Subject benchmark statements: Midwifery
This Subject benchmark statement provides a means of describing the nature and characteristics of programmes of study and education in midwifery in Scotland. It also represent general expectations about standards for the award of qualifications at a given level and articulates the attributes and capabilities that those possessing such qualifications should be able to demonstrate.
Subject benchmark statements are used for a variety of purposes. Primarily, they are an important external source of reference when new programmes are being designed and developed. They provide general guidance for articulating the learning outcomes associated with the programme but are not a specification of a detailed curriculum. Benchmark statements provide for variety and flexibility in the design of programmes and encourage innovation within an agreed overall conceptual framework.
Subject benchmark statements also provide support in the pursuit of internal quality enhancement. They enable the learning outcomes specified for a particular programme to be reviewed and evaluated against agreed general expectations about standards.
Subject benchmark statements are one of a number of external sources of information that are drawn upon for the purposes of academic review* and for making judgements about threshold standards being met. Reviewers do not use Subject benchmark statements as a crude checklist for these purposes however. Rather, they are used in conjunction with the relevant programme specifications, the associated documentation of the relevant professional and statutory regulatory bodies, the institution's own self evaluation documentation, together with primary data in order to enable reviewers to come to a rounded judgement based on a broad range of evidence.
The benchmarking of standards in health care subjects is undertaken by groups of appropriate specialists drawn from higher education institutions, service providers and the professional and statutory regulatory bodies. Drawing on initial work undertaken within a UK context, the statements represent the first attempt to make explicit in published form the general academic characteristics and standards of awards in midwifery within the context of a devolved Scottish education system. In due course, the statements will be revised to reflect developments in the subjects and the experiences of institutions, academic review and others that are working with it.
This statement is © The Quality Assurance Agency for Higher Education 2002.
It may be reproduced by educational institutions solely for educational purposes, without permission. Excerpts may be reproduced for the purpose of research, private study, or review without permission, provided full acknowledgement is given to the subject benchmarking group for this subject area and to the copyright of the Quality Assurance Agency for Higher Education.
Electronic storage, adaptation or translation of the statement is prohibited without prior written agreement from the Quality Assurance Agency for Higher Education.
* academic review in this context refers to the Agency's new arrangements for external assurance of quality and standards. Further information regarding these may be found in the Handbook for Academic Review, which can be found on the Agency's web site.
Convener's Introduction
The main aim of the Scottish Nursing, Midwifery and Health Visitors Subject Benchmark Task Group was to develop higher education subject benchmarks that reflected the health and education sectors in Scotland. Therefore, the benchmark statements presented in this document will provide practitioner and academic curricula designers in Scotland with a framework on which to build creative and forward-looking pre-registration programmes. The benchmark statements will also provide learners with a clear guide to what a programme of preparation should enable them to do and what is required of them before they are eligible for professional registration.
The Scottish Benchmark Task Group members came from a wide range of academic
and practice subject communities. It was therefore challenging for the
Group members to be engaged in the diverse
multi-disciplinary debate, a debate that often questioned existing beliefs, standards
and ideas.
In the early stages of its work, the emergence of the triangular framework and the Task Group's endorsement of the plan to build upon the already complete UK benchmarking exercise1 gave the Group a true sense of identity, teamwork and clarity of direction. To ensure that each discipline was clearly represented the Task Group split into subject discipline groups, led by a 'champion'. The champions facilitated the subject discipline discussion and cross-referencing of the benchmark statements with the statutory competency requirements for registration. The Task Group met on pre-arranged dates, but much of the work was undertaken via electronic communication.
Also the full consultation period and consultation event provided subject communities with the opportunity to offer robust feedback which enhanced the quality of the finished documents. Therefore, it is with some confidence that the Benchmark Task Group present you with these Subject benchmark statements that meet the requirements of academic study at degree level and incorporate the statutory competency requirements for admission to the professional register.
Subject benchmark statements are an important part of the 'vocabulary for describing learning opportunities'.2 within the total quality standards framework. If you are a practitioner or an academic I encourage you to become fully conversant with the statements. Please use them when you are engaged in the development of any new curriculum design group.
I also urge you to encourage students, in the academic and practice setting, to reflect upon the relationship between the three main aspects of Professional Preparation and Development and debate with them how all three will enhance the meaningfulness of their learning.
Jennie Parry
Chairperson
Nursing, Midwifery and Health Visiting Scottish Benchmark group 2002.
1 Quality Assurance Agency for Higher Education (2001) Benchmark Statement: Health Care Programmes. The Emerging health professions framework. Gloucester: QAA.
2 Quality Assurance Agency for Higher Education (2001) The Framework for Qualifications of Higher Education in Scotland. Gloucester: QAA.
See also An Introduction to the Scottish Credit and Qualifications Framework page 2 (vii); The Scottish Credit and Qualifications Framework, 2001.
This Subject benchmark statement (statement) describes the nature and standards of programmes of study in midwifery that lead to the subject awards made by higher education institutions in Scotland. It has built on the valuable work already done in which midwifery programmes in other parts of the UK have been benchmarked1. The Scottish statement not only strongly endorses this previous work, but has also incorporated parts of it, and has drawn upon it in various ways that renders the Scottish statement congruent with the UK context, both in terms of specificity to the midwifery profession and to the possibility of an emerging health professions framework.
Within such a UK context, Scotland has a devolved education system. This is reflected in the fact that the Scottish Credit and Qualifications Framework (SCQF) is slightly different from that of its counterparts in the rest of the UK2. In particular, Scotland has continued to embrace the development and award of the Scottish Ordinary Degree for a range of vocational and professional programmes of preparation. This is further reflected in the fact that the Scottish Executive Health Department, through its contracting arrangements with higher education institutions, has provided the opportunity for pre-registration students of midwifery to qualify at ordinary degree level. The Scottish benchmarking group has therefore taken into account that pre-registration midwifery students in Scotland may qualify at two academic levels on the SCQF, being that of Diploma of Higher Education and Ordinary Degree.
The Diploma of Higher Education in Midwifery remains the threshold standard for pre-registration midwifery programmes in Scotland, but to this must be added the fact that the Scottish Diploma of Higher Education in Midwifery attracts 60 credit points at SCQF level 9 (SHE level 3) which is Scottish Ordinary Degree level. It is for these reasons that the Scottish statement for midwifery has been designed and presented in a way that differs slightly from its counterparts in the rest of the UK, while, as noted above, still remaining congruent with the overall purpose and value of the work already undertaken, including that of an emerging health professions framework.
The design and presentation of the Scottish statement for midwifery has also been influenced by the benchmark information pertaining to the standard for initial teacher education in Scotland3. In particular, the Scottish benchmarking group placed a high value on the way in which a single set of benchmarks and expected features were presented as the threshold standard for professional preparation at different levels of academic award. The group took the view that such a manner of presentation was also appropriate for the midwifery context in Scotland with its two different levels of award, and therefore made the decision to proceed down that route. This will enable the different higher education providers of midwifery education in Scotland to meet the threshold standards in their programme design while also facilitating the academic levels of provision and completion as and where appropriate.
The benchmarks for midwifery in Scotland, along with the expected features of the threshold standard are set out under the following three main headings:
A Professional Knowledge and Understanding
B Professional Skills and Abilities
C Professional Values, Accountability and Development
It is important to note that these three headings signify a high degree of interdependence where the academic nature of the programme meets the professional requirements of a programme that is practice-based but education led. In this respect, the benchmarking group valued the opportunity to cross reference the benchmarks and their expected features with the competencies for entry onto the professional register. This fact has also strongly influenced the template in which threshold standards are presented.
The section on teaching, learning and assessment draws attention to the central role of practice in the design of learning opportunities for students and the importance of ensuring that professional competence developed through practice is adequately assessed and rewarded. It also notes how essential it is that the integration of theory and practice is a planned process within the overall arrangements made for teaching and learning.
The statement acknowledges the need to put the prospective client/patient at the centre of the student's learning experience and to promote within that experience the importance of team-working and cross-professional collaboration and communication. Implicit in the statement are the opportunities that exist for shared learning across professional boundaries, particularly in the latter stages of training when inter-professional matters can be addressed most productively. It is essential that the opportunities that exist for shared learning in practice are optimised, as well as best use being made of similar opportunities that prevail more obviously in classroom-based activities.
This statement and the associated statements will therefore allow higher education institutions, in partnership with service providers (where appropriate), to make informed curriculum choices about the construction of shared learning experiences. In this context shared learning is seen as one of a number of means of promoting improved collaborative practice and addressing a range of issues which span professional accountability and professional relationships. The statement has also been written in the context of the modernisation agenda for the health service in Scotland, where the goal is that of an ever-improving service and a continuing focus on patient/client-centred needs in what remains a practice-based and education led preparation. In this respect, benchmarking statements strive to make education fit for purpose in a manner that augments transparency and accountability to all stakeholders.
The statement does not set a national curriculum for programmes leading to awards in midwifery. It acknowledges that the requirements of the statutory regulatory body needs to be incorporated into the design of programmes. It seeks to encourage higher education institutions and service providers to work collaboratively in the design and delivery of their curricula. Its essential feature is the specification of threshold standards, incorporating academic and practitioner elements, against which higher education institutions are expected, as a minimum, to set their standards for the award.
Finally, the Subject benchmark statement for midwifery in Scotland has also been designed in such a way that looks to the future, both in terms of internal quality enhancement, continuing professional development and the modernisation agenda. Thus the statement that follows is seen as the first phase in an ongoing evolution of both quality systems, inter-professional collaboration, and transparency of programme content and design in a manner that is clear to all stakeholders. In this respect it is presented as a sound platform for the future of the midwifery profession in Scotland.
1 Quality Assurance Agency for Higher Education (2001) Benchmark Statement: Health Care Programmes - Midwifery, QAA, Gloucester. The emerging health professions framework is given in Appendix One.
2 Quality Assurance Agency for Higher Education (2001) The Framework for Qualifications of Higher Education in Scotland, QAA, Gloucester. See also, Scottish Executive (2001) An Introduction to the Scottish Credit and Qualifications Framework, Edinburgh, Scottish Executive.
3 Quality Assurance Agency for Higher Education (2000) The Standard for Initial Teacher Education in Scotland: Benchmark Information, QAA, Gloucester.
Benchmark statement for midwifery
Introduction
Midwives work with women and their families to assess their needs and to determine and provide programmes of care and support prior to conception and throughout the antenatal, intranatal and postnatal periods. They focus on providing holistic care which respects individual needs, choices and cultures in a variety of contexts. Legislation enables midwives to carry out their role autonomously, while expecting them to work in partnership with others and across professional boundaries when this is in the best interests of women and their families. Midwives work in and across a wide range of settings, from women's homes to acute hospitals. They also make a significant contribution to the wider public health agenda.
As already noted in the foreword, a key feature of the midwife's role is that of collaborative working with other professionals, and also in a facilitative manner with other support workers. This latter role is of particular importance within a Scottish context where the SCQ framework has been designed to augment parallel developments between vocational modes of study and higher education.
Nature and extent of programmes in midwifery
This section describes midwifery as an applied academic discipline recognising that while the profession is moving towards all graduate status some students may exit the programme with the minimum requirement of diploma in higher education. Irrespective of the academic award individuals undertaking programmes that lead to registration on Part 10 of the professional register must achieve the midwifery competencies.
Midwifery programmes involve integrated study of the following:
- the subject knowledge, understanding and associate skills that are required;
- the essential learning and assessment arrangements for programmes in the subject;
- the academic and practitioner standards that need to be demonstrated.
This Subject benchmark statement, embraces the learning outcomes and competencies required for professional practice as defined in Midwives Rule 33 of the statutory regulatory body, and the Registrar's Letter 35/2000 respectively. It also encompasses the requirements of the European Union Midwives Directive (80/155/EEC Article 4). The standards described in this statement relate, consequently, to both academic and practitioner attributes and capabilities.
The International Confederation of Midwives (ICM), the International Federation of Gynaecologists and Obstetricians (FIGO), and the World Health Organisations (WHO) have adopted the following definition of a midwife:
'A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.
'She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries on her own responsibility and to care for the new-born and the infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counselling and education, not only for the women, but also within the family and the community. The work should involve antenatal education and preparation for parenthood and extend to certain areas of gynaecology, family planning and child care. She may practise in hospitals, clinics, health units, domiciliary conditions or in any other service.'
The above definition places a sharp focus on the nature of midwifery as an applied academic subject, underpinned by the human biological sciences and the social sciences, in particular psychology and sociology. However, it is not driven by such propositional knowledge alone, because its mastery requires proficiency in a range of cognitive, affective and psychomotor skills. It is the integration of these underpinning elements through the coherent planning of programmes which establishes the basis for midwives to provide care which is woman centred and focused on the premise that childbirth is (normally) a natural, physiological and important event in women's lives.
The midwife's role also centres on the woman in the family context. The care of the family during childbearing is central to the definition of the discipline and as such the boundaries of the discipline/profession articulate with other health and social care professions.
The pre-registration midwifery programmes of education and training are built around university and practice-based learning. The sound organisation of these two elements, enables students to develop autonomy and confidence and to emerge as competent practitioners with the capacity to work effectively in women's homes, hospital, community clinics, or other settings as part of a broadly based health and social care team.
The following principles inform the design and delivery of the programme leading to registration on Part 10 of the Professional Register:
- a midwife is an independent, autonomous practitioner and provides holistic, woman-centred midwifery care prior to conception and throughout the antenatal, intranatal and postnatal periods;
- a midwife plays a key role in health promotion and within the public health agenda.
- partnership and effective communication with women is central to a unique relationship;
- a midwife works in collaboration with other health care professionals to provide seamless care and appropriate interventions that enhance outcomes;
- a midwife achieves quality care through using best available evidence, research, and audit of practice;
- midwifery knowledge and practice are dynamic and responsive to the changing needs of society;
- midwifery practice is moral and ethical with the rights, beliefs and values of others acknowledged and respected in a multi-dimensional society.
Threshold standard for midwifery programmes in Scotland: Elements of Professional
Development
Programmes of pre-registration midwifery preparation are the first step in a lifelong career of professional development. Programmes of inititial preparation for registration require to promote three main aspects of such development.
A Professional Knowledge and Understanding
B Professional Skills and Abilities
C Professional Values, Accountability and Development
The significance of placing these aspects of professional preparation within
a triangle is to emphasise that they are not simply lists of competencies
or outcomes.
They are interdependent aspects of the professional preparation of the student.
It is the relationship between the three aspects that constitutes a meaningful
education and preparation for professional practice. Benchmark statements have
been produced for each of the three aspects. Programmes will be designed to give
attention to each of these and to their interaction. The Benchmark statements,
as well as meeting the requirements of academic study, also incorporate the competencies
that are a statutory requirement for registration.
The threshold standard for pre-registration midwifery programmes in Scotland contains the following three key elements. First, the 'benchmarks' which are statements specifying the design requirements for programmes of pre-registration midwifery in Scotland. Second, each benchmark contains a bullet list of 'expected features' which designate aspects of student performance that the programme is designed to achieve in relation to a particular benchmark. These 'expected features' will be used in designing assessment strategies that facilitate the integration of academic work and practice learning. Third, each benchmark has been cross-referenced to the appropriate competencies, the meeting of which is a statutory requirement for initial registration as a midwife in the United Kingdom4. In this manner the benchmarking exercise has occurred within the context of a devolved Scottish education system while still embracing the UK context of the midwifery profession and its statutory requirements.
4 The UKCC competencies for Midwifery are enumerated in Appendix Two.
Threshold standard for pre-registration midwifery programmes in Scotland
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: |
Cross reference to professional competencies |
| A1 Understand, interpret and reflect upon the nature of professional midwifery and forms of midwifery knowledge and practice. |
|
16, 24 and 27 |
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: |
Cross reference to professional competencies |
| A2 Understand the appropriate life and human sciences that underpin and contribute to midwifery and public health. |
|
12, 15 and 26 |
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: |
Cross reference to professional competencies |
| A3 Acquire knowledge of the appropriate social sciences that underpin and contribute to midwifery and public health. |
|
3, 15, 22, 23, 25 and 26 |
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: |
Cross reference to professional competencies |
| A4 Acquire knowledge of, and reflect upon, the centrality of ethics, law and the humanities for professional midwifery practice. |
|
15, 16, 17, 18 and 19 |
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: | Cross reference to professional competencies |
| A5 Acquire sound knowledge of midwifery, healthcare management, clinical skills and psychosocial caring skills. |
|
1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 18, 19, 21, 23, 26, 27 and 29 |
A Professional Knowledge and Understanding
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: | By the end of the programme students will be able to: | Cross reference to professional competencies |
| A5 Acquire sound knowledge of midwifery, healthcare management, clinical skills and psychosocial caring skills. |
|
As above. |
| A6 Acquire knowledge and skills in handling information technology related to client care, health promotion and continuing professional development. |
|
13, 18, 19, 26, 27 and 28 |
A Professional Knowledge and Understanding
| Benchmark |
Expected features |
Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
A7 Acquire knowledge of skills in numeracy and literacy for safe care of the mother and baby. |
|
12, 13, 18 and 19 |
B Professional Skills and Abilities
| Benchmark |
Expected features |
Competencies |
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
B1 Utilise the principles involved in developing and maintaining therapeutic relationships through the use of appropriate communication and interpersonal skills. |
|
1, 3, 4, 5, 9, 16, 17, 18 and 19 |
B Professional Skills and Abilities
|
Benchmark |
Expected features |
Competencies |
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
B2 Utilise appropriate knowledge, skills, tools and instruments to identify and assess the healthcare needs of women and babies. |
|
1, 2, 3, 4, 5, 13, 14, 17, 18, 19 and 20 and 26 |
B Professional Skills and Abilities
| Benchmark |
Expected features |
Competencies
|
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
| B3 Use all the information gained from assessment to formulate plans and strategies to meet the healthcare needs of women and babies working, as appropriate, with families and members of the multiprofessional team. |
|
3, 4, 513, 15, 19, 20, 22, 25 and 27 |
B Professional Skills and Abilities
|
Benchmark
|
Expected features |
Competencies
|
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
B4 Deliver safe, appropriate care based on the best available evidence to women, babies and their families across a range of midwifery situations. |
|
1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 16, 17, 18, 19, 21, 22 and 29 |
B Professional Skills and Abilities
| Benchmark | Expected features | Competencies |
|---|---|---|
| The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
B4 Deliver safe, appropriate care based on the best available evidence to women and babies and their families across a range of midwifery situations. |
|
As above. |
|
B5 Continuously evaluate the effect of care delivered and alter care according to changing needs and circumstances. |
|
2, 5, 14, 17, 21, 23, 26 and 29 |
B Professional Skills and Abilities
|
Benchmark
|
Expected features |
Competencies
|
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will be able to: |
Cross reference to professional competencies |
|
B6 Engage in effective team work, inter-agency and collaborative working. |
|
4, 5, 9, 10, 16, 18, 20, 25 and 27 |
C Professional values, accountability and development
|
Benchmark
|
Expected features |
Competencies
|
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will: |
Cross reference to professional competencies |
|
C1 Value and demonstrate a commitment to promoting health and maternity care for women, babies and their families regardless of age, gender, sexuality, race, disability, creed or culture. |
|
3, 15, 16, 17, 18 and 19 |
C Professional values, accountability and development
| Benchmark | Expected features | Competencies |
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will: |
Cross reference to professional competencies |
|
C2 Understand the importance and requirements of professional practice and accountability in different healthcare settings and employer contexts. |
|
3, 4, 5, 7, 8, 9, 18, 21, 23 and 29 |
C: Professional values, accountability and development
|
Benchmark |
Expected features |
Competencies
|
|---|---|---|
|
The Programme of Preparation will enable students to: |
By the end of the programme students will: |
Cross reference to professional competencies |
|
C3 Value themselves as growing professionals by taking responsibility for their lifelong learning, reflective practice and professional development. |
|
16, 23, 24, 25, 26, 27 and 29 |
Teaching, learning and assessment
The pre-registration midwifery programmes are structured to reflect the complexity of independent midwifery practice alongside the midwife's multi-faceted role as a member of different health and social care teams. The integration of university and practice based learning is explicit across a wide variety of learning environments. Students' prior learning and experiences will be capitalised upon and developed alongside the acquisition of essential new knowledge and skills which will be adapted according to maternity care contexts. The overall aims and final outcomes of the award together with the available learning environments and specific topic requirements should inform the progression staging points and the learning and teaching strategies and assessment methods.
Effective learning requires appropriate and supportive learning environments. From the outset of the programme students need to be assisted in the effective use of theory in practice and the use of practice to inform theory, as well as the development of essential observational, communication and psychomotor skills. Early targeted visits to midwifery practice areas with university teachers/lecturers, as well as specific placements with midwife practitioners, will enable students to understand the breadth and depth of knowledge and understanding that are needed to underpin competent midwifery practice. Placements in appropriate non-midwifery settings and with other health professionals will provide opportunities to develop broader clinical skills and multi-professional teamwork. Consideration needs to be given to the length, continuity and variety of practice settings, midwife mentors, and practice educators that will enable students to experience the full scope of midwifery practice. Opportunities for multiprofessional learning to enhance a team approach to the care of women should be capitalised upon. The final two to three months of the programme should be designated as a period of consolidation to assist students gain confidence in their capabilities to be autonomous midwife practitioners.
The learning is facilitated by appropriately qualified and experienced lecturers in the university and mentors in practice who are academically and clinically credible. The learning process can be expressed in terms of three inter-related themes:
Multiple ways of knowing:
-
The woman's perspective, research and other relevant evidence from a
broad subject field, the
multi-professional reflexivity perspective and awareness and motivation to engage in new ways of thinking and acting.
Student centred learning:
- To include approaches which are manipulated by wide ranging prior knowledge and experiences, the various contexts and environments experienced by women with very different needs together with peer, teacher/lecturer and practice based mentor/assessor feedback on performance. These approaches will enable students to be self-critical and make adjustments to their attitudes and goals. They will also be facilitated to understand the need for self-directed and lifelong learning.
Holistic and specific skills learning:
- Which encompass key midwifery skills and the ability to integrate skills and knowledge with relevant contextual understanding to target midwifery care according to individualised holistic needs and health priorities.
The pre-registration midwifery programme acknowledge the wide entry gate for students and the expectation that they will learn at different rates and in diverse ways. Students need, therefore, to develop their preferred learning style, and also to learn new learning styles to equip them for the breadth, depth and differing speed of responses needed to cope with complexity and change in midwifery practice. A variety of learning and teaching strategies is required to enable this process.
Learning approaches may include:
- enquiry based learning/problem based learning which enables students to participate actively in setting the learning agenda, to frame/reframe and solve problems and to learn from each other;
- small group inter-professional learning (in the learning about each other context when objectives are shared, rather than learning about subjects together) to enhance multi-professional/multi-agency teamwork;
- use of real life scenarios, lectures, role play, simulation of practice situations that are infrequently encountered, individual and group experiences and reflection on the practice of others, seminars, skills learning in laboratory and practice environments, computer assisted learning, learning journals/diaries and reflection on the development of learning, individual and group tutorials;
- use of a variety of communication strategies and information technology systems and understanding of different research methodologies to enhance informed choice and relationships with women and their families as well as providing evidence for improving practice.
Assessment strategies should recognise the inter-dependent nature of theory and practice and hence incorporate a tripartite partnership between student, university midwife teacher/lecturer and practice-based mentors/assessors. Assessors must be both academically and clinically credible and assessment should take place in the contexts which are most appropriate for making valid assessment judgements. This can only be achieved if practice based mentors are given appropriate preparation and time to undertake this role. Midwife lecturers need to support the mentors by being visible on a regular basis in the midwifery practice placements.
Pre-registration midwifery programmes assess competence in practice on a continuous basis so that a repertoire of skills are assessed, as well as the capability to integrate knowledge and skills with relevant contextual understanding and empathy to provide holistic midwifery care.
Methods of assessment should include: student's portfolio of learning which draws upon evidence from practice, research and scholarship; essays, examinations, case studies, seminar papers, poster presentations, critical incidents, health promotion packages etc. Academic assessment is designed to be diagnostic, developmental and to test cognitive skills, drawing on the contexts of midwifery practice and reflecting the learning and teaching methods employed.
Appendix One
An emerging health professions framework
The subject specific statements for midwifery have been set within the emerging health professions framework outlined below. As indicated in the foreword, this framework developed as a result of the benchmarking work undertaken collaboratively by 11 different health professional groups. Further evolution of the framework is anticipated through a second phase of the project which will address its goodness of fit with a range of other health and social care professions benchmark statements.
A Expectations of the health professional in providing patient/client services
This section articulates the expectations of a registered professional
within health and social care services.
It describes what is regarded as a minimum range of expectations of a professional
that will provide safe and competent practice for patients/clients in a variety
of health and social care contexts.
A1 Professional autonomy and accountability
The award holder should be able to:
- maintain the standards and requirements of professional and statutory regulatory bodies;
- adhere to relevant codes of conduct;
- understand the legal and ethical responsibilities of professional practice;
- maintain the principles and practice of patient/client confidentiality;
- practise in accordance with current legislation applicable to health care professionals;
- exercise a professional duty of care to patients/clients/carers;
- recognise the obligation to maintain fitness for practice and the need for continuing professional development;
- contribute to the development and dissemination of evidence-based practice within professional contexts;
- uphold the principles and practice of clinical governance.
A2 Professional relationships
The award holder should be able to:
- participate effectively in inter-professional and multi-agency approaches to health and social care where appropriate;
- recognise professional scope of practice and make referrals where appropriate;
- work, where appropriate, with other health and social care professionals and support staff and patients/clients/carers to maximise health outcomes;
- maintain relationships with patients/clients/carers that are culturally sensitive and respect their rights and special needs.
A3 Personal and professional skills
The award holder should be able to:
- demonstrate the ability to deliver quality patient/client-centred care;
- practise in an anti-discriminatory, anti-oppressive manner;
- draw upon appropriate knowledge and skills in order to make professional judgements, recognising the limits of his/her practice;
- communicate effectively with patients/clients/carers and other relevant parties when providing care;
- assist other health care professionals, support staff and patients/clients/carers in maximising health outcomes;
- prioritise workload and manage time effectively;
- engage in self-directed learning that promotes professional development;
- practise with an appropriate degree of self-protection;
- contribute to the well-being and safety of all people in the work place.
A4 Profession and employer context
The award holder should be able to:
- show an understanding of his/her role within health and social care services;
- demonstrate an understanding of government policies for the provision of health and social care;
- take responsibility for his/her own professional development;
- recognise the value of research and other scholarly activity in relation to the development of the profession and of patient/client care.
B The application of practice in securing, maintaining or improving health and well-being
All health care professionals draw from the knowledge and understanding associated with their particular profession. This knowledge and understanding is acquired from theory and practice. It forms the basis for making professional decisions and judgements about the deployment in practice of a range of appropriate skills and behaviours, with the aim of meeting the health and social care needs both of individual clients/patients and of groups, communities and populations. These decisions and judgements are made in the context of considerable variation in the presentation, the setting and in the characteristics of the client/patient health and social care needs. They often take place against a backdrop of uncertainty and change in the structures and mechanisms of health and social care delivery.
Sound professional practice is essentially a process of problem solving.
It is characterised by four
major phases:
- the identification and analytical assessment of health and social care needs;
- the formulation of plans and strategies for meeting health and social care needs;
- the performance of appropriate, prioritised health promoting/health educating/caring/diagnostic/therapeutic activities;
- the critical evaluation of the impact of, or response to, these activities.
B1 Identification and assessment of health and social care needs
The award holder should be able to:
- gather relevant information from a wide range of sources including electronic data;
- adopt systematic approaches to analysing and evaluating the information collected;
- communicate effectively with the client/patient, (and his/her relatives/carers), group/community/population, about their health and social care needs;
- use a range of assessment techniques appropriate to the situation and make provisional identification of relevant determinants of health and physical, psychological, social and cultural needs/problems;
- recognise the place and contribution of his/her assessment within the total health care profile/package, through effective communication with other members of the health and social care team.
B2 Formulation of plans and strategies for meeting health and social care needs
The award holder should be able to:
- work with the client/patient, (and his/her relatives/carers), group/community/population, to consider the range of activities that are appropriate/feasible/acceptable, including the possibility of referral to other members of the health and social care team and agencies;
- plan care within the context of holistic health management and the contributions of others;
- use reasoning and problem solving skills to make judgements/decisions in prioritising actions;
- formulate specific management plans for meeting needs/problems, setting these within a timescale and taking account of finite resources;
- record professional judgements and decisions taken;
- synthesise theory and practice.
B3 Practice
The award holder should be able to:
- conduct appropriate activities skilfully and in accordance with best/evidence-based practice;
- contribute to the promotion of social inclusion;
- monitor and review the ongoing effectiveness of the planned activity;
- involve client/patient/members of group/community/population appropriately in ongoing effectiveness of plan;
- maintain records appropriately;
- educate others to enable them to influence the health behaviour of individuals and groups;
- motivate individuals or groups in order to improve awareness, learning and behaviour that contribute to healthy living;
- recognise opportunities to influence health and social policy and practices.
B4 Evaluation
The award holder should be able to:
- measure and evaluate critically the outcomes of professional activities;
- reflect on and review practice;
- participate in audit and other quality assurance procedures;
- contribute to risk management activities.
C Knowledge, understanding and skills that underpin the education and training of health care professionals
The education and training of health care professionals draws from a range of well-established scientific disciplines that provide the underpinning knowledge and understanding for sound practice. Each health care profession will draw from these disciplines differently and to varying extents to meet the requirements of their specialty. It is this contextualisation of knowledge, understanding and skills that is characteristic of the learning in specific health care programmes. Consequently, in this introductory section, the attributes and capabilities expected of the student are expressed at a generalised level.
C1 Knowledge and understanding
The award holder should be able to demonstrate:
-
understanding of the key concepts of the disciplines that underpin the
education and training of all health care professionals, and detailed
knowledge of some of these. The latter would include a broad understanding
of:
-
the structure and function of the human body, together with a knowledge
of dysfunction
and pathology; -
health and social care philosophy and policy, and its translation
into ethical and evidenced
based practice; - the relevance of the social and psychological sciences to health and healthcare;
- the role of health care practitioners in the promotion of health and health education;
-
the legislation and professional and statutory codes of conduct that
affect health and
social care practice.
-
the structure and function of the human body, together with a knowledge
of dysfunction
C2 Skills
Information gathering
The award holder should be able to demonstrate:
- an ability to gather and evaluate evidence and information from a wide range of sources;
- an ability to use methods of enquiry to collect and interpret data in order to provide information that would inform or benefit practice.
Problem solving
The award holder should be able to demonstrate:
- logical and systematic thinking;
- an ability to draw reasoned conclusions and sustainable judgements.
Communication
The award holder should be able to demonstrate:
- effective skills in communicating information, advice, instruction and professional opinion to colleagues, patients, clients, their relatives and carers; and, when necessary, to groups of colleagues or clients.
Numeracy
The award holder should be able to demonstrate:
- ability in understanding, manipulating, interpreting and presenting numerical data.
Information technology
The award holder should be able to demonstrate:
- an ability to engage with technology, particularly the effective and efficient use of information and communication technology.
Appendix Two
Competencies for Professional Register
Domain - Effective Midwifery Practice
1. Communicate effectively with women and their families throughout the preconception, antenatal, intrapartum and postnatal stages.
2. Diagnose pregnancy, assess and monitor women holistically throughout the preconception, antenatal, intrapartum and postnatal stages through the use of a range of assessment methods and reach valid, reliable and comprehensive conclusions.
3. Determine and provide programmes of care and support for women which:
- are appropriate to the needs, contexts, culture and choices of the women, babies and their families;
- are made in partnership with women;
- are ethical;
- are based on best evidence and clinical judgement;
- involve other practitioners when this will improve health outcomes.
4. Provide seamless care and interventions in partnerships with women and other care providers during the antenatal period which:
- are appropriate for women's assessed needs, context and culture;
- promote their continuing health and well-being;
- are evidence-based;
- are consistent with the management of risk;
- draw upon the skills of others to optimise health outcomes and resource use.
5. Refer women who would benefit from the skills and knowledge of other individuals:
- to an individual who is likely to have the requisite skills and experience to assist;
- at the earliest possible time;
- supported by accurate, legible and complete information which contains the reasoning behind making the referral and describes the woman's needs and preferences.
6. Care for, monitor and support women during labour and monitor the condition of the fetus and conduct spontaneous deliveries.
7. Undertake appropriate emergency procedures to meet the health needs of women and babies.
8. Examine and care for babies immediately following birth.
9. Work in partnership with women and other care providers during the postnatal period to provide seamless care and interventions which:
- are appropriate to the woman's assessed needs, context and culture;
- promote their continuing health and well-being;
- are evidence-based;
- are consistent with the management of risk;
- are undertaken by the midwife because she is the person best placed to do them and is competent to act;
- draw on the skills of others to optimise health outcomes and resource use.
10. Examine and care for babies with specific health or social needs and refer to other professionals or agencies as appropriate.
11. Care for and monitor women during the puerperium, offering the necessary evidence-based advice and support on the baby and self care.
12. Select, acquire and safely administer a range of permitted drugs consistent with legislation, applying knowledge and skills to the situation which pertains at the time.
13. Complete, store and retain records of practice which:
- are accurate and legible;
- detail the reasoning behind any actions taken;
- contain the information necessary for the record's purpose.
14. Actively monitor and evaluate the effectiveness of programmes of care and modify them to improve the outcomes for women, babies and their families.
15. Contribute to enhancing the health and social well-being of individuals and their communities.
Domain - Professional and Ethical Practice
16. Practise in accordance with the UKCC's Code of professional conduct, within the limitations of the individual's own competence, knowledge and sphere of professional practice, consistent with the legislation relating to midwifery practice.
17. Practise in a way which respects and promotes individuals' rights, interests, preferences, beliefs and cultures.
18. Practise in accordance with relevant legislation.
19. Maintain the confidentiality of information.
20. Interact with other practitioners and agencies in ways which:
- value their contribution to health and care;
- enable them to participate effectively in the care of women, babies and their families;
- acknowledge the nature of their work and the context in which it is placed.
21. Manage and prioritise competing demands.
22. Support the creation and maintenance of environments which promote the health, safety and well-being of women, babies and others.
23. Contribute to the development and evaluation of guidelines and policies and make recommendations for change in the interests of women, babies and their families.
Domain - Developing the Individual Midwife and Others
24. Review, develop and enhance the midwife's own knowledge, skills and fitness to practise.
25. Demonstrate effective working across professional boundaries and develop professional networks.
Domain - Achieving Quality Care through Evaluation and Research
26. Apply relevant knowledge to the midwife's own practice in structured ways which are capable of evaluation.
27. Inform and develop the midwife's own practice and the practice of others through using best available evidence and reflecting on practice.
28. Manage and develop care utilising the most appropriate information technology (IT) systems.
29. Contribute to the audit of practice to review and optimise the care of women, babies and their families.
Appendix Three
Midwifery Benchmark Group membership (Scotland)
Ms Joan Cameron, University of Dundee
Dr Lesley Storrie, University of Paisley
Ms Denise Gray, Bell College
Ms Lynne Christie, Forth Park Hospital, Kirkcaldy
Chairperson
Ms Jennie Parry, The Robert Gordon University
Development Officer
Dr John Drummond, University of Dundee
QAA Officers
Dr David Bottomley
Ms Sheila Dunn
Appendix Four
Benchmark Steering Group Membership (Scotland)
David Bottomley, QAA
Mary Boyle, NHS Education for Scotland
Helen Bryers, Midwife, Highland Acute Hospitals NHS Trust
John Drummond, University of Dundee
Rhona Hotchkiss, Clinical Standards Board for Scotland
Karen Lockhart, The Scottish Executive
Helen Mackinnon, NHS Education for Scotland
Jennie Parry, The Robert Gordon University
Jack Rae, University of Paisley
Ishbel White, Health Visitor, Greater Glasgow Primary Care NHS Trust
Acknowledgements
The Scottish benchmarking group would like offer thanks to the following for their valuable contribution to this document.
1. Professor Bart McGettrick for his input, and the members of the Initial Teacher Education Benchmarking Group for allowing their document to be used as a resource.
2. UK-wide Midwifery Benchmarking Group for provision of a document that proved to be a resource of immense value in the production of the Scottish benchmarking statement.
ISBN 1 85824 820 5
AR068 11/2002
© Quality Assurance Agency for Higher Education 2002
Published by Quality Assurance Agency for Higher Education
The Quality Assurance Agency for Higher Education is a company limited by guarantee
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