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<p dir="ltr">Nurse managers recognize clinical judgment as a core competency of practice readiness (Boyer et al., 2019; Harrisona et al., 2020). Reflection is vital for novice nurses’ clinical judgment development (Tanner, 2006), enhancing their ability to deliver safe care. Despite its importance, nurse educators lack the ability to measure reflection in simulation debriefings. To address this gap, the Student-Centered Reflection Scale (SCRS) was created to assess reflection during simulation debriefings. This study aimed to conduct item testing and evaluate the psychometric properties of the SCRS to measure the presence of reflection during simulation debriefings.</p><p dir="ltr">Four sequential psychometric studies conducted initial item testing and evaluated the SCRS’s reliability and validity. The first two studies, a content validity study with 11 experts and pretesting study with 16 undergraduate nursing students, provided feedback for item revision and evidence of validity. Then an exploratory factor analysis (EFA) and item analysis study, involving 92 undergraduate nursing students from a Midwest public baccalaureate nursing school, was completed. Finally, a confirmatory factor analysis (CFA) and convergent validity study were completed using the SCRS and Groningen Reflective Ability Scale (GRAS; Aukes et al., 2007) in a convenience sample of 218 nonoverlapping undergraduate nursing students from the same educational institution.</p><p dir="ltr">The EFA revealed 20 items with four factors or subscales: (a) comparison of previous knowledge (four items); (b) analysis of biases, beliefs, and consideration of moral and ethical criteria (five items); (c) analyzing the scenario (eight items); and (d) challenging assumptions and considering a change in practice (three items). These subscales explained 82.78% of the variance and demonstrated acceptable item loadings ranging from .50–.83 and inter-item reliability ranging from .219–.664. The CFA demonstrated acceptable global fit (RMSEA = .071, CFI = .914, TLI = .900) and component fit. The SCRS also demonstrated reliability (α = .92) and convergent validity (<i>r </i>= .496) with the GRAS.</p><p dir="ltr">In conclusion, the SCRS demonstrated adequate reliability and validity with this sample. The SCRS is a resource for educators to evaluate and foster reflective skills in undergraduate nursing students during simulation debriefings, thereby promoting nursing students’ overall practice preparedness.<br></p>

Improving the quality of abortion care can reduce stigma, increase access, and enhance knowledge about pregnancy prevention and reproductive health. Midwifery-led medication abortion is considered effective, efficient, accessible, person-centred, equitable, and safe in alignment with the World Health Organization’s framework on quality abortion care. As research on client-centred access to healthcare recommends, Ontario’s expanded midwifery care models are improving the ease with which people can find and use sexual and reproductive services most appropriate to their unique needs. The expanded midwifery care presented in this study demonstrates how midwifery-led medication abortion provides high-quality services, decreases stigma, and improves access to safe, acceptable, and client-centred abortion care, particularly for commonly underserved populations deserving of health equity and Reproductive Justice. / The World Health Organization, the International Confederation of Midwives, and the Canadian Association of Midwives advocate for the inclusion of comprehensive abortion care within midwifery practice. International evidence shows positive outcomes in terms of efficacy, safety, acceptability, and post-abortion contraception uptake when midwives provide abortion services. In Canada, midwifery services are available across various populations, including urban, rural, remote, and Northern areas, suggesting a potential to enhance access and quality of abortion care, particularly for underserved people. Expanding the role of Canadian midwives to include comprehensive abortion care could improve accessibility, address gaps in service provision, support community needs, ensure professional sustainability, foster interprofessional collaboration, and offer continuity of care. Since 2017, the Ontario Ministry of Health has funded Expanded Midwifery Care Models to support midwifery integration, interprofessional collaboration, and delivery of midwifery-led sexual and reproductive care that is not funded under the current payment model. This research explores the individual and shared experiences of midwifery-led medication abortion delivered through Expanded Midwifery Care Models across three distinct regions in Ontario. The study employs interpretive description methodology to understand how midwifery influences the experiences of medication abortion for midwives, collaborating healthcare professionals, and clients. The methodology focuses on exploring how integrating a midwifery model of abortion care supports medication abortion services and promotes Reproductive Justice within primary care settings. By gathering insights from multiple perspectives, the findings hope to inform clinical practice, interest policymakers, and identify outcomes valued by midwives, clients, and healthcare professionals for future research on midwifery-led abortion care. / Thesis / Master of Science (MSc) / Quality abortion care improves the lives, health, and wellness of reproductive-aged people. Abortion is time-sensitive and people face barriers to this care. Reproductive-aged people benefit from healthcare systems that make abortion simple, safe, and effective. Internationally, midwives play a significant role in abortion care by delivering comprehensive services within sexual and reproductive healthcare. In Canada, however, the potential of midwifery in providing abortion care has not been fully realized. As an exception, Ontario’s Expanded Midwifery Care Models (EMCMs) - innovative sexual and reproductive healthcare delivery programs - have made it possible for midwives to provide abortion services. Midwifery-led abortion care in EMCMs includes providing early abortion care in ways that make it easier for people who find it difficult to access care. This research explores and compares the personal and professional experiences of medication abortion care delivered by midwives across three regions in Ontario.

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Yes / This article considers the difficulties with using Gillon's model for health care ethics in the context of clinical practice. Everyday difficulties can arise when caring for people from different ethnic and cultural s, especially when they speak little or no English. A case is presented that establishes, owing to language and cultural barriers, that midwives may have difficulty in providing ethically appropriate care to women of Pakistani Muslim origin in the UK. The use of interpreters is discussed; however, there are limitations and counter arguments to their use. Training is identified as needed to prepare service providers and midwives for meeting the needs of a culturally diverse maternity population.

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