed for various situations encountered in practice. Health care provider students need to master the required core knowledge and skills but also need to assess, analyze, judge, decide on action, act, and evaluate their actions. Lecture-heavy classroom teaching, which is usually delivered separately from clinical experiences in health care education, focuses on knowledge acquisition, often leaving knowledge application to trial and error. Case studies are commonly used by faculty with a problem-based learning approach, which is more analytic but sometimes static. The unfolding case study presents students with a patient scenario that changes over time and allows for discussion; lecture points as needed; and decision making as the situation or condition changes, reflecting what happens in real-life clinical practice. The use of the unfolding case study moves health care provider education from fact-based lecturing to situation-based discussion and decision making as a person's condition or situation changes. Use of the unfolding case facilitates collaborative learning, covers necessary content, and assists students to think beyond the facts and use their clinical imagination. Unfolding case studies require students to begin to grasp the nature of a clinical situation and adjust interventions as the clinical situation unfolds. Steps in developing and using an unfolding case study for midwifery students are presented, including 2 examples. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
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Abstract
Women's health care in the United States is at a critical juncture. There is increased demand for primary care providers, including women's health specialists such as certified nurse-midwives/certified midwives, women's health nurse practitioners, and obstetrician-gynecologists, yet shortages in numbers of these providers are expected. This deficit in the number of women's health care providers could have adverse consequences for women and their newborns when women have to travel long distances to access maternity health care. Online education using innovative technologies and evidence-based teaching and learning strategies have the potential to increase the number of health care providers in several disciplines, including midwifery. This article reviews 3 innovative uses of online platforms for midwifery education: virtual classrooms, unfolding case studies, and online return demonstrations of clinical skills. These examples of innovative teaching strategies can promote critical and creative thinking and enhance competence in skills. Their use in online education can help enhance the student experience. More students, including those who live in rural and underserved regions and who otherwise might be unable to attend a traditional onsite campus, are provided the opportunity to complete quality midwifery education through online programs, which in turn may help expand the women's health care provider workforce. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
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Thackrah RD, Thompson SC, Durey A. Exploring undergraduate midwifery students' readiness to deliver culturally secure care for pregnant and birthing Aboriginal women. BMC Med Educ 2015; 15:77. [PMID: 25885286 PMCID: PMC4428011 DOI: 10.1186/s12909-015-0360-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 03/30/2015] [Indexed: 05/19/2023]
Abstract
BACKGROUND Culturally secure health care settings enhance accessibility by Aboriginal Australians and improve their satisfaction with service delivery. A culturally secure health service recognises and responds to the legitimate cultural rights of the recipients of care. Focus is upon the health care system as well as the practice and behaviours of the individuals within it. In an attempt to produce culturally secure practitioners, the inclusion of Aboriginal content in health professional programs at Australian universities is now widespread. Studies of medical students have identified the positive impact of this content on knowledge and attitudes towards Aboriginal people but relatively little is known about the responses of students in other health professional education programs. This study explored undergraduate midwifery students' knowledge and attitudes towards Aboriginal people, and the impact of Aboriginal content in their program. METHODS The study surveyed 44 students who were in their first, second and third years of a direct entry, undergraduate midwifery program at a Western Australian (WA) university. The first year students were surveyed before and after completion of a compulsory Aboriginal health unit. Second and third year students who had already completed the unit were surveyed at the end of their academic year. RESULTS Pre- and post-unit responses revealed a positive shift in first year students' knowledge and attitudes towards Aboriginal people and evidence that teaching in the unit was largely responsible for this shift. A comparison of post-unit responses with those from students in subsequent years of their program revealed a significant decline in knowledge about Aboriginal issues, attitudes towards Aboriginal people and the influence of the unit on their views. Despite this, all students indicated a strong interest in more clinical exposure to Aboriginal settings. CONCLUSIONS The inclusion of a unit on Aboriginal health in an undergraduate midwifery program has been shown to enhance knowledge and shift attitudes towards Aboriginal people in a positive direction. These gains may not be sustained, however, without vertical integration of content and reinforcement throughout the program. Additional midwifery-specific Aboriginal content related to pregnancy and birthing, and recognition of strong student interest in clinical placements in Aboriginal settings provide opportunities for future curriculum development.
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Affiliation(s)
- Rosalie D Thackrah
- Western Australian Centre for Rural Health, University of Western Australia, Perth, Western Australia, Australia.
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Perth, Western Australia, Australia.
| | - Angela Durey
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia.
- Centre for Aboriginal Studies, Curtin University, Perth, Western Australia, Australia.
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