Collective action for the development of national standards for midwifery education in Australia

This article describes a sequence of events that led to the development of national standards for the accreditation of Australian midwifery education programmes for initial registration. This process occurred within a climate of polarised opinions about the value of the introduction of three-year degree programmes for midwives who are not nurses (known as the BMid in Australia) and concerns about the invisibility of midwifery within nursing regulation, education, policy and nomenclature.Concerted efforts to develop standards to inform the introduction of BMid programmes through a process of collective action are described. This involved arguing successfully for the positioning of midwifery as a separate profession from nursing, with a need for its own discreet regulation.     

A historical narrative of the development of midwifery education in Indonesia

AimTo describe the history of midwifery education, present the current education programmes and explore the ways that have been undertaken to advance the midwifery profession in Indonesia.MethodsHistorical and contemporary government documents were reviewed.FindingsThe history of midwifery education in Indonesia shows a complex picture during and since colonisation with government, education institutes and association proposing different ways in which midwives were to be educated. Advocacy from the midwifery profession in Indonesia meant increasingly it is midwives who are determining how midwifery education is provided. Recent initiatives have resulted in a diploma, advanced diploma, bachelor’s degree, and a master’s degree in midwifery. The work of the midwifery profession advocating for midwifery education culminated in the Midwifery Act 2019. These changes in this Act will ensure that midwifery education meets the needs of women and their families but also lead to competent midwives who have the knowledge and skills to provide midwifery services at all levels of health provision. The history of midwifery in Indonesia illustrates the importance of the ICM pillars of association, regulation, and education.ConclusionThe history of midwifery education in Indonesia shows that for too long midwifery education was decided, determined and even regulated by authorities and disciplines other than midwifery. However, when the midwifery association and regulation inform and regulate midwifery education then there is an opportunity to provide care that will make a difference in outcomes for women and their families. The historical analysis of the story of Indonesia midwifery gives insight into what is required for quality education.     

Acknowledging the primacy of continuity of care experiences in midwifery education

BackgroundContinuity of midwifery care is the best maternity care model for women at any risk level, and there is a global imperative to improve access to midwifery-led care. However, diverse perspectives about how best to prepare graduates for working in midwifery continuity of care models persist. The continuity of care experience standard in Australia was anticipated to address this.AimTo challenge the dearth of published information about the structures and processes in midwifery education programs by identifying: the educational value and pedagogical intent of the continuity of care experience; issues with the implementation, completion and assessment of learning associated with continuity of care experience; and discuss curriculum models that facilitate optimal learning outcomes associated with this experience. We discuss the primacy of continuity of care experience in midwifery education programs in Australia.DiscussionThe inclusion of continuity of care experience in midwifery programs in Australia became mandatory in 2010 requiring 20, however this number was reduced to 10 in 2014. Research has shown the beneficial outcomes of continuity of care experience to both students and women. Continuity of care experience builds mutual support and nurturing between women and students, fosters clinical confidence, resilience, and influences career goals. We require curriculum coherence with both structural and conceptual elements focusing on continuity of care experience.Implications and recommendationsEducation standards that preference continuity of care experience as the optimal clinical education model with measurable learning outcomes, and alignment to a whole of program philosophy and program learning outcomes is required.     

Simulation based learning in midwifery education: a systematic review

AimTo critically examine the evidence for simulation based learning in midwifery education.BackgroundSimulated Learning Programs (SLPs) using low to high fidelity techniques are common in obstetric professionals’ education and focus on the development of team work, labour and obstetric emergencies.Review methodsA systematic review incorporating critical appraisal approaches, setting clear objectives and a defined search and analysis strategy. Evidence from obstetrics, neonatology, technical and non-technical skills (teamwork) was included where it informed the development of midwifery curricula. Studies in English from 2000 to 2010 were included searching CINAHL Plus, OVID Medline, Cochrane, SCOPUS and ProQuest and Google Scholar.ResultsTwenty-four papers were identified that met the inclusion criteria. All were quantitative reports; outcomes and levels of evidence varied with two notable papers indicating that simulation had an impact on clinical practice. Benefits of SLP over didactic formats were apparent, as were the development of non-technical skills confidence and competence. The study outcomes were limited by the range of evidence and context of the reports which focussed on obstetric emergency training using a number of simulation techniques.ConclusionThere is evidence that simulated learning of midwifery skills is beneficial. Simulation learning has an educational and clinical impact and advantages over didactic approaches. Where clinical practice is infrequent i.e. obstetric emergencies, simulation is an essential component of curricula. Simulation enhances practice and therefore may reduce the time taken to achieve competence; however there is no evidence from the literature that simulation should replace clinical practice.     

性教育该走向何方

本文通过对家庭、学校、社会在性教育中所扮演角色的论述 ,提出 :一、家庭是性教育的基本场所 ;二、学校是性教育的主要承担者 ;三、社会是性教育的天然课堂。本文对我国性教育的目的、功能、内容及作用作了深刻的分析 ,指出在我国开展及时、正确的性教育的重要性 ,探询适合我国国情的性教育途径     

A global review of the inferred meaning of woman centred care within midwifery professional standards

BackgroundAs an integral and guiding approach, woman centred care is well-grounded as the cornerstone of midwifery training and practice. A previous global review established that the concept, even though acknowledged as pivotal, has limited attention within the professional standards documents that underpin the discipline [1]. Whilst not detracting from the overall importance of woman centred care, it is further suggested that a broader meaning is generally being implied.ObjectiveWhether other related inferences and meanings of the actual term ‘woman centred care’ are also being utilised, has not yet been established. Therefore, this review of professional documents sought to investigate the occurrence of further depictions of the concept.MethodsWith an implied and inferred meaning of ‘woman centred care’ as the focus, a review and synthesis of narrative from a global sample of midwifery professional standards was conducted. The principles of meta-ethnography were utilised to develop a qualitative approach. Rather than the actual words ‘woman centred care’ further phrases implying or inferring the concept were sought. ‘A priori’ phrases were developed and narrative and examples were synthesised for each.FindingsStandards and governance documents were located from within Australia, the United Kingdom and New Zealand and a further 139 nations. Overall, the seven phrases, each considered as an inference to woman centred care, were all substantiated. As a proportion of all documents, these were collated with the outcomes being a woman’s right to choice (89%), being culturally sensitive (80.5%), a woman’s voice and right to be heard (78%), the woman as an individual (68%), universal human rights (40%), being holistic (39%) and being self-determined (17.5%).ConclusionThe outcomes of this review demonstrate that woman centred care may be a multidimensional concept. There were occurrences of all seven phrases across a broad scope of global professional midwifery documents, and each can be shown through its meaning to contribute something to an understanding of woman centred care. The creation of a universal meaning is recommended.     

Native American population at contact: discursive strategies and standards of proof in the debate

The author reviews the literature on the estimation of population size in the Americas at the time of European contact in the late fifteenth century.     

Examining the transformation of midwifery education in Australia to inform future directions: An integrative review

BackgroundIntegral to quality midwifery practice is the education of midwives. Like other countries, Australia faces ongoing challenges in delivering midwifery education programs. Reasons include escalating program costs, challenges in securing meaningful clinical experiences, subsumption of midwifery with nursing, and associated loss of identity in some institutions.AimTo critically examine the literature exploring the historical and current drivers, supports and impediments for entry-to-practice midwifery programs to identify strategies to strengthen midwifery education in Australia.MethodsA structured integrative literature review using Whittemore and Knafl’s five-stage framework was undertaken; 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation of results.FindingsThe literature search identified 50 articles for inclusion. The thematic analysis identified four key themes: i. a commitment to educational reform, ii. building a midwifery workforce, iii. quality maternity care through midwifery education, and iv. progressing excellence in midwifery education.DiscussionExtensive literature describes the evolution of midwifery education in Australia over the last 30 years. Through collaboration and amidst opposition, quality midwifery education has been established in Australia. Identification of midwifery as a distinct profession and transformative leadership have been integral to this evolution and must be grown and sustained to prevent a decline in standards or quality.ConclusionThere is a need to address priorities in midwifery education and for the evaluation of midwifery programs and pedagogy. The provision and maintenance of quality education and practice require shared responsibility between education providers and health care services.