Essential components of midwifery ethics education: results of a Delphi study.


Megregian M(1), Low LK(2), Emeis C(3), de Vries R(4), Nieuwenhuijze M(5).
Author information:
(1)Assistant Professor, Nurse-Midwifery, School of Nursing, Oregon Health & Science University, 3455 US Veterans Hospital Rd, Portland OR 97239. Electronic address: [Email]
(2)Professor, School of Nursing and Department of Women's Studies and Department of Obstetrics and Gynecology, University of Michigan, 400 North Ingalls Suite 3160 Ann Arbor Michigan 48103. Electronic address: [Email]
(3)Associate Professor, Director of the Nurse-Midwifery Program, School of Nursing, Oregon Health & Science University, 3455 US Veterans Hospital Rd, Portland, OR, 97239. Electronic address: [Email]
(4)Professor, CAPHRI, School of Public Health and Primary Care Maastricht, Zuyd University, Universiteitssingel 60, 622ER Maastricht, Maastricht, The Netherlands; Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School 2800 Plymouth Rd Ann Arbor MI 48109. Electronic address: [Email]
(5)Professor of Midwifery, Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands; Universiteitssingel 60, 6229 ER Maastricht, The Netherlands. Electronic address: [Email]


OBJECTIVE: Ethical dilemmas are an inevitable part of a midwife's experience in clinical care. Midwifery educational programs have an obligation to provide students the opportunities to acquire the skills and knowledge to recognize and negotiate ethical dilemmas. Implementation of strategies for imparting ethical competencies and clinical ethics decision-making skills in formal midwifery curricula have been challenging and inconsistent. The purpose of this study was to gather information and opinions from midwifery educators and clinical preceptors about the essential components of ethics education for midwifery students in the United States (U.S.), aiming for consensus on key content, competencies, learning outcomes, and teaching strategies. DESIGN: This is an online Delphi study conducted in three rounds. Round 1 consisted of open-ended questions to explore and identify key content, competencies, learning outcomes, and teaching strategies for midwifery ethics education. In Rounds 2 and 3, experts rated statements on a 1 to 7 Likert scale, with positive consensus defined as 70% or more of the experts scoring ≥6. PARTICIPANTS: The panel included midwifery educators (midwifery program directors, faculty, and clinical preceptors) from the United States. FINDINGS: Of the 12 statements on key content of ethics education, midwives emphasized that content promoting an understanding of shared decision-making is essential for inclusion. Of the statements regarding competencies, learning outcomes, and teaching strategies, 20 of 21 statements met consensus, including those related to shared decision-making and ethical decision-making, as well as attributes such as compassion and courage. Midwives did not agree that an essential teaching strategy includes a validated assessment tool for evaluating students on any component of ethics learning (knowledge, skills, behaviour). KEY CONCLUSIONS: This Delphi study reveals what midwifery educators consider essential components of ethics education for midwifery students, with a particular focus on the professional attributes of shared decision-making. IMPLICATIONS FOR PRACTICE: Initial insights about optimal ways to incorporate the essential ethics education components into midwifery program curricula are provided, and more research is needed.