Evaluation of competence and competencies of midwives: A qualitative research

Objective: This study was done in order to evaluate the qualifications and competencies of midwives through a qualitative research. Method: The research was a two-stage qualitative study, using interview and observation method in data collection stage. The research was conducted between October 2018 and June 2019 in T.C. Ministry of Health Sakarya University Training and Research Hospital Gynaecology and Child Emergency Campus. Interview method was used in the first stage of data collection and observation method was used in the second stage. The population of the study was 24 midwives working in the delivery room and the sample of the first stage consists of 18 midwives and the sample of the second stage consists of 14 of the same midwives. In the collection of data; in the first stage, interview method was used. The midwives were asked the semi-structured questions in the Midwife Introduction and Interview Form and voice recorded (October 04-12, 2018). In the second stage, observation method was used. Each midwife was observed using the "Domains of Midwives' Competency Assessment Form" and "Assessment Form of Technology Used in Labor" until five pregnant women were followed up (January 02 - June 14, 2019). In the first stage, descriptive and content analysis was conducted using MAXQDA 2018 Qualitative Data Analysis program. In the analysis of the second stage, the midwives' competency domains were evaluated with the "Domains of Midwives' Competency Assessment Form", the observations of five pregnant followed by each midwife were written in the excel table and each theme, category and subcategory were evaluated based on 165 points and each sub-category was calculated as 1 point. The technology used during labor was evaluated with the "Assessment Form of Technology Used in Labor", practices performed according to the competency domain and category was calculated by writing observations of five pregnant followed by each midwife in the excel table, and every midwife evaluated on a total of five pregnants for five practices, with one for each pregnant. Results: It was determined that eight midwives were aged 30 and over, one midwife master, eight midwife bachelor, one midwife associate degree and eight midwife high school graduates and six midwives were educated outside of midwifery education and six midwives have been employed for 16 years and over, eight midwives have been working in the delivery room for 6-8 months. As a result of qualitative data analysis, 9 themes, 27 categories, 61 codes and a total of 503 code numbers were generated. It was determined that midwives defined the concept of proficiency in midwifery appropriately, did not make enough definition in defining the concept of competence, in terms of being aware of their own competencies and used in practice, and their explanations about competency areas were proportional to the competency areas determined by ICM and EUCEP. It was determined that midwives will gain professional satisfaction and self-confidence depending on education, experience-based competence and feeling sufficiency, they used electronic fetal monitoring as high technology and dosiflow for induction as low technology. Conclusion: It was determined that midwives did not make enough explanations about defining the concept of competence in midwifery, being aware of their own competences and using their competences in practice and their explanations about competency areas did not contain research and public health services. It was determined that midwives' thoughts of communication barriers, distancing from women, dealing with other jobs and the behaviours they showed in practice were parallel to each other.