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How well does pre-service education prepare midwives for practice: competence assessment of midwifery students at the point of graduation in Ethiopia.

Yigzaw T, Ayalew F, Kim YM, Gelagay M, Dejene D, Gibson H, Teshome A, Broerse J, Stekelenburg J - BMC Med Educ (2015)

Bottom Line: However, the extent to which graduating students acquire core competencies for safe and effective practice is not known.Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores.The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems.

View Article: PubMed Central - PubMed

Affiliation: Jhpiego, Addis Ababa, Ethiopia. tegbar.yigzaw@jhpiego.org.

ABSTRACT

Background: Midwifery support and care led by midwives is the most appropriate strategy to improve maternal and newborn health. The Government of Ethiopia has recently improved the availability of midwives by scaling up pre-service education. However, the extent to which graduating students acquire core competencies for safe and effective practice is not known. The purpose of this study was to evaluate the quality of midwifery education by assessing the competence of graduating midwifery students.

Methods: We conducted a cross-sectional study to assess the competence of students who completed basic midwifery education in Ethiopia in 2013. We interviewed students to obtain their perceptions of the sufficiency and quality of teachers and educational resources and processes. We assessed achievement of essential midwifery competencies through direct observation, using a 10-station Objective Structured Clinical Examination (OSCE). We calculated average percentage scores of performance for each station and an average summary score for all stations. Chi-square test, independent sample t test, and linear regression analysis were used to assess the statistical significance of differences and associations.

Results: We assessed 484 graduating students from 25 public training institutions. Majority of students rated the learning environment unfavorably on 8 out of 10 questions. Only 32 % of students managed 20 or more births during training, and just 6 % managed 40 or more births. Students' overall average competence score was 51.8 %; scores ranged from 32.2 % for manual vacuum aspiration to 69.4 % for active management of the third stage of labor. Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores.

Conclusions: The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems. In-service training and mentoring to fill competence gaps of new graduates is also essential.

No MeSH data available.


Related in: MedlinePlus

Percent of study participants who met minimum national and global requirements for the number of births attended during midwifery education
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Fig1: Percent of study participants who met minimum national and global requirements for the number of births attended during midwifery education

Mentions: Only 32 % of all students had attended 20 or more births (a national standard) and a much smaller 6 % had attended 40 or more births under supervision. University students were almost twice as likely as TVET students to meet the national standard of assisting at least 20 births (45.3 and 26.2 %, respectively, Pearson chi-square =17.18, degree of freedom = 1, p < 0.001) (Fig. 1). Likewise, post-basic TVET students were more than three times as likely as direct entry TVET students to meet the national standard (48.4 and 13.8 %, respectively, Pearson chi-square = 48.5, degree of freedom = 1, p < 0.001). The median number of births attended by study participants was 11; and 20 students (4.1 %) did not report attending even a single delivery during training.Fig. 1


How well does pre-service education prepare midwives for practice: competence assessment of midwifery students at the point of graduation in Ethiopia.

Yigzaw T, Ayalew F, Kim YM, Gelagay M, Dejene D, Gibson H, Teshome A, Broerse J, Stekelenburg J - BMC Med Educ (2015)

Percent of study participants who met minimum national and global requirements for the number of births attended during midwifery education
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4536794&req=5

Fig1: Percent of study participants who met minimum national and global requirements for the number of births attended during midwifery education
Mentions: Only 32 % of all students had attended 20 or more births (a national standard) and a much smaller 6 % had attended 40 or more births under supervision. University students were almost twice as likely as TVET students to meet the national standard of assisting at least 20 births (45.3 and 26.2 %, respectively, Pearson chi-square =17.18, degree of freedom = 1, p < 0.001) (Fig. 1). Likewise, post-basic TVET students were more than three times as likely as direct entry TVET students to meet the national standard (48.4 and 13.8 %, respectively, Pearson chi-square = 48.5, degree of freedom = 1, p < 0.001). The median number of births attended by study participants was 11; and 20 students (4.1 %) did not report attending even a single delivery during training.Fig. 1

Bottom Line: However, the extent to which graduating students acquire core competencies for safe and effective practice is not known.Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores.The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems.

View Article: PubMed Central - PubMed

Affiliation: Jhpiego, Addis Ababa, Ethiopia. tegbar.yigzaw@jhpiego.org.

ABSTRACT

Background: Midwifery support and care led by midwives is the most appropriate strategy to improve maternal and newborn health. The Government of Ethiopia has recently improved the availability of midwives by scaling up pre-service education. However, the extent to which graduating students acquire core competencies for safe and effective practice is not known. The purpose of this study was to evaluate the quality of midwifery education by assessing the competence of graduating midwifery students.

Methods: We conducted a cross-sectional study to assess the competence of students who completed basic midwifery education in Ethiopia in 2013. We interviewed students to obtain their perceptions of the sufficiency and quality of teachers and educational resources and processes. We assessed achievement of essential midwifery competencies through direct observation, using a 10-station Objective Structured Clinical Examination (OSCE). We calculated average percentage scores of performance for each station and an average summary score for all stations. Chi-square test, independent sample t test, and linear regression analysis were used to assess the statistical significance of differences and associations.

Results: We assessed 484 graduating students from 25 public training institutions. Majority of students rated the learning environment unfavorably on 8 out of 10 questions. Only 32 % of students managed 20 or more births during training, and just 6 % managed 40 or more births. Students' overall average competence score was 51.8 %; scores ranged from 32.2 % for manual vacuum aspiration to 69.4 % for active management of the third stage of labor. Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores.

Conclusions: The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems. In-service training and mentoring to fill competence gaps of new graduates is also essential.

No MeSH data available.


Related in: MedlinePlus