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Building, Bridging, Being: The Transition to Clinical Practice for New Registrant Midwives in Ontario
Get PDFBackground: The transition to clinical practice is a phenomenon that all health care professionals experience and one that has been studied in many fields of health care, yet remains largely unexamined for Canadian midwives. This study asked the question: How do new registrant midwives in Ontario navigate the transition from student to clinician during their first year of clinical practice?
Methodology: In this grounded theory study, a total of 13 semi-structured interviews were conducted with Ontario midwives from three participant groups: A) New registrants in their first year of clinical practice; B) Registered midwives with 1-5 years of clinical experience; C) Registered midwives who work with new registrants as supervisors or mentors.
Findings: The Building, Bridging, and Being theory describes how new registrants transitioned to clinical practice. During the Building phase, individuals developed the knowledge and skills for clinical practice; midwifery students experienced elements of this phase during their final clinical placement. The Bridging phase occurred when new registrants embarked on independent clinical practice; this phase was characterized by providing clinical care without the safety net of a preceptor. Finally, the Being phase occurred when new registrants developed confidence in their skills and professional identity as midwives. A final theme, Bettering, encompassed participants’ suggestions of ways to help improve the transition process.
Conclusion: The Building, Bridging, Being theory contributes to the present understanding of the transition to clinical practice for midwives in Ontario. This study highlighted the importance of strengthening the Preparation, Orientation, Mentorship, and Ongoing Education of new registrants through their transition to clinical practice. The findings of this study are relevant to individuals and organizations invested in educating and integrating midwives into the Ontario health care system and provides a starting point for further research centered on the transition to clinical practice for midwives in Ontario and throughout Canada.ThesisMaster of Science (MSc)The transition to clinical practice is a phenomenon that all health care professionals experience and one that has been studied in many fields of health care, yet remains largely unexamined for Canadian midwives. This study asked the question: How do new registrant midwives in Ontario navigate the transition from student to clinician during their first year of clinical practice? Thirteen interviews were conducted with Ontario midwives from three participant groups: A) New registrants in their first year of clinical practice; B) Registered midwives with 1-5 years of clinical experience; C) Registered midwives who work with new registrants as supervisors or mentors. The findings of this study led to the development of the Building, Bridging, and Being theory, which helps explain how midwives in Ontario transition to clinical practice and provides a starting point for further research centered around the transition to clinical practice midwives in Ontario and throughout Canada
Evaluation of Point of Care Ultrasound Training for Midwives
Get PDFMSc. ThesisIntroduction: In 2018, the College of Midwives of Ontario expanded the scope of practice for registered midwives to include performing point of care ultrasound (POCUS) to aid their obstetrical clinical assessments. This project evaluated learner sonography knowledge, skill acquisitions, and integration of this technology following an innovative POCUS curriculum developed for midwives to understand the impacts of this training.
Methods: Concurrent triangulation with mixed methods was used in this study through surveys and interviews. First, the surveys were used to collect data across four time points including before and after the intervention. Five- and seven-point Likert scale questions were analyzed through descriptive statistics. Open-ended questions were qualitatively analyzed using thematic analyses. Second, the semi-structured interviews were conducted to better understand participants’ attitudes and clinical behaviours. Interviews were coded and analyzed using a combination of Corbin and Strauss as well as Charmaz approaches to grounded theory.
Results: The findings demonstrated how there was a positive growth in learner comfort with POCUS and a desire to continue using it during clinical practice. The frequency of POCUS use within antenatal care increased with common applications including fetal presentation and assessment of pregnancy viability. The interviews highlighted five themes: facilitating learning, improving care, refining the role of the midwife, serving community, and maintaining competency. Access to clinical placements and the cost of a device were identified as barriers to promoting POCUS skill sets. Participants who had access to a device and completed the clinical practicum are continuing to use sonography within their clinics to provide more comprehensive client care.
Conclusions: This project demonstrates how POCUS training can positively impact midwives particularly with aiding clinical decision making such as those regarding fetal viability and presentation. However, the challenges with obtaining a clinical practicum to ensure competency and the cost and access to a device, are significant barriers that unless they are addressed, may result in minimal integration within community practices.ThesisMaster of Health Sciences (MSc)The ability to conduct ultrasounds has recently been included in Ontario midwives’ scope of practice. This project evaluated a newly developed Point of Care Ultrasound (POCUS) curriculum for practicing midwives to understand how midwives can learn and apply POCUS into their clinical work. Learners completed surveys at four time points from pre-course to one-year post-course to share their experiences of knowledge and skill acquisition and applying this training to their clinical work. Five midwives also participated in an interview to share their perspectives about the course more in-depth. It was found that Ontario midwives were very interested to learn POCUS to improve client care. Unfortunately, they struggled finding time and opportunities to refine their sonography skills such as securing a clinical practicum or the funds to purchase a device. However overall, POCUS in midwifery was well received, this technology and its respective education should continue to be supported in Ontario
Investigating the normalization and normative views of gestational weight gain: Balancing recommendations with the promotion and support of healthy pregnancy diets
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Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Maternity Care Collaboration in Ontario: The Perspectives of Obstetricians and Midwives
Get PDFIntroduction:
Interprofessional collaborative care is the gold standard in maternity care and has been proposed as the best way to manage the impending maternity care crisis in Ontario. This thesis researched the benefits and barriers to interprofessional collaboration from the perspectives of obstetricians and midwives. The goal was to understand how obstetricians and midwives view collaborative practice, how the different professions perceive collaboration, and to explore the attitudes and perceptions regarding collaboration of clinicians practicing in each discipline.
Methods:
This study adopted a mixed methods design. A province-wide survey was distributed to actively practicing obstetricians and midwives in Ontario. Following completion of the survey, participants were invited to contribute further opinions and perceptions in semi-structured interviews, conducted using a grounded theory approach.
Results:
Quantitative and qualitative data revealed three key findings. First, when comparing the opinions of obstetricians and midwives, scope of practice was viewed as a contentious issue with fee structures and turf protection being contributory factors. Second, the definition of interprofessional collaboration, and its application to clinical practice, varied by profession, and was viewed as a barrier to effective communication between disciplines. Finally, philosophy of care, particularly surrounding the provision of homebirth and women-centered care, varied starkly across the disciplines.
Conclusion:
Members of each profession need to develop strategies to ensure mutual respect is given in cases of philosophical and scope differences, an essential component to successful implementation of collaborative initiatives. Governing bodies and professional associations of each discipline need to strive for mutual agreement on appropriate scope of practice to ensure buy-in from members of each profession.ThesisMaster of Health Sciences (MSc)This thesis examines the perceptions of interprofessional collaboration from the perspectives of midwives and obstetricians, and contrasts how these perceptions vary by the profession. Data was collected in two ways: through an online survey and semi-structured interviews. Midwives and obstetricians were asked about their experiences with collaboration, their perspectives on the barriers to collaboration and thoughts about an improved system in Ontario to facilitate enhanced maternity care collaboration. The results demonstrate the key barriers to collaboration including contentious views on scope of practice, the definition and interpretation of interprofessional collaboration and varying philosophies of care. The changing landscape of maternity care in Ontario is imminent; family doctors who provide obstetrical care are on the decline, increasing the workload for obstetricians and midwives necessitating the need to eliminate barriers to achieve successful interprofessional collaboration
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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