MSc. Thesis / Introduction: In 2018, the College of Midwives of Ontario expanded the scope of practice for registered midwives to include performing point of care ultrasound (POCUS) to aid their obstetrical clinical assessments. This project evaluated learner sonography knowledge, skill acquisitions, and integration of this technology following an innovative POCUS curriculum developed for midwives to understand the impacts of this training.
Methods: Concurrent triangulation with mixed methods was used in this study through surveys and interviews. First, the surveys were used to collect data across four time points including before and after the intervention. Five- and seven-point Likert scale questions were analyzed through descriptive statistics. Open-ended questions were qualitatively analyzed using thematic analyses. Second, the semi-structured interviews were conducted to better understand participants’ attitudes and clinical behaviours. Interviews were coded and analyzed using a combination of Corbin and Strauss as well as Charmaz approaches to grounded theory.
Results: The findings demonstrated how there was a positive growth in learner comfort with POCUS and a desire to continue using it during clinical practice. The frequency of POCUS use within antenatal care increased with common applications including fetal presentation and assessment of pregnancy viability. The interviews highlighted five themes: facilitating learning, improving care, refining the role of the midwife, serving community, and maintaining competency. Access to clinical placements and the cost of a device were identified as barriers to promoting POCUS skill sets. Participants who had access to a device and completed the clinical practicum are continuing to use sonography within their clinics to provide more comprehensive client care.
Conclusions: This project demonstrates how POCUS training can positively impact midwives particularly with aiding clinical decision making such as those regarding fetal viability and presentation. However, the challenges with obtaining a clinical practicum to ensure competency and the cost and access to a device, are significant barriers that unless they are addressed, may result in minimal integration within community practices. / Thesis / Master of Health Sciences (MSc) / The ability to conduct ultrasounds has recently been included in Ontario midwives’ scope of practice. This project evaluated a newly developed Point of Care Ultrasound (POCUS) curriculum for practicing midwives to understand how midwives can learn and apply POCUS into their clinical work. Learners completed surveys at four time points from pre-course to one-year post-course to share their experiences of knowledge and skill acquisition and applying this training to their clinical work. Five midwives also participated in an interview to share their perspectives about the course more in-depth. It was found that Ontario midwives were very interested to learn POCUS to improve client care. Unfortunately, they struggled finding time and opportunities to refine their sonography skills such as securing a clinical practicum or the funds to purchase a device. However overall, POCUS in midwifery was well received, this technology and its respective education should continue to be supported in Ontario.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/26969 |
| Date | January 2021 |
| Creators | Johnston, Bronte K |
| Contributors | Murray-Davis, Beth, Health Science Education |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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