Shawn Walker1, Prasanth Perilakalathil2, Jenny Moore3, Claire L Gibbs4, Karen Reavell5, Kenda Crozier6. 1. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Gt Yarmouth, Norfolk NR31 6LA, UK. Electronic address: Shawn.Walker@nhs.net. 2. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Gt Yarmouth, Norfolk NR31 6LA, UK. Electronic address: Prasanth.Perilakalathil@jpaget.nhs.uk. 3. School of Nursing Sciences, Edith Cavell Building, University of East Anglia, Norwich NR4 7TJ, UK. Electronic address: J.F.Moore@uea.ac.uk. 4. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Gt Yarmouth, Norfolk NR31 6LA, UK. Electronic address: Claire.Gibbs2@jpaget.nhs.uk. 5. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Gt Yarmouth, Norfolk NR31 6LA, UK. Electronic address: Karen.Reavell@jpaget.nhs.uk. 6. School of Nursing Sciences, Edith Cavell Building, University of East Anglia, Norwich NR4 7TJ, UK. Electronic address: K.Crozier@uea.ac.uk.
Abstract
INTRODUCTION: expansion of advanced and specialist midwifery practitioner roles across professional boundaries requires an evidence-based framework to evaluate achievement and maintenance of competency. In order to develop the role of Breech Specialist Midwife to include the autonomous performance of external cephalic version within one hospital, guidance was required on standards of training and skill development, particularly in the use of ultrasound. METHODS: a three-round Delphi survey was used to determine consensus among an expert panel, including highly experienced obstetric and midwife practitioners, as well as sonographers. The first round used mostly open-ended questions to gather data, from which statements were formed and returned to the panel for evaluation in subsequent rounds. FINDINGS: standards for achieving and maintaining competence to perform ECV, and in the use of basic third trimester ultrasound as part of this practice, should be the same for midwives and doctors. The maintenance of proficiency requires regular practice. CONCLUSIONS: midwives can appropriately expand their sphere of practice to include ECV and basic third trimester ultrasound, according to internal guidelines, following the completion of a competency-based training programme roughly equivalent to those used to guide obstetric training. Ideally, ECV services should be offered in organised clinics where individual practitioners in either profession are able to perform approximately 30 or more ECVs per year in order to maintain an appropriate level of skill.
INTRODUCTION: expansion of advanced and specialist midwifery practitioner roles across professional boundaries requires an evidence-based framework to evaluate achievement and maintenance of competency. In order to develop the role of Breech Specialist Midwife to include the autonomous performance of external cephalic version within one hospital, guidance was required on standards of training and skill development, particularly in the use of ultrasound. METHODS: a three-round Delphi survey was used to determine consensus among an expert panel, including highly experienced obstetric and midwife practitioners, as well as sonographers. The first round used mostly open-ended questions to gather data, from which statements were formed and returned to the panel for evaluation in subsequent rounds. FINDINGS: standards for achieving and maintaining competence to perform ECV, and in the use of basic third trimester ultrasound as part of this practice, should be the same for midwives and doctors. The maintenance of proficiency requires regular practice. CONCLUSIONS: midwives can appropriately expand their sphere of practice to include ECV and basic third trimester ultrasound, according to internal guidelines, following the completion of a competency-based training programme roughly equivalent to those used to guide obstetric training. Ideally, ECV services should be offered in organised clinics where individual practitioners in either profession are able to perform approximately 30 or more ECVs per year in order to maintain an appropriate level of skill.
Authors: S Derisbourg; E Costa; L De Luca; S Amirgholami; V Bogne Kamdem; A Vercoutere; W H Zhang; S Alexander; P M Buekens; Y Englert; A Pintiaux; C Daelemans Journal: BMC Pregnancy Childbirth Date: 2020-07-29 Impact factor: 3.007