Quality of pre-service midwifery education in public and private midwifery schools in Afghanistan: a cross sectional survey

Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. The aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders on priorities for improving quality of midwifery education. Methods A cross-sectional assessment of midwifery schools was conducted from September 12–December 17, 2017. The Midwifery Education Rapid Assessment Tool was used to assess 29 midwifery programs related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice due to low case-loads in clinical sites, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

Investigation of Intercultural Sensitivity and Ethnocentrism Levels of Midwife Candidates in Turkey Sample: A Cross-Sectional Study

Introduction: As women experience cultural practices during their lifespan, midwives’ displaying a culture-specific approach from the school years is of great importance for the quality of care. This study was conducted to determine the intercultural sensitivity and ethnocentrism levels of midwife candidates in Turkey. Method: This cross-sectional study was conducted with 1,616 midwifery students who studied in seven different regions of Turkey in the 2018–2019 academic year. Data were collected through a questionnaire, Intercultural Sensitivity Scale, and Ethnocentrism Scale. Results: It was determined that the variables such as the region where the midwife candidates grew up and location of the university, their years at school, and having friends from different cultures were effective on their intercultural sensitivity and ethnocentrism levels ( p < .05). Discussion: Consequently, it is concluded that international student exchange programs and culture-sensitive-based care approaches during midwifery education will increase the intercultural sensitivity levels of students and contribute to reducing ethnocentrism levels.

Enhancing undergraduate midwifery: using drug and alcohol baby simulators in education

Background In the UK, simulation in midwifery education mostly relates to developing clinical skills such as managing obstetric emergencies. However, there is minimal use of neonate simulators in educating student midwives on the impact of teratogens on fetal development. There is also limited research on using neonatal simulators as a creative pedagogical tool in undergraduate midwifery education. Objectives The two main objectives of this study were to ascertain whether students could recognise the physical impact of teratogens in the early postnatal period while interacting with simulators and to explore whether midwifery students understood their role as future midwives when working with pregnant women who may be misusing substances. Methods This qualitative research involved Level 4 student midwives from south England. A taught session on protecting the unborn environment was provided and students were tasked to interact with low fidelity fetal alcohol syndrome simulators and medium fidelity drug affected simulators. Student responses to group activities, such as interacting with the simulators and considering their role as future midwives in educating pregnant women about the impact of teratogens on a fetus and newborn baby, were collected. Results The use of the simulators was a useful pedagogical tool for enhancing student knowledge around teratogenesis and fetal impact. Conclusions Neonatal simulators can be used to engage undergraduate midwifery students and enhance their learning and knowledge.