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Midwives and Abortion Care: A Model for Achieving Competency
Author(s) -
Levi Amy,
Angel James Evelyn,
Taylor Diana
Publication year - 2012
Publication title -
journal of midwifery and womens health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/j.1542-2011.2012.00182.x
Subject(s) - medicine , curriculum , certification , abortion , trainer , nursing , health care , competence (human resources) , medical education , pregnancy , psychology , pedagogy , social psychology , biology , political science , computer science , law , economics , genetics , programming language , economic growth
Throughout history, the care of women's reproductive health needs has included termination of unwanted pregnancy. Unfortunately, access to safe first‐trimester abortion is restricted by a lack of skilled providers. In an effort to provide data‐based evidence and increase access to first‐trimester abortion care in California, the University of California, San Francisco, under the auspices of the Health Workforce Pilot Program, developed a competency‐based training model to increase the number of certified nurse‐midwives, nurse practitioners, and physician assistants who can provide uterine aspiration. This article describes the training program, which uses a curriculum comprising both self‐directed didactic material and supervised clinical experience with a minimum of 40 procedures. Successful completion of the program requires passing a written examination and satisfactory achievement of a competency‐based clinical assessment. Thirty‐eight trainees have completed the training to date, achieving competency following an average of 6 training days. Competency development in the clinical area is monitored by both the trainer and the trainee, using daily and final competency assessments in 4 domains: patient comfort, procedural completeness, speed, and ability to identify problems. Analysis of complications is used to identify concerns about clinician safety. The availability of a competency‐based training curriculum for uterine aspiration has the potential to increase the number of first‐trimester abortion providers by making training available to experienced clinicians, including nurse‐midwives, who would like to provide this care.