Yale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Section of Obstetrics and Midwifery, New Haven, CT, United States.
Yale School of Nursing and Midwifery, New Haven, CT, United States.
Midwifery. 2021 May;96:102941. doi: 10.1016/j.midw.2021.102941. Epub 2021 Feb 9.
In recent decades, there has been a call to foster effective collaborative models of practice between midwives and obstetricians/gynecologists (OB/GYNs) in the United States in order to improve clinician satisfaction and outcomes for childbearing women. Currently, there is no existing validated scale that measures the collaboration between obstetricians and midwives on labor and birth units. We sought to develop and validate a Midwifery- Obstetrics Collaboration (MOC) Scale that measures obstetricians' attitudes towards collaboration between obstetricians and midwives on labor and birth units.
Validation study. The items in the questionnaire to be validated were developed de novo by the authors, based on their experiences and expertise in collaborative practice as well as by incorporating key principles of effective collaborative practice documented in the literature. The questionnaire was then piloted among 13 content experts.
Anonymous online survey conducted in the United States.
We validated the questionnaire among 471 obstetricians in the United States from Sept 2019 to March 2020. The respondents included general obstetrician and gynecologists (OB/GYN) attendings, OB/GYN hospitalists, maternal fetal medicine (MFM) fellows and MFM attendings who practice on a labor and birth unit in the United States.
We performed reliability analysis of the a priori items. We measured concurrent validity with an existing scale that measures inter-professional collaboration between nurses and physicians. We also correlated our scale with concerns for liability when working in a collaborative practice with midwives. Lastly, we measured discriminant validity with a single item burn out scale. The novel MOC Scale demonstrated construct and concurrent validity, and high inter-item reliability (a=0.93). The MOC Scale correlated with concerns about liability (r=0.63, p <0.001) but was not associated with burnout indicating the uniqueness of the new construct.
The MOC Scale is validated to assess collaboration between obstetricians and midwives on labor and birth units from an obstetrician's perspective IMPLICATIONS FOR PRACTICE: The MOC Scale can be used as a tool in clinical practice, to assess and foster effective collaboration between obstetricians and midwives from an obstetricians' perspective especially when used in conjunction with other tools that take into the account the perspectives of midwives and childbearing women.
近几十年来，人们呼吁在美国培养助产士和妇产科医生/妇科医生（OB/GYN）之间有效的合作模式，以提高临床医生的满意度和母婴的结局。目前，尚无现有的经过验证的量表来衡量产科医生在分娩单位的合作情况。我们旨在开发和验证一个衡量产科医生在分娩单位与助产士合作态度的助产-产科合作（MOC）量表。
验证研究。待验证问卷的项目由作者根据他们在合作实践中的经验和专业知识以及纳入文献中记录的有效合作实践的关键原则而开发。然后，该问卷在 13 名内容专家中进行了试点研究。
在美国进行的匿名在线调查。
我们在美国招募了 471 名妇产科医生参与该问卷验证，他们包括普通妇产科医生、妇产科医院医生、母胎医学（MFM）研究员和在美国分娩单位工作的 MFM 医生。
我们对预先确定的项目进行了可靠性分析。我们使用现有的衡量护士和医生之间的跨专业合作的量表来衡量同时效性。我们还将我们的量表与在与助产士合作实践中对责任的担忧进行了相关性分析。最后，我们使用一项倦怠量表来衡量判别有效性。新型 MOC 量表具有构建和同时效性，并且项目间的相关性较高（a=0.93）。MOC 量表与对责任的担忧相关（r=0.63，p<0.001），但与倦怠无关，表明新结构的独特性。
MOC 量表从产科医生的角度验证了评估产科医生与分娩单位助产士之间合作的有效性。
MOC 量表可作为一种工具用于临床实践，从产科医生的角度评估和促进产科医生与助产士之间的有效合作，特别是与考虑到助产士和产妇观点的其他工具一起使用时。
