Innovations in Midwifery Education: The Academic Medical Center Model.

Workforce analyses project a need for women's health care providers, especially in maternity care. With a stagnant number of certified nurse-midwife/certified midwife (CNM/CM) education programs, the present production of new CNMs/CMs is not robust enough to meet the growing demand. This article describes an existing but underutilized model for CNM/CM education programs, based in an academic medical center with an existing academic affiliation. Advantages include a federal funding source through the Centers for Medicare and Medicaid Services, lower tuition costs than most current programs, and expanded job satisfaction for CNMs/CMs in clinical practice.

The costs and benefits of nurse-midwifery education: model and application.

To promote nurse-midwifery education, it is important for educators to know the value students bring to clinical training sites and academic institutions, the value nurse-midwifery graduates bring to taxpayers who help support nurse-midwifery education, and the value an education in nurse-midwifery brings to the graduate. The first purpose of this study was to develop a model to include all costs and benefits of nurse-midwifery education to: 1) students; 2) clinical sites where nurse-midwifery students obtain clinical experience; 3) academic institutions that house nurse-midwifery education programs; and 4) others (most often taxpayers) who may contribute to nurse-midwifery education. The second purpose of the study was to develop a prototype nurse-midwifery education program to illustrate the use of the model. Considering the four entities together, the costs, benefits, and net benefits to society were estimated. Data were collected to estimate all costs and benefits to the four entities as they function within this prototypical program. For the prototype, all entities realize a net benefit from the investment in nurse-midwifery education. For society, the benefit-cost ratio is 1.57. Nurse-midwifery students show the highest benefit-cost ratio (2.05) of the four entities, followed by the clinical sites, others (primarily taxpayers), and academic institutions.

The cost and value of pre-registration clinical placements for Project 2000 students.

The research outlined in this article was commissioned by the Sheffield and North Trent College of Nursing and Midwifery to explore the cost implications of pre-registration clinical placements in the context of Project 2000. The authors outline the methodology and findings of an exercise designed to collect relevant cost information which was not readily available. On the basis of these findings, they suggest that: at 1995/1996 pay and prices, clinical placements cost the education provider approximately pound 890 per student per annum; in terms of real resources, the value to service providers of the service contribution made by second- and third-year nursing and midwifery students on ward-based placements outweighs the value of the time spent by qualified staff on their supervision and education. Once the funding assumptions underlying the introduction of Project 2000 have been taken into account, second- and third-year nursing and midwifery students benefit the service provider by on average pound 3.46 for every hour they spend in an unrostered ward-based placement. The service contribution made by students in community-based clinical placements cannot free staff time in the same way as on the wards and, because qualified staff in these areas are generally more highly graded, the value of the time they spend on the supervision and education of students on placement is higher than in ward-based placements. Second- and third-year students therefore appear to cost the service provider on average pound 0.48 for each hour they spend in a community-based placement. It was not possible to determine whether this cost translates into a reduction in patient contacts.