The effect of a midwifery continuity of care program on clinical competence of midwifery students and delivery outcomes: a mixed-methods protocol

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Abstract

Background

The midwifery continuity of care model is one of the care models that have not been evaluated well in some countries including Iran. We aimed to assess the effect of a program based on this model on the clinical competence of midwifery students and delivery outcomes in Ahvaz, Iran.

Methods

This sequential embedded mixed-methods study will include a quantitative and a qualitative phase. In the first stage, based on the Iranian midwifery curriculum and review of seminal midwifery texts, a questionnaire will be developed to assess midwifery students’ clinical competence. Then, in the second stage, the quantitative phase (randomized clinical trial) will be conducted to see the effect of continuity of care provided by students on maternal and neonatal outcomes. In the third stage, a qualitative study (conventional content analysis) will be carried out to investigate the students’ and mothers’ perception of continuity of care. Finally, the results of the quantitative and qualitative phases will be integrated.

Discussion

According to the nature of the study, the findings of this research can be effectively used in providing conventional midwifery services in public centers and in midwifery education.

Trial registration

This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1401.460). Also, the study protocol was registered in the Iranian Registry for Randomized Controlled Trials (IRCT20221227056938N1).

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Most cited references 33

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Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

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Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.

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The provision of midwife-led care in low-and middle-income countries: An integrative review

Michaela Michel-Schuldt, Alison McFadden, Mary J Renfrew … (2020)

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Midwifery continuity of care: A scoping review of where, how, by whom and for whom?

Billie F. Bradford, Alyce N. Wilson, Anayda Portela … (2022)

Systems of care that provide midwifery care and services through a continuity of care model have positive health outcomes for women and newborns. We conducted a scoping review to understand the global implementation of these models, asking the questions: where, how, by whom and for whom are midwifery continuity of care models implemented? Using a scoping review framework, we searched electronic and grey literature databases for reports in any language between January 2012 and January 2022, which described current and recent trials, implementation or scaling-up of midwifery continuity of care studies or initiatives in high-, middle- and low-income countries. After screening, 175 reports were included, the majority (157, 90%) from high-income countries (HICs) and fewer (18, 10%) from low- to middle-income countries (LMICs). There were 163 unique studies including eight (4.9%) randomised or quasi-randomised trials, 58 (38.5%) qualitative, 53 (32.7%) quantitative (cohort, cross sectional, descriptive, observational), 31 (19.0%) survey studies, and three (1.9%) health economics analyses. There were 10 practice-based accounts that did not include research. Midwives led almost all continuity of care models. In HICs, the most dominant model was where small groups of midwives provided care for designated women, across the antenatal, childbirth and postnatal care continuum. This was mostly known as caseload midwifery or midwifery group practice. There was more diversity of models in low- to middle-income countries. Of the 175 initiatives described, 31 (18%) were implemented for women, newborns and families from priority or vulnerable communities. With the exception of New Zealand, no countries have managed to scale-up continuity of midwifery care at a national level. Further implementation studies are needed to support countries planning to transition to midwifery continuity of care models in all countries to determine optimal model types and strategies to achieve sustainable scale-up at a national level.

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Author and article information

Contributors

Parvin Abedi:

ORCID: http://orcid.org/0000-0002-6980-0693

parvinabedi@ymail.com

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6920

Publication date (Electronic): 26 March 2024

Publication date PMC-release: 26 March 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 338

Affiliations

[1 ]Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, ( https://ror.org/01rws6r75) Ahvaz, Iran

[2 ]Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, ( https://ror.org/01rws6r75) Ahvaz, Iran

[3 ]Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundisahpur University of Medical Sciences, ( https://ror.org/01rws6r75) Golestan BLvd, Ahvaz, Iran

[4 ]GRID grid.411230.5, ISNI 0000 0000 9296 6873, Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran

[5 ]Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, ( https://ror.org/03mwgfy56) Tehran, Iran

[6 ]Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, ( https://ror.org/01rws6r75) Ahvaz, Iran

[7 ]MPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, ( https://ror.org/05wvpxv85) Boston, USA

[8 ]Department of Obstetrics and Gynecology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, ( https://ror.org/01rws6r75) Ahvaz, Iran

Author information

Fatemeh Razavinia http://orcid.org/0000-0002-6827-509X

Parvin Abedi http://orcid.org/0000-0002-6980-0693

Mina Iravani http://orcid.org/0000-0002-8854-1738

Eesa Mohammadi http://orcid.org/0000-0001-6169-9829

Bahman Cheraghian http://orcid.org/0000-0001-5446-6998

Shayesteh Jahanfar http://orcid.org/0000-0001-6149-1067

Mahin Najafian http://orcid.org/0000-0002-6649-3931

Article

Publisher ID: 5321

DOI: 10.1186/s12909-024-05321-5

PMC ID: 10967075

PubMed ID: 38532384

SO-VID: aab5e40d-d1eb-4c40-9534-73984f23b5c5

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 28 October 2023

Date accepted : 15 March 2024

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ScienceOpen disciplines: Education

Keywords: continuity of care,clinical competence,mixed-methods,midwifery students,pregnancy outcomes

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ScienceOpen disciplines: Education

Keywords: continuity of care, clinical competence, mixed-methods, midwifery students, pregnancy outcomes

The effect of a midwifery continuity of care program on clinical competence of midwifery students and delivery outcomes: a mixed-methods protocol

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Methods

Discussion

Trial registration

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Special Issue: Colleges as Anchor Institutions in their Local Community

Most cited references 33

Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

The provision of midwife-led care in low-and middle-income countries: An integrative review

Midwifery continuity of care: A scoping review of where, how, by whom and for whom?

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