The Construction Of A Clinical Practice Base Evaluation System For Master Of Nursing Specialist In Midwifery

PurposeThis study takes the international basic competencies for midwifery practice as a framework,combines the Global Standards for Midwifery Education(revised in 2021)with the training objectives of China’s master’s degree in nursing,and localizes the construction of a clinical practice base evaluation system for midwifery-oriented professional degree students,so as to provide a reference direction for the construction of a clinical practice base for midwifery-oriented professional degree students in China.Methods1.Literature analysis method: This study firstly used bibliometric method to search relevant literature to understand the current situation of assessment,accreditation,evaluation and development of clinical practice bases in medical education at home and abroad,as well as the current situation of construction of clinical practice bases for midwifery specialist nurses in C hina,so as to provide a theoretical basis for the development of expert correspondence questionnaires and form the initial framework of the evaluation system of clinical practice bases for master of nursing specialist in midwifery.2.Semi-structured expert interview method: Based on the literature review,a semistructured interview outline was developed,and nursing managers,postgraduate nursing educators and medical midwifery experts in midwifery-related fields were selected for interviews to understand the current status of clinical practice in midwifery and the needs for the construction of clinical practice bases,and to further supplement the evaluation index system.3.Delphi Method: Using a purposive sampling method,two rounds of expert correspondence were conducted with national experts in midwifery-related fields of nursing management,postgraduate nursing education,obstetricians and midwives.The Likert 5-point scale was used to ask the invited experts to assign importance to the entries and to solicit comments on the revision of the entries.The selection criteria for each level of evaluation index met the importance value >4.5,cv <0.20,and full score rate >20%,and were modified or deleted according to the discussion of the subject group,which finally formed the evaluation index system for the clinical practice base of MNS postgraduate students in midwifery.4.Statistical methods: Excel 2019 and SPSSAU statistical software were used for data analysis and result processing.The general information of the correspondence experts was statistically described by frequency,rate and mean with standard deviation;the scientific reliability of the correspondence results was analyzed by the degree of positivity of the correspondence experts,the degree of authority of the experts and the Kendall coordination coefficient;the hierarchical analysis method was applied to determine the weight values of the indicators at each level and the reliability of the indicator entries was analyzed.Results1.Results of literature review: A total of 113 literature related to this study were obtained through literature search and literature inclusion and exclusion criteria.The content of the non-directly related literature(39 articles)included the current situation of midwifery nurse specialist training,training mode and core competencies;the directly related literature(74 articles)mainly focused on the training mode and objectives of MNS postgraduate bed practice,clinical practice competencies,assessment and eva luation,and the quality of professional degree postgraduate education.The three major elements of the evaluation system of MNS clinical practice base in midwifery direction were initially formulated: basic conditions of the base,practice teaching system,base management and administration as well as the framework of first and second level index entries under it.2.Results of semi-structured interviews: The results of interviews with nursing managers,postgraduate nursing educators and midwifery medical experts in midwiferyrelated fields were used to refine the content of the evaluation system of clinical practice teaching bases for MNS postgraduates in midwifery direction by combining three major elements and three aspects(training institutions,practice bases and professional characteristics).3.Delphi results: In this study,27 experts from 22 higher education institutions and affiliated hospitals in 14 provinces or municipalities directly under the central government were invited to participate in the consultation,of which 20 experts completed two rounds of consultation.The positive coefficients of the two rounds of consultation were 84.38% and 74.07% respectively,the group authority coefficients of the two rounds of consultation were 0.91 and 0.94 respectively,and the Kendall’s W of the two rounds of consultation were 0.230 and 0.297 respectively,and the Kendall coordination coefficients of the two rounds of consultation showed significance(p<0.001),all of which were statistically significant.4.After two rounds of expert consultation,the number of indicators in the first round was 101,and the Cronbach’α was 0.930;the number of indicators in the second round was 95,and the Cronbach’α was 0.965;finally,the evaluation system of MNS postgraduate clinical practice base in midwifery was constructed,including 5 primary indicators(basic status of the base,base resources allocation,base system and policies,base teaching management and clinical practice),14 secondary indicators and 76 internal indicators;and the weight values of the indicators at each level and the internal indicators were calculated by using hierarchical analysis.ConclusionThis study constructs an evaluation system for MNS postgraduate clinical practice base in midwifery direction in C hina based on the localization of the basic competencies of international midwifery practice,including: 5 primary indicators,14 secondary indicators and 76 internal indicators,with scientific construction process,reasonable content setting,focused opinions of invited experts and scientific and reliable correspondence results,which can provide a reference direction for the future construction of MNS postgraduate clinical practice base in midwifery direction and help to further realize advanced midwifery practice.