Reliability and validity of Midwifery - Obstetrics Collaboration (MOC) scale: A tool to improve collaborative practice.

Affiliation

Onibokun OO(1), Morelli EM(2), Illuzzi JL(3), White MA(4).
Author information:
(1)Yale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Section of Obstetrics and Midwifery, New Haven, CT, United States. Electronic address: [Email]
(2)Yale School of Nursing and Midwifery, New Haven, CT, United States.
(3)Yale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Section of Obstetrics and Midwifery, New Haven, CT, United States.
(4)Yale School of Public Health, Department of Social and Behavioral Sciences, New Haven, CT, United States.

Abstract

OBJECTIVE: In recent decades, there has been a call to foster effective collaborative models of practice between midwives and obstetricians/gynecologists (OB/GYNs) in the United States in order to improve clinician satisfaction and outcomes for childbearing women. Currently, there is no existing validated scale that measures the collaboration between obstetricians and midwives on labor and birth units. We sought to develop and validate a Midwifery- Obstetrics Collaboration (MOC) Scale that measures obstetricians' attitudes towards collaboration between obstetricians and midwives on labor and birth units. DESIGN: Validation study. The items in the questionnaire to be validated were developed de novo by the authors, based on their experiences and expertise in collaborative practice as well as by incorporating key principles of effective collaborative practice documented in the literature. The questionnaire was then piloted among 13 content experts. SETTING: Anonymous online survey conducted in the United States. PARTICIPANTS: We validated the questionnaire among 471 obstetricians in the United States from Sept 2019 to March 2020. The respondents included general obstetrician and gynecologists (OB/GYN) attendings, OB/GYN hospitalists, maternal fetal medicine (MFM) fellows and MFM attendings who practice on a labor and birth unit in the United States. MEASUREMENTS AND FINDINGS: We performed reliability analysis of the a priori items. We measured concurrent validity with an existing scale that measures inter-professional collaboration between nurses and physicians. We also correlated our scale with concerns for liability when working in a collaborative practice with midwives. Lastly, we measured discriminant validity with a single item burn out scale. The novel MOC Scale demonstrated construct and concurrent validity, and high inter-item reliability (a=0.93). The MOC Scale correlated with concerns about liability (r=0.63, p <0.001) but was not associated with burnout indicating the uniqueness of the new construct. KEY CONCLUSIONS: The MOC Scale is validated to assess collaboration between obstetricians and midwives on labor and birth units from an obstetrician's perspective IMPLICATIONS FOR PRACTICE: The MOC Scale can be used as a tool in clinical practice, to assess and foster effective collaboration between obstetricians and midwives from an obstetricians' perspective especially when used in conjunction with other tools that take into the account the perspectives of midwives and childbearing women.