Mid Sweden University

Objective

Previous international studies have shown that midwifery students do not feel confident in many areas where they are supposed to practice independently.

The knowledge about Swedish midwifery students’ confidence is fairly under investigated. The purpose of the present study was to explore final years’ midwifery students’ professional confidence in basic midwifery skills according to ICM competencies and associated factors.

Methods

A cross-sectional survey where all midwifery programs in Sweden were invited to participate. Data was collected by a questionnaire that measured midwifery students self-reported assessment of confidence against four selected domains of ICM competencies; antenatal, intrapartum, postpartum and new-born care.

Result

The main findings of this study showed that Swedish midwifery students were confident in managing normal pregnancy, labour and birth. Midwifery students at a school with a medical faculty were more confident in handling obstetric emergency situations. Some background variables were also associated with confidence.

Conclusion

This study highlighted some midwifery skills that needs further training and reflection. More training and developing confidence in complicated and emergency situations are needed. There seem to be a need of midwifery education reforms if we believe that high levels of confidence at the time of graduation is equal to competent and skilled midwives in the future.

Introduction:The world needs skilled, well educated, and confident midwives, but there is a lack of instruments to measure confidence in the Swedish context. The aim was to psychometrically test and adapt the COMICE (Confidence Of Midwifery students on selected midwifery Competencies at completion of Education) questionnaire on Swedish midwifery students.

Methods:This is a national cross-sectional study of midwifery students from all 13 universities in Sweden in 2016–2017. The questionnaire comprised antenatal, intrapartum, postpartum and newborn care and underwent a principal component analysis. Analysis of variance was used to study associations with students’ background characteristics.

Results:A total of 238 students (78% response rate) completed the questionnaire. For antenatal care, two components were identified: performing routine midwifery assessments during pregnancy and identifying fetal and maternal risk factors while educating parents (KMO=0.895, p<0.001; Cronbach’s alpha=0.848 and 0.827, respectively). For intrapartum care, three components emerged: managing physiological birth and providing support, managing complicated labor and birth, and identifying and providing lifesaving measures (KMO=0.905, p<0.001; Cronbach’s alpha=0.917, 0.809, and 0.777, respectively). Postnatal and newborn care included managing uncomplicated care while educating parents and managing complications (KMO=0.941, p<0.001; Cronbach’s alpha=0.993 and 0.558, respectively). Younger students (<31 years) reported greater confidence in routine antenatal assessments compared to older students (mean: 27.43 vs 26.01, p=0.004), managing physiological births (mean: 65.41 vs 62.85, p=0.01), and handling complicated labors (mean: 20.37 vs 19.05, p=0.046).

Conclusions:This study supports the Swedish version of the COMICE questionnaire as a tool to measure confidence among midwifery students in a Swedish context.

Objective: Midwifery students’ need to be confident, and it is important to identify factors that might affect students’ confidence. Achieving registration as a midwife requires academic, clinical and professional competence. In the 1,5-year post-nursing program in Sweden 50% is allocated to clinical practice, and students must assist a minimum of 50 births. There is a lack of knowledge regarding the significance of supervision and to consider both theoretical and practical aspects of midwifery education. This study intends to identify relationships between midwifery students’ confidence in intrapartum care and associated factors. An additional aim was to provide a member check of the validity of the findings. Methods: All midwifery programs in Sweden participated in this cross-sectional study, where 238 (78%) midwifery students completed a questionnaire based on the competency descriptions by the International Confederation of Midwives. Confirmatory interviews were conducted for checking the results relevance. Result: The organization of midwifery education, satisfaction with supervision and theoretical teaching significantly impacted students’ confidence. Few background variables were associated with confidence. Conclusion: Clinical supervision was important. Students preferred lectures and practical demonstrations instead of self-studies. The structure and quality of both practical and theoretical training are crucial for building confidence. Newly graduated midwives qualitatively confirmed the results of the analysis. They also experienced a stressful environment, only focusing on to assist at the required 50 births. 

Objectives: Confidence is essential in performing midwifery care since the profession places great demands on the ability to work independently with a scientific approach and professional responsibility. Clinical training is extensive during midwifery education and is essential for the development of midwifery student’s confidence and competence. The aim of the study was to describe the factors that increased and decreased confidence for midwifery students in clinical practice. Study design: A qualitative design was used. Data was collected by a questionnaire that measured Swedish students’ self-reported assessment of selected midwifery competencies. Two open questions gave the students the possibility to comment on what affected confidence during clinical practice. There were 401 comments analyzed by manifest content analysis. Results: Five categories described the experience of the students. Supervision during clinical training and the relationship with the midwives were most important factors for developing confidence. Further, to be theoretically and practically prepared before entering clinical practice. Regardless of activity the environment has to be learning and give time for reflection. Personal factors could affect professional confidence but above all it takes time to learn and practice midwifery. Factors that decreased confidence were stressed and uninterested supervisors. Patronizing attitudes towards students and the fear of doing something wrong also decreased confidence. Conclusions: Several factors contributes to enhance confidence among midwifery students in clinical training. The most important factor was supervision and the role as supervisor must be emphasized and sufficient time must be allocated to supervising midwives for them to fulfil their commitment.