Credentialling midwives : what are the experiences of midwives working in midwifery-led models of care in NSW who undertake the credentialling process?

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Title Credentialling Midwives: the experiences‘of midwives working in midwifery-led models of care in NSW who undertook the credentialling process. Background In 2004, NSW Health issued a Policy Directive that required midwives, who worked in midwifery-led models of care, to undergo a process known as credentialling. Credentialling for midwives in NSW involves a four-step process: self-assessment, panel review of midwifery practice, emergency management skills assessment and discussion of a case study from practise. The NSW Midwives Association (NSWMA), a state branch of the national midwifery professional body the Australian College of Midwives (ACM), administers the process. The introduction of credentialling for midwives in NSW was contentious and there was much debate about the need for credentialling and its introduction for a specific group of midwives. Method This descriptive exploratory study examined the experiences of the midwives who undertook the mandated credentialling process in NSW. The study collected data through in-depth, semi-structured interviews with twelve midwives who had experienced the credentialling process. Data were analysed using simple descriptive and thematic analysis. Findings The midwives‘in the study had similar experiences of undertaking the credentialling process. Preparation for the process was time-consuming, difficult and stressful. Much of this was because this was a new process introduced into midwifery in NSW and the midwives in the study were among the first midwives ever to undertake the process. The midwives were generous in their praise for the panel review, and were both proud and relieved when awarded the credential. The more contentious findings were that the midwives saw themselves as an 'elite‘ group who practised at an 'advanced‘ level and therefore were probably less likely to need their practice reviewed. This led to a general feeling that credentialling was just ‘ticking the box‘, jumping through the hoop‘or merely completing what was required of them rather than something they, or the women they cared for, would benefit from. Implications for practice The introduction of credentialling within midwifery was contentious. This was particularly so as it was introduced for one specific group of midwives. The midwives offered several suggestions that they felt would improve the process. These included improving the clarity of information available and providing more practical assistance around preparing for the process. They also felt the experience would mean more if the process was standardised across midwifery. Standardising the process and applying the process to all midwives would work toward addressing the perceived 'advanced practice‘notions that have evolved through targeting only one group of midwives. Although, standardising the process to be applicable to all may be difficult. This is because many midwives currently do not work in a system that provides for ensuring that they all practise in the full role and scope of practise of the midwife.
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