Master course Physician Assistant for Clinical Midwifery

Transcription

1 Master course Physician Assistant for Clinical Midwifery Rotterdam, the Netherlands Irma van der Velden

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4 The staff Evelien Cellissen MPA midwifery Rudy Riijke MD,PhD Irma v.d. Velden Medical Biologist Bernice Engeltjes MPA Midwifery Menno Kiel MD Eveline Wouters MD,PhD Els Grijseels MD,PhD Nicole Steemers MD Gynaecologist Yvonne Post MPA Midwifery

5 the Netherlands: some facts and figures

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7 41,160 sq km 16,7 million inhabitants 320 km Groningen Amsterdam Utrecht Leiden Rotterdam Nijmegen Maastricht 180 km

8 Average inhabitants per sq km in the Netherlands: 491 Highest population density per sq km: The Hague 5967 inhabitants

9 Number of home deliveries in the Netherlands traditionally high (compared to other W-European countries) Last decades a decreasing number: 1989: 38 % 2009: 24 %

10 Factors that contribute to this decrease increased request for pain relief during labour a relatively high perinatal mortality (compared to other European countries) women get older before they get their first born, more risk more chronicle diseases, more obese

11 Number of midwives: 2500 (yr 2010) 750 clinical midwives 47 male Annual number of baby deliveries: 184,000 (yr 2010)

12 Perinatal care in the Netherlands: basic principle low risk high risk midwife obstetrician home delivery hospital delivery

13 Outlines of a Community Midwife Takes care of patients with low-risk pregnancies and in many cases the patient will deliver at home Works autonomously, but abide by the rules of a national midwifery referral manual With help of this manual, a risk analysis can be made Patients can be referred to an obstetrician during pregnancy and/or labour, if there is any reason to suspect an increased obstetric or medical risk.

14 What happend the last 10 years: Midwifes started to play a more important role in the obstetric departments of the hospital. In many hospitals the community midwives started to run the labour ward under supervision of the obstetrician.

15 Due to the growing responsibilities: The need: 1. Properly qualify the midwives for the function they were fulfilling 2. Give them the opportunity to expand their tasks. The Master Physician Assistant Programme for Clinical Midwives was developed for them. And introduced in 2005 in Rotterdam.

16 Community midwife ~ Clinical midwife Clinical Midwife Master courses*: The Rotterdam MPA - KV Community Midwife Four years Bachelor s degree *Amsterdam MSc

17 Characteristics of the programme Duration: 2½ years ~ 150 ECTS* The study is divided into: first year (60 ECTS), second year (60 ECTS) third year (30 ECTS), All years: including on-the-job training * (ECTS= credit points,according to the European Credit Transfer System).

18 Characteristics of the programme Title: Master Physician Assistant Midwifery (MPA - Midwifery)

19 Characteristics of the programme Access requirements: A Bachelor s degree in Midwifery Legal qualification in midwifery (according to the Dutch Individual Health Care Professions Act) = Dutch BIG Act Two years of relevant practical experience A paid position for 32 hours per week An obstetrician acts as a personal study counsellor / teacher on-the-job

20 Characteristics of the programme The personal study counsellor / teacher on-the-job: An expert in obstetric health care An obstetrician/ gynaecologist A rollmodel for the students A supervisor on the job who evaluates the practical competencies

21 Characteristics of the programme Structure: School: Clinic: One day in the week to school Follow 17 theoretical and practical courses Including a research programme and a integrative masterthesis Work at 3 or 4 days Based on a task book Being assessed by the trainer on the job

22 Characteristics of the programme The Rotterdam Master Advanced Midwifery Practice Program defines 7 professional roles: Expert Manager Caregiver Medical counselor Teacher Researcher Professional

23 Roles Professional domain Competencies Expert Manager Caregiver Medical counselor Clinical midwifery expert Coordination and management of the health care proces Support of the healthcare process Medical care 1. Safeguardance and promotion of physiology 2. Risk evaluation 1. Coördination 2. Triage 1. Optimal communication 2. Provision of psychosocial care 1. Diagnostic evaluation 2. Treatment Teacher Expertise 1. Promotion of expertise Practical research 1. Evidence based practice Researcher 2. Medical research Professional Clinical midwife 1. Professionalisation 2. Quality control

24 Characteristics of the programme 17 training courses: Learning skills Safeguarding physiology Clinical decision making Pathology Physical examination Triage Counseling Quality control o Psychosocial problems o o o o o o o o o Teaching skills o Ultrasonography o Research skills o Evidence based practice o Literature review o Master thesis o Management skills o Managing obstetric medical emergencies

25 percentage van de normale bevallingen Result: the role of Clinical Midwives rises 57% jaar Bewerking van: de Neef T, Franx A. Ned Tijdschr Obstet Gynaecol 2009;122:270. Gegevens van de Stichting Perinatale Registratie Nederland, bewerkt met LVRinsight.

26 Main conclusions, based on assessments Students: undergo an important development, resulting in functioning at a master level are more capable in dealing with complex clinical situations take more initiative show leadership qualities are creative and innovative in multidisciplinary teams

27 Some opinions of medical specialists in the obstetric units of the hospitals They work on a higher level in our department, function more independent, show more initiative, show more overview in complex situations They have more practical knowledge and skills in clinic (pathology, gynecology, evidence-based practice) They are more competent in discussions with physicians, and take responsibility for the team

28 New tasks: First point of contact for the obstetric department Making diagnoses and prescribe therapy Responsible for writing and evaluation of protocols in the delivery rooms Establish skill and drill in emergency training at the department Providing perinatal audits and education Conducting scientific research First shelter for the home deliveries by suspecting an increased obstetric or medical risk

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30 Dutch tradition at the birth of a baby Bisquit with anise sprinkles!

31 Thank you! Rotterdam, the Netherlands