Baluwa Masumbuko Albert, Mndolo Neggie Chinyanga Mkundika, Yeboa Naomi Kyeremaa, Mpeta-Phiri Cynthia, Haruzivishe Clara, Chirwa Ellen
School of Maternal, Neonatal and Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Department of Nursing and Midwifery, Mzuzu University, Mzuzu, Malawi.
Adv Med Educ Pract. 2023 Sep 26;14:1067-1075. doi: 10.2147/AMEP.S426347. eCollection 2023.
The purpose of midwifery education is to produce clinically competent midwives. However, clinical training in Malawi faces multiple challenges, and the concept of Clinical Competency (CC) has not been analysed in this context. This article analyses CC during undergraduate midwifery training in Malawi to elucidate its attributes, antecedents, consequences, and empirical referents.
A literature search was performed on data bases, Google Scholar, PubMed, and CINAHL, using the following terms: clinical competency, midwifery competency, nursing competency, nursing and midwifery competency. Published articles were retrieved and clinical competency analysis was guided by Walker and Avant's strategy.
CC attributes were knowledge, skills, attitudes, performance level, professionalism, and entrustable professional activity. Antecedents included motivation, role models, learning environment and personal traits. The consequences of CC include confidence, client safety, and quality of care. CC can be measured through a combination of four strategies: observing a student practising it in clinical area, simulation or Objective Structured Clinical Examination (OSCE), application through written essays or case presentations, and knowledge-based assessment.
CC is a multidimensional concept and its definition and defining attributes are contextual. Similarly, clinical competencies are a major determinant of educational decisions such as curriculum nucleus, length of clinical placement, teaching strategies, and student assessment methods. However, CC and its attributes have not been fully utilised in Malawi, especially in clinical teaching and student clinical assessments. There is a need to adequately prepare midwifery educators, clinical staff, and students to deliver quality clinical competencies consistent with competency-based education. Adoption of different assessment strategies and development of valid and reliable tools is necessary to comprehensively measure CC among midwifery students in Malawi.
助产士教育的目的是培养具备临床能力的助产士。然而，马拉维的临床培训面临多重挑战，且在此背景下尚未对临床能力（CC）的概念进行分析。本文分析了马拉维本科助产士培训期间的临床能力，以阐明其属性、 antecedents、后果和实证参照。
在数据库、谷歌学术、PubMed和CINAHL上进行文献检索，使用以下术语：临床能力、助产士能力、护理能力、护理和助产士能力。检索已发表的文章，并以沃克和阿万特的策略为指导进行临床能力分析。
临床能力属性包括知识、技能、态度、表现水平、专业精神和可托付的专业活动。antecedents包括动机、榜样、学习环境和个人特质。临床能力的后果包括信心、客户安全和护理质量。临床能力可通过四种策略的组合来衡量：观察学生在临床领域的实践情况、模拟或客观结构化临床考试（OSCE）、通过书面论文或病例报告进行应用以及基于知识的评估。
临床能力是一个多维度的概念其定义和定义属性是具体情境相关的。同样，临床能力是教育决策的主要决定因素，如课程核心、临床实习时长、教学策略和学生评估方法。然而，临床能力及其属性在马拉维尚未得到充分利用，尤其是在临床教学和学生临床评估中。有必要充分准备助产士教育工作者、临床工作人员和学生，以提供与基于能力的教育相一致的高质量临床能力。采用不同的评估策略并开发有效可靠的工具对于全面衡量马拉维助产专业学生的临床能力是必要的。
