gms | German Medical Science

Background: The challenges of midwifery are increasingly subject to change and the duties of a midwife are shifting to outpatient midwifery care, among other things. Various studies conducted in Germany confirm that practical training in outpatient midwifery (so-called externships – Externate) as well as clinical and theoretical training need to be adapted to such new challenges [1][2][3]. Stone concludes that it is fundamental to master “low-intervention” childbirth, stating that this is not ensured at conditions prevailing in Germany [4].

Method: The objective of the research at hand is to gain insight on the experiences of midwives and to know their assessment of such externships. To this end, a qualitative cross-sectional study was conducted, where seven self-employed midwives commanding experience in outpatient midwifery education were interviewed by means of a partly standardized interview guideline. These expert interviews were evaluated according to Mayring’s qualitative content analysis. Based on the summary, categories were formed and then reduced in two stages; what remained was a corpus that illustrated the base material.

Findings: The following categories may be stated as key findings:

1.

Aside from technical expertise, the midwives describe the formation of personal and social skills as the vital basis for providing midwifery care on a self-employed basis.

2.

The midwives give varied descriptions of the manner in which midwives to be can learn how to perform these activities. A major distinction is made between ‘taking on’ and ‘observing’ activities. All of the midwives are pointing out that observing activities is crucial.

3.

All of the interviewed midwives are quite motivated to provide training for midwives to be.

4.

All of the interviewed midwives describe the time frame of externships as being too short to gather sufficient experience in outpatient midwifery care.

5.

The midwives deem professional practical tutelage important for proper education and express their willingness to take further training, themselves. The questioned midwives request pecuniary appreciation of qualitatively demanding training services.

Recommendations for practice: In order to adjust practical training in outpatient midwifery care to current requirements, externships need to be extended and the ‘maximum period of externships’ set forth in the Act on Midwifery should be repealed. Specific training profiles should be defined and practical qualification of trainers should be ensured. Usable findings for developing such training profiles are already available in existing research and in this paper. The strong motivation on the part of the midwives can be utilised as an opportunity for implementation. However, pecuniary appreciation of the trainers should be implemented in order to ensure proper training in the long term.

On the basis of the findings of this study the author designed a “model-externship” in cooperation with the midwifery school in Hannover which she carries out from May to December 2015. The experiences of the student and the practical trainer/ author will be presented in a single case study.