della - standard for mw education for eb midwifery_ day 2
TRANSCRIPT
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Education Standard for Midwifery:
to ensure midwifery educationleads to Midwives who are Fit-For-
Purpose?
Della R Sherratt, Int. Midwifery Consultant
IMA International Midwifery Conference, Jakarta, Indonesia
8thOct 2!" #Day $2%
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Presentation Outline
4 Parts:
Part 1: Definitions: what do we mean by standard Standard setting process
Where is the responsibility for setting standards for midwiferyeducation
Part 2:What are the essential components necessary for competent
midwives
Part 3:!lobal "ompetencies # standards for Midwifery $ducators
Part 4:Midwifery $ducation in %ndonesia & using the global competencies
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Part 1:Definitions
Words can be very confusing at times '''''' and their
meaning change over time and place and how they are used
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Standard As used in quality assurance !A"wor#:
a level of (uality) achievement)etc*) that is consideredacceptable or desirable
something that is very good andthat is used to ma+e ,udgmentsabout the (uality of other things
standards: ideas about morallycorrect and acceptable behaviour
-http:##www*merriam.webster*com#dictionary#standard/
As a noun:soðin' considered (y an
authority or (y 'eneral consent
as a (asis of co&)arison* an
a))ro+ed &odel. an o(ect that
is re'arded as the usual or
&ost co&&on si-e or for& of
its kind
As an ad$ecti%e
0sed or accepted as normal or
average
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"ompetence +ersus "ompetencies
1he concept of competence and the lin+s between competence) competencies and performance andthe (uality of services are now well established*
&o'petenceis lin+ed to the combination
of the #nowled(e andpsyc)o'otor*co''unication and
decision-'a#in( s+ills thatenable an individual to
perform a specific tas+ to a
defined level of proficiency
&o'petencies Competencies arethe broad
set or combination ofcomplementary knowledge,skills and abilities/behaviours that arerequired (or enable aperson) to perform afunctionwith proficiency.
so&eti&es referred to as core competencies
For a more detailed discussion on competence, competency and thediference between competence and competencies see Fullerton et al.,
2011
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&o'petency +,o'ain
"ompetencies for anyprofessional group are made upof many indi%idualco'ponents) such as a set of
practical psychomotor skills,scientific, professional andbehavioural knowledge,professional behaviours,personal attributes, as wellas critical thinkin', decision$&akin' and ud'e&ent skills.
23: we used to say a competency was madeup of the 0nowled'e skills andattitudes10SA...#and so&eti&ese)erience%, but now more often usepersonal attributes in place ofattitude4*
Domain 5 sub,ect matter
an area of activity considered as
belonging to or controlled by a
particular person or group-macmillaindictionary*com/
6 specified sphere of activity or +nowledge-o7forddictionaries*com/
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Fit-for-Purpose
6 3fit$for$)ur)ose curriculu&4is onewhere the inputs) processes andoutcomes are based on what+nowledge) s+ills) attitudes#
behaviours and e7periences areneeded to proficiently practiceaccording to the defined scope ofpractice 8or standards4 within theprevailing conte7t#country where theprogramme is being developed
WHO 2014, Adaptatio
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Standard Settin(Process
GatherEvidence
Reviewevidence and
Agreestatement(s
Implementation (include
how andwhen toAudit)
MonitorImplementat
ion
Auditongoing
periodically and attime span
Dynamic
Practical
"ost effective
$vidence.based
Standards must be SM691 '*Must 90M36''*
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Source: UH Bristol, Clin
Team, 2009
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Part "omponents of standards needed to ensure competent
midwives at the end of tier programme''''
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.)at Action is /eeded for &reation of ProfessionalMidwife cadre ?
EmpoweredRespected by health service mangers,OG!s, other members o" the team
#ommunity Recognition andpartnership
$ave a %oice (lobby, Advocacy,development o" the &ro"ession,mar'eting )
eployment (repro*le wor'new posts, "unctions, +ob e
$R$wor'"orce planning) -upportive -upervision Retention (including career p .unctionality / supplies, e0u Re"erral system # 1 A -ervice provision (M an
AAA)
.it "or purpose curriculum (musensure competency to "unction per"orm well / 2,-,A 3E)
#ompetent "aculty (pedagogy aclinical, need mentorship)
41A education institution and
process, (including clinical pracsites)
create posts "or M5s /allevels o" $-
; 0i()t to enter education pro(ra''eentry standards"
; 0i()t to Practice 0e(istrationlicence* process 'ust testco'petency"
; Scope of Practice* w)at t)ey can do
; Standards for education pro(ra''esincludin( accreditation of nstitution faculty and pro(ra''es"
; Standards of Practice
; Maintainin( ri()t to practice
; ,isciplinary and 0e'o%al of ri()t topractice
0e(ulation icencin( Education
5ealt)Syste'
Professional
dentityet)ic" Association
Policy Strate(yStrate(ic
,irections
/ational Plan#&ana'e&ent of chan'e%
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Evidence-based
Planning
(Action Plan)
Production of Midwi%es needs 'ore t)an a curriculu' 67
faculty
Competent Midwife to
promote and protect good
RMNH (life span) and save
lives of mothers newborns
!"pportive !"pervision
(#"alit$)
Monitoring
Eval"ation
(Acceptabilit$
%"alit$)
Political Commitment
towards Access
for All(Access)
E'"it$ Approach
o Reach All
(Affordabilit$)
!tewardship Reso"rce
Mobili*ation management
(incl"ding HRH+ Plan)
Enabling environment
Enabling
Reg"lator$
Environment
(Acco"ntabilit$)
Competenc$-based
#"alit$ Ed"cation
,n-service
programmes (#A)(curriculum, faculty, T & L
materials Clinical sites)
UNFPA, I!, "#$ 200%ommunity' (essons (e
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17 8ut quality 'idwifery education does need:
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Part 3!lobal Standards for Midwifery Educators ''''' 8Pashtoonwill loo+ at other elements '''''**4
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!lobal
"ompetencies for
Midwifery
$ducators 8>
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WHO 2014, p9
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@ow do !lobal "ompetencies differ from %"M
Standards for Midwifery $ducation
&M 9 standards 8A BCadditional statements4
Standard : r(anisation Ad'inistration 9"
Standard : Midwifery Faculty ; < ;su="
Standard : &urriculu' 9 < 4"
Standard : 0esources* facilitiesand ser%ices @"
Standard : Assess'ent strate(ies@"
.5 lo=al &o'petenciesarran(ed under ; ,o'ains wit)1B co'petency state'ents
,o'ain 1: $thical Eegal principles
,o'ain: Midwifery Practice
,o'ain 3: 1heoretical learning
,o'ain 4:Eearning in the clinical are
,o'ain @: 6ssessments $valuation ofstudents and programmes
,o'ain 9: OrganiFation) Management Eeadership
,o'ain >: "ommunication) leadership 6dvocacy
,o'ain ;: 9esearch
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$7amples'''**%"M Standards
Standard 8%%4 : Midwifery Gaculty
* a4 1he midwife teacher has formalpreparation in midwifery*
%%**( 5he &idwife teacher de&onstratesco&)etency in &idwifery )ractice, 'enerallyacco&)lished with two #2% years full sco)e
)ractice.
II.2.c 5he &idwife teacher holds a currentlicense6re'istration or other for& of le'al
reco'nition to )ractice &idwifery.II.2.d 5he &idwife teacher has for&al
)re)aration for teachin', or undertakes such)re)aration as a condition of continuin' tohold the )osition on co&)letion.
II.2.e 5he &idwife teacher &aintainsco&)etence in &idwifery )ractice andeducation*
!lobal "ompetencies
Midwifery $ducators
Midwifery educators maintain current+nowledge and s+ills in midwifery
theory and practice based on the bestevidence available7
&o'petency C3:Maintaincompetence in midwifery practice*
&o'petency C 4: Practise midwiferyin ways that reflect evidence.based
and up.to.date +nowledge*
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!lobal
"ompetencies
What H) S andbehaviours are re(uiredfor competency I= andI?
"an be used to develop
an assessment tool toidentify if e7isting#new midwife teacherhas what is needed tofunction as re(uired
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Fro' lo=al toocal 66667
7O has de+elo)ed an Ada)tation 9uide to
assist the )rocess with 'uidance and
)ractical ti)s and alternati+es
9efer slide J
even if you are basing your standardon national 8or !lobal4 some wor+ is
needed to ma+e them SM691
Who needs to be involved "onsultedwith %nformed
What 6dvocacy is needed
0e'e'=er:Action without a :lan islikely to stay only a day drea&
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%mplementing the standard'**
"ore "ompetencies
2ew 1eachers
$7isting 1eachers
!ap 6nalysis
Prepare effective "3 updates
DonKt forget to monitor and
evaluate
Many tools on the mar+et to assit
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.al#in( wit) Mrs D
8oard a'eBased on original game Why did Mrs X Die
in WHO Safe Motherhood Module:
Foundation Module - Midwife in the Community
rodu!ed By
Hands on For Mothers and Ba"ies
#&akers of new #realiti+ly% ;7hy Did Mrs < Die Retold= +ideo6d+d%
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Designed to "e #layed as a stand alone game "y interested grou#sindi$iduals to learn more a"out safe motherhood and the "arriers fawomen around the world %u# to &or ' #layers in ea!h grou#(
r as part of a ed"cation programme %training module designedas #art of WHO Safe Motherhood Module( for midwi$es and other !are wor)ers with medi!al )nowledge* Can "e used for #re-ser$i!e#rofessional u#date #rogrammes+ in!luding tutor #re#aration and u
,ames are the same e!e#t for one set of #laying !ards .Your Hefor general use( and 0our Health Medi!al %#in) - for health #rofess
1he game !an "e used in !on2un!tion with $iewing the d$d ./h$ ++ie Retold1 %a$aila"le on 0ou1u"e(
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1he game !onsists of a "oard with a di!e and suffi!ient !ounters
ea!h #layer in the grou# %& to ' ma( and ' sets of !ards* 1h
!ards are:
Abo"t 2o"
2o"r Health or2o"r Health Medi!al
2o"r Comm"nit$ %yellow(
Chance
Safe Motherhood Card
Maternal Death Card
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.)at co'petencies can t)is (a'e )elp de
%n addition to being a fun way to raise awareness of the safe motherhood
game offers many opportunities to develop or enhance specific competencthe game can:
5elp student 'idwi%es de%elop so'e of t)e &M =asic essential co'pet
@elping to develop their +nowledge) s+ills and awareness about the commsocial determinants of health 8e*g*) income) literacy and education) wateand sanitation) housing) environmental haFards) food security) diseascommon threats to health4
"onsider the principles of community.based primary care using health prodisease prevention and control strategies
"onsider direct and indirect causes of maternal and neonatal mortalmorbidity in the local community and strategies for reducing them*
help e7plore the principles of health education
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!ame can help student midwives discuss and so
help develop +nowledge and awareness on:
national and lo!al health ser$i!es and infrastru!tures
su##orting the !ontinuum of !are %organi3ation and referral
systems(+ how to a!!ess needed resour!es for midwifery !are
)nowledge of how to assist !ommunity mem"ers to a!!ess
ser$i!es+ su!h as immuni3ation and #re$ention or treatment of
health !onditions #re$alent in the !ountry (
ad$o!a!y and em#owerment strategies for women
lo!al !ulture and "eliefs %in!luding religious "eliefs+ gender roles(*
4nd mu!h more55*
. l#i it) M D l = d t
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.al#in( wit) Mrs D can also =e used toprepareupdate 'idwifery educators77
%n line with W@O lo=al Midwifery Educator &o'petencies) and &M co'petencie
Midwife Educators*the game can be used to develop#refresh#update educators comto:
3ecome more aware of local relevant community health issues .5 C4"
%ncorporate education strategies to promote active learning .5 C@"L especially ateaching and learning approaches that combine problem.based learning with semina
e7periential learning* 1he game also allows opportunities for the development of cr
thin+ing s+ills and application of evidence.based care 8especially when considering c
out negative cards & how) why and what is the evidence for*
Select and use effective learning strategies .5 C9"* discussion on how to create aenvironment for players if they have e7perienced a maternal death or similar
9ecogniFe and support different learning styles .5 C>"as each student can addraspects and draw different conclusions from the one game as each story will be uni(
ee suggestions included in the instructions for the game! after game activities
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Part 4:Does %ndonesia need a new
Standard for Midwifery $ducators@ow do you +nowWhat ne7t
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9emember:
Adequate attention 'ust =e (i%en to followin( a syste'aticprocess for adoptin( t)e (lo=al core co'petencies7 )eprocess s)ould not =e li'ited to disse'ination of t)edocu'ent wit) an epectation of co'pliance wit) t)econtents7
4rans"orming the educational processes "or pre
service education programmes calls "orsimultaneous actions to strengthen postbasic,ongoing and continuing education and trainingprogrammes6
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6ssessing current competence of
teachers 8gap analysis4 +/ote: %t is not necessary to loo+ at the competencies of all midwifery
educators#teachers) but it is important to have a representative sample* 1his
is essential where there are sub.national variations in provision of health
services* %f only educators#teachers competencies in the central training
institutions are assessed) this may lead to missing gaps for those wor+ing in
remote or rural areas* %n the "ambodia midwifery review) for e7ample) a
percent random sample of all operational districts in the country outside the
capital were assessed* 6 sample of teachers from the capital was also
assessed) but for comparison reasons these results were not aggregated into
the overall assessment 89!o" Mo@) >>4
ource" #$% Core Competencies &idwifery Educators 'daptation ool, *+
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%n conclusionP/S &/S,E0 when adopting global competencies for midwifery e
educators:
it is a critical step in i'pro%in( t)e quality of 'idwifery )ealt) ser
6lways include a plan for )ow t)ey can =e i'ple'ented incl M E
Must =e in line wit)* and co'ple'ent* ot)er actions to stren(t)eser%ices) especially implementation of evidence.based clinical standard
1he purpose behind developing the midwifery educator core compe
transform the education and preparation of midwives so that it
co'petence*
9emember) c)an(e is always ine%ita=le* as is resistance to c)an(eareas* Such resistance is often due to the limited information of those w
Plans for implementation must =uild on eistin( co'petencies of eteachers and should not be used to demotivate or downgrade staff