Back 17 June 2013

Workshop on Education

The Global Standards of Midwifery Education have been disseminated widely in the past few years and have helped improve and/or develop midwifery curricula all over the world. This week, in a three day workshop facilitated by Joyce Thompson, educator and co-developer of the standards, ICM staff will share best practices of implementation, challenges and ways of improvement. Topics include: Curriculum analysis: how to review and evaluate a midwifery education curriculum; How to support the development of a competency based curriculum in a country specific setting; Application and use of Model Curriculum Outlines; and continuing professional education for midwives. 

First Day

Joyce started the workshop explaining the differences between competency based curricula and competency based education that she had observed in Latin America. It is important to distinguish competency-based education from the ICM Essential Competencies for Basic Midwifery Practice that form the core content of any midwifery education program. That is, the ICM competencies are “what is to be taught, learned, and demonstrated” and the Competency-Based Education (CBE) is “how one teaches, learns and assesses” the demonstration of the ICM competencies.

During her work of updating the standards and guidelines in the field, Joyce says that if she learned one thing it was that: “education means nothing if you don’t have enabling regulation to practice as a midwife”. She learned this lesson from a country, where the government and nurses had successfully developed a curriculum for midwives but couldn’t offer the first class of midwife graduates any employment because the law didn’t allow them to practice as midwives. Many of those midwives had to go back to nursing, instead of developing their skills in midwifery such as for example decision-making. “Decision-making is a difficult concept to teach, and that’s why curricula should include critical thinking, clinical reasoning and midwife care process”. One method to ensure that such crucial concepts are taught, is to analyze curricula. Dr. Judith Fullerton has developed the curricula concordance map that allows to map out the ICM competencies that are being taught by each course, and it has been used in Latin America to offer feedback to countries wanting to initiate or upgrade midwifery education.

Second Day

On the second day of the workshop questions around how to support the development of a competency based curriculum were adressed with country specific examples. Joyce recommended to remember what women want as it is these needs that a midwife follows and therefore, midwives should be taught and subsequently develop competencies that address these needs: 

  • Listening to the woman
  • Respecting the woman
  • Looking at the woman instead of hiding behind paperwork
  • Help the woman understand what's happening with her 
  • Encourage the woman
  • Be competent 

All of these competencies need to be developed through education, which is why they are all included in the Model Curriculum Outlines for Professional Midwifery Education

In the afternoon, questions on continuing education for midwives were discussed. Who is responsible for the continuing education of midwives? Should it be the employer or the employee (the midwife). What is the role of professional associations and could a strategy for continued professional development be designed? What are the financial implications of such professional development and what is the content of such a training? The questions were raised and much experience has been shared on the challenges such as expected payment and difficulties of funding with examples from African and Latin American countries. However, the discussion will continue on the third day of the workshop.

Third Day

The conversation on continuing education (CE) continued. "Much CE exist on high risk skills, but not much on competencies in normal care", said Joyce drawing on her rich experience. The workshop participants mused over potential solutions to find a way that member associations could be supported in setting up their own CE. As many associations have their own system of CE in place, an interesting option would be twinning, preferrably in the South-South direction. Those already with a CE system in place could support others, who have not yet set-up a CE.

In general, the take home message of all three days is the big task on how to strengthen midwifery across the world using a variety of strategies such as the ICM core documents, the position statements, twinning programmes, the expertise of midwive association and staff and volunteers supporting each other. "Only together can we move the work of ICM forward and strengthen midwives and midwifery globally", concluded Joyce. 

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