Assistant Professor, Nurse-Midwifery, School of Nursing, Oregon Health & Science University, 3455 US Veterans Hospital Rd, Portland OR 97239.
Professor, School of Nursing and Department of Women's Studies and Department of Obstetrics and Gynecology, University of Michigan, 400 North Ingalls Suite 3160 Ann Arbor Michigan 48103.
Midwifery. 2021 May;96:102946. doi: 10.1016/j.midw.2021.102946. Epub 2021 Feb 10.
Ethical dilemmas are an inevitable part of a midwife's experience in clinical care. Midwifery educational programs have an obligation to provide students the opportunities to acquire the skills and knowledge to recognize and negotiate ethical dilemmas. Implementation of strategies for imparting ethical competencies and clinical ethics decision-making skills in formal midwifery curricula have been challenging and inconsistent. The purpose of this study was to gather information and opinions from midwifery educators and clinical preceptors about the essential components of ethics education for midwifery students in the United States (U.S.), aiming for consensus on key content, competencies, learning outcomes, and teaching strategies.
This is an online Delphi study conducted in three rounds. Round 1 consisted of open-ended questions to explore and identify key content, competencies, learning outcomes, and teaching strategies for midwifery ethics education. In Rounds 2 and 3, experts rated statements on a 1 to 7 Likert scale, with positive consensus defined as 70% or more of the experts scoring ≥6.
The panel included midwifery educators (midwifery program directors, faculty, and clinical preceptors) from the United States.
Of the 12 statements on key content of ethics education, midwives emphasized that content promoting an understanding of shared decision-making is essential for inclusion. Of the statements regarding competencies, learning outcomes, and teaching strategies, 20 of 21 statements met consensus, including those related to shared decision-making and ethical decision-making, as well as attributes such as compassion and courage. Midwives did not agree that an essential teaching strategy includes a validated assessment tool for evaluating students on any component of ethics learning (knowledge, skills, behaviour).
This Delphi study reveals what midwifery educators consider essential components of ethics education for midwifery students, with a particular focus on the professional attributes of shared decision-making.
Initial insights about optimal ways to incorporate the essential ethics education components into midwifery program curricula are provided, and more research is needed.
伦理困境是助产士在临床护理中经验的必然组成部分。助产教育计划有义务为学生提供获得识别和协商伦理困境的技能和知识的机会。在正式的助产学课程中实施传授伦理能力和临床伦理决策技能的策略一直具有挑战性和不一致性。本研究的目的是从助产教育者和临床导师那里收集有关美国（美国）助产学生伦理教育基本要素的信息和意见，旨在就关键内容、能力、学习成果和教学策略达成共识。
这是一项在线德尔菲研究，分三轮进行。第一轮包括开放式问题，旨在探索和确定助产伦理教育的关键内容、能力、学习成果和教学策略。在第二轮和第三轮中，专家对陈述进行了 1 到 7 的李克特量表评分，正面共识定义为 70%或以上的专家评分≥6。
该小组包括来自美国的助产教育者（助产项目主任、教师和临床导师）。
在伦理教育的关键内容的 12 个陈述中，助产士强调，促进对共同决策的理解的内容对于包含在内至关重要。在关于能力、学习成果和教学策略的陈述中，21 个陈述中有 20 个达成共识，包括与共同决策和伦理决策以及同情和勇气等属性相关的陈述。助产士不同意一个基本的教学策略包括一个验证的评估工具，用于评估学生在任何伦理学习组成部分（知识、技能、行为）上的表现。
这项德尔菲研究揭示了助产教育者认为助产学生伦理教育的基本组成部分，特别关注共同决策的专业属性。
提供了有关将基本伦理教育要素纳入助产计划课程的最佳方式的初步见解，需要进一步研究。
