Health Professions Education: Problems and System Goals

Problems

Disease focus of maternity care education and clinical training

The primary focus of training for most maternity caregivers is on diagnosis and interventions to address complications of pregnancy and childbirth. There is insufficient emphasis on knowledge and skills to prevent complications, promote health, and support physiologic pregnancy, birth, and early parenting. Additionally, most health professional education curricula lack sufficient content in psychosocial aspects of pregnancy and birth, woman- and family-centered care, cultural competence, collaborative practice, system thinking, and shared decision making.

Wide variation in the content and process of education across disciplines, with education and training for each occurring in isolation

Although health professionals work in teams, they are educated separately and their education does not help them learn how to work effectively together. Education programs differ across disciplines with respect to content, depth, and focus of material taught, views of relationships between caregivers and women, philosophy about use of technology and resources, and what constitutes best practice.

Inadequate emphasis on appraisal and use of the best available evidence

Skills for critically appraising research reports are not systematically incorporated into maternity health professional education. Although comprehensive compendia of systematic reviews of best evidence for pregnancy and childbirth care have been available, updated, and augmented for two decades, the evidence is not reliably translated into practice, suggesting the need to explore educational content and modalities that are effective at improving evidence uptake.

Ineffective continuing education

Current continuing education requirements are poorly aligned across disciplines, may not be effective in bringing about practice improvement, and in some domains, such as anesthesia, do not reflect content specific to the provision of maternity care even if that is the primary practice setting. Most continuing education programs rely on didactic rather than skill-based modalities, and have not been associated with improved practice patterns and/or patient outcomes. Potential conflicts of interest are introduced when continuing education is sponsored by the medical industry.

System Goals

  • An orientation toward prevention and wellness forms the foundation of maternity care education and clinical training across disciplines.
  • Education and clinical training across all disciplines adheres to the tenets of the ‘‘Sicily Statement on Evidence-Based Practice‘‘ (Dawes et al., 2005).
  • Funding for maternity care education is aligned with national goals for maternity care workforce development and performance.
  • To promote successful collaborative practice, interdisciplinary maternity care education is the norm.

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Reference

Dawes, M., Summerskill, W., Glasziou, P., Cartabellotta, A., Martin, J., Hopayian, K., et al. (2005). Sicily statement on evidence-based practice. BMC Medical Education, 2005, 5, 1–7.