The Collaboration for Maternal and Newborn Health: Interprofessional Maternity Care Education for Medical, Midwifery, and Nursing Students

The Collaboration for Maternal and Newborn Health, a multidisciplinary group of maternity care providers from the University of British Columbia (UBC), received funding from Health Canada to develop interprofessional education programs for health care students. Medical, midwifery, and nursing students from UBC were invited to participate in the three programs described in this article. The Interprofessional Student Doula Support Program, a year‐long program for 15 students, combines classroom learning about marginalized women with on‐call doula support to attend births. The Interprofessional Normal Labour and Birth Workshop is a 5‐hour event, comprised of lectures and hands‐on stations about normal labour, birth, and the immediate postpartum period. The Maternity Care Club Hands‐on Night occurs twice a year, and students gather to practice at maternity care stations in a casual setting. A total of 467 participants over 3 years completed evaluations of their experiences. Students rate these programs very highly in terms of benefits of multidisciplinary collaboration. Providing students with opportunities to engage with other health care disciplines enhances interest in the professions of maternity care and the benefits of collaboration.     

Obstetrics and Gynecology Residencies: Education in Preventive and Primary Health Care for Women

Objective: To test the hypothesis that the Residency Review Committee program requirements for obstetrics and gynecology residencies, when properly followed, will result in residents being educated in preventive and primary ambulatory health care for women during their residency training program as specialists in obstetrics and gynecology.Methods: The 60 requisite residency training competencies identified as essential to educate generalist physicians, and viewed by some educators as a benchmarking standard, each were evaluated to determine whether residents in obstetrics and gynecology are now being educated in each of these areas. The answer was considered affirmative if any of the following pertained: 1) the Residency Review Committee program requirements indicate that the competency “must” or “should” be taught, 2) the Residency Review Committee requests numerical verification related to the competency on the accreditation review application, or 3) by virtue of a specific rotation required by the Residency Review Committee it can be assumed that the resident will be educated in the competency. To make our assessment, we identified and listed the section of the Residency Review Committee for Obstetrics-Gynecology program requirements, which, when properly followed, would result in education in the particular competency.Results: Fifty-seven of the 60 competencies were considered applicable to obstetrician-gynecologists (care of infants, care of children, and infant/child preventive care were not), and residents in obstetrics and gynecology were found to be educated in 54 (95%).Conclusion: During their residency training programs as specialists in obstetrics and gynecology, residents are being educated to be able to be providers of preventive and ambulatory primary health care for women.     

The Effect of Interprofessional Student-Led Reproductive Health Education on Youths in Juvenile Detention

Study Objective

To assess the effects of an interprofessional student-led comprehensive sexual education curriculum in improving the reproductive health literacy among at-risk youths in detention.

A Planning Checklist for Interprofessional Consultations for Women in Midwifery Care

Team‐based, interprofessional models of maternity care can allow women to receive personalized care based on their health needs and personal preferences. However, involvement of multiple health care providers can fragment care and increase communication errors, which are a major cause of preventable maternal morbidity and mortality. In order to improve communication within one health system, a community‐engaged approach was used to develop a planning checklist for the care of women who began care with midwives but developed risks for poor perinatal outcomes. The planning checklist was constructed using feedback from women, nurses, midwives, and physicians in one interprofessional, collaborative network. In feasibility testing during 50 collaborative visits, the planning checklist provided a prompt to generate a comprehensive plan for maternity care and elucidate the rationale for interventions to women and future health care providers. In interviews after implementation of the checklist within a new collaborative format of prenatal physician consultations, women were pleased with the information received, and nurses, midwives, and physicians were positive about improved communication. This tool, developed with stakeholder input, was easy to implement and qualitatively beneficial to satisfaction and health system function. This article details the creation, implementation, and qualitative evaluation of the planning checklist. The checklist is provided and can be modified to meet the needs of other health systems.     

MIDWIFERY IN THE 21ST CENTURY: Recommendations from the Pew Health Professions Commission/UCSF Center for the Health Professions 1998 Taskforce on Midwifery*

Unprecedented changes in the delivery and financing of health care have produced angst and opportunity, criticism, and innovation. To explore the effects of these market-driven changes on midwifery, the University of California at San Francisco Center for the Health Professions convened a Taskforce on Midwifery in 1998. Consisting of eight experts from across the country, the Taskforce was charged with exploring the impact of health care system developments on midwifery, and identifying issues facing the profession and the roles midwives play in women's health care. The Taskforce answered its charge by offering 14 recommendations related to midwifery practice, regulation, education, research, and policy. The recommendations incorporate the Taskforce vision that the midwifery model of care should be embraced by, and incorporated into, the health care system in order to make it available to all women and their families. Midwives, educators, collaborators, and policymakers can use the recommendations to develop curricula, practice sites, and laws for an improved health care system that fully includes midwives and encompasses the midwifery model of care. J Nurse Midwifery 1999;44:341–8 © 1999 by the American College of Nurse-Midwives.     

SYMPTEK Homemade Foam Models for Client Education and Emergency Obstetric Care Skills Training in Low-resource Settings

Clinical training for health care workers using anatomical models and simulation has become an established norm. A major requirement for this approach is the availability of lifelike training models or simulators for skills practice. Manufactured sophisticated human models such as the resuscitation neonatal dolls, the Zoë gynaecologic simulator, and other pelvic models are very expensive, and are beyond the budgets of many training programs or activities in low-resource countries. Clinical training programs in many low-resource countries suffer greatly because of this cost limitation. Yet it is also in these same poor countries that the need for skilled human resources in reproductive health is greatest.The SYMPTEK homemade models were developed in response to the need for cheaper, more readily available humanistic models for training in emergency obstetric skills and also for client education. With minimal training, a variety of cheap SYMPTEK models can easily be made, by both trainees and facilitators, from high-density latex foam material commonly used for furnishings. The models are reusable, durable, portable, and easily maintained. The uses, advantages, disadvantages, and development of the SYMPTEK foam models are described in this article.     

Incorporating an Equity Agenda into Health Professions Education and Training to Build a More Representative Workforce

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.     

Health Care in the 1990s: Changes in Health Care Delivery Models for Survival

Changes in the health care environment are causing health care providers to review and re-engineer the provision of perinatal and women's health care. Expanded programs need to be developed using alternative levels of care. Employers, payers, and providers have a unique opportunity to band together in effecting changes in care from the traditional illness model to a more current wellness/health promotion/prevention model. New areas to explore include life care partners/case managers and virtual health management.     

Health Care for Women

To provide optimum care to women, nurses need to understand some of the social, historical, and political factors that have influenced women and women's health care. Nurses, as consumers and providers of health care, play a central role in the women's health-care movement by providing education, support, and counseling. Although educational topics are vital, even more important is the way nurses communicate caring, support the woman in decision making, and mobilize available support persons. To provide women's health care, nurses must first do a nursing assessment, which involves gathering physiological, psychosocial, and cognitive data. A sample women's health-care assessment is outlined.     

An Academic Midwifery Fellowship: Addressing a Need for Junior Faculty Development and Interprofessional Education

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.     

Midwifery in the 21st century. Recommendations from the Pew Health Professions Commission/UCSF Center for the Health Professions 1998 Taskforce on Midwifery.

Unprecedented changes in the delivery and financing of health care have produced angst and opportunity, criticism, and innovation. To explore the effects of these market-driven changes on midwifery, the University of California at San Francisco Center for the Health Professions convened a Taskforce on Midwifery in 1998. Consisting of eight experts from across the country, the Taskforce was charged with exploring the impact of health care system developments on midwifery, and identifying issues facing the profession and the roles midwives play in women's health care. The Taskforce answered its charge by offering 14 recommendations related to midwifery practice, regulation, education, research, and policy. The recommendations incorporate the Taskforce vision that the midwifery model of care should be embraced by, and incorporated into, the health care system in order to make it available to all women and their families. Midwives, educators, collaborators, and policymakers can use the recommendations to develop curricula, practice sites, and laws for an improved health care system that fully includes midwives and encompasses the midwifery model of care.     

HOME BIRTH AND SHORT-STAY DELIVERY: Lessons in Health Care Financing for Providers of Health Care for Women

The current restructuring of the U.S. health care delivery system is driven primarily by economic forces. Although primary care providers may understand the roles of technology and advocacy in fostering fundamental change, they may not be familiar with the issues related to financing of health care and, thus, may not fully appreciate the extent to which economic factors influence the character of their professional lives and the services they provide. Analysis of the loss of the home birth option in the 1950s provides a method for understanding and influencing the factors driving health care restructuring today. In examining short-stay delivery in the 1990s, this article also addresses ways in which managed health care systems may improve or restrict women's access to a variety of primary care services.     

A Framework for Web‐Based Interprofessional Education for Midwifery and Medical Students

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.