Webb Sara S, Skene Esther R, Manresa Margarita, Percy Elizabeth K, Freeman Robert M, Tincello Douglas G
Birmingham Women's & Children's NHS Foundation Trust, Edgbaston, Birmingham, UK; Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK.
University of Leicester Medical School, University of Leicester, University Road, Leicester, LE17RH, UK.
Eur J Obstet Gynecol Reprod Biol. 2021 Jan;256:140-144. doi: 10.1016/j.ejogrb.2020.10.065. Epub 2020 Nov 5.
The aim of this study was to evaluate current education and training of student and registered midwives across the UK and Spain; analysing both pelvic floor teaching and practical experience.
A cross-sectional survey was carried out by 711 student and 384 registered midwives across different universities and regions in the UK and Spain.
The vast majority (91.5 % n = 382) of UK students complete training without ever cutting or repairing an episiotomy. This compares to 39.4 % (n = 85) of registered midwives who did not cut an episiotomy during training. Only 20 % (n = 9) of Spanish and 10 % (n = 45) of UK registered midwives felt confident undertaking these techniques. In Spain just 15 % (n = 6) of students, compared to 54.8 % (n = 80) of registered midwives had received teaching on longer-term pelvic floor complications.
There is a considerable deficit in the current training practices for midwives regarding episiotomies. This lack of practice and confidence may be impacting on the increased rates of perineal tears and pelvic dysfunction in post-partum women. Across registered midwives there are gaps in education regarding longer-term pelvic floor complications. Our study was limited by a smaller sample size from Spain compared to the UK. Our results show practical assessment of skills during training is desirable and could improve both the confidence and competence of midwives upon registration.
本研究旨在评估英国和西班牙学生助产士及注册助产士目前的教育与培训情况;分析盆底教学及实践经验。
英国和西班牙不同大学及地区的711名学生助产士和384名注册助产士开展了一项横断面调查。
绝大多数(91.5%,n = 382)英国学生在完成培训时从未进行过会阴切开术或修复术。相比之下,39.4%(n = 85)的注册助产士在培训期间未进行过会阴切开术。只有20%(n = 9)的西班牙注册助产士和10%(n = 45)的英国注册助产士对实施这些技术有信心。在西班牙,只有15%(n = 6)的学生接受过关于盆底远期并发症的教学,而注册助产士的这一比例为54.8%(n = 80)。
目前助产士会阴切开术的培训实践存在相当大的不足。这种实践和信心的缺乏可能正在影响产后妇女会阴撕裂和盆底功能障碍发生率的上升。在注册助产士中,关于盆底远期并发症的教育存在差距。与英国相比,我们的研究因西班牙样本量较小而受到限制。我们的结果表明,培训期间对技能进行实践评估是可取的,这可以提高助产士注册后的信心和能力。