"Working towards being ready": A grounded theory study of how practising midwives maintain their ongoing competence to practise their profession.

OBJECTIVE: to present a grounded theory research study explaining how New Zealand midwives maintain their ongoing competence to practise their profession. DESIGN: grounded theory, an interpretive emergent research methodology was used to examine the process of maintaining competence in midwifery practice. SETTING: New Zealand urban and rural practice settings. PARTICIPANTS: twenty-six midwives from across New Zealand were interviewed and asked about maintaining their competence to practise. Five midwives were interviewed twice, to explore the emerging findings and as one method of member checking. FINDINGS: the grounded theory of 'working towards being ready' describes a continuous process in which midwives engage as they work to maintain practice competence. The component parts comprise professional positioning, identifying needs, strategizing solutions and reflecting on practice. The process is contextual, diverse and is influenced by the practice setting where the salient conditions of resourcing, availability and opportunity for engagement in activities are significant. KEY CONCLUSIONS: across the midwifery profession, midwives in New Zealand are currently working under the generic umbrella of midwifery practice. Midwives work across a range of practice arenas in diverse ways focussed on providing safe care and require a range of professional development activities germane to their area of practice. When the midwife has access to professional development pertinent to their practice, women and the profession benefit. As there is diversity of practice, then mandated processes for ongoing competence need to have flexibility to reflect that diversity. IMPLICATIONS FOR PRACTICE: midwives engage in development that allows them to remain current in practice and that enables them to provide appropriate care to women and their babies. As a consequence they can develop expertise in certain aspects of midwifery. Mandated processes that require engagement in activities aimed at demonstration of competence should be evaluated and tailored to ensure they meet the needs of the developing profession.

Supporting New Zealand graduate midwives to stay in the profession: An evaluation of the Midwifery First Year of Practice programme.

BACKGROUND: the transition from undergraduate midwifery student to working as a confident midwife can be challenging for many newly qualified midwives. Supporting a smooth transition may have a positive impact on the confidence and retention of the new graduates within the workforce. In New Zealand the Midwifery First Year of Practice programme (MFYP) was introduced in 2007 as a structured programme of support for new graduate midwives for the whole of their first year of practice. The main components of the programme include support during clinical practice, provision of a funded mentor midwife chosen by the new graduate midwife, financial assistance for education and a requirement to undertake a quality assessment and reflection process at the end of the first year. AIM: the aim of this study was to explore the retention of new graduates in midwifery practice following participation in the Midwifery First Year of Practice programme. METHOD: data was obtained from the register of MFYP participants between the years 2007 and 2010. This data was cross referenced with the Midwifery Council of New Zealand register and workforce data for 2012. FINDINGS: between the years 2007 and 2010 there were 441 midwives who graduated from a midwifery pre-registration education programme in New Zealand. Of these 415 participated in the MFYP programme. The majority were of New Zealand European ethnicity with 10% identifying as Maori. The mean age of participants reduced from 36.4 (SD 7.3) in 2007 to 33.4 (SD 8.1) in 2010. The overall retention rate for new graduate midwives who had participated in the MFYP programme was 86.3%, with 358 midwives still practising in 2012. CONCLUSION: there is good retention of new graduate midwives within New Zealand and the MFYP programme would appear to support retention.

Linking violent thinking: implicit theory-based research with violent offenders.

Violent offenders often articulate offense-supportive cognitions during rehabilitation, yet these statements have received little theoretical attention, and intervention approaches have targeted each type of statement individually, as if they were unrelated. An implicit theory approach to cognitions has proved fruitful for research and intervention. The authors apply it to violent offenders. The first study presents a grounded theory investigation of offense-supportive cognition in prisoners attending an intensive rehabilitation program for violent offenders. Analysis of offense transcripts enabled the identification of several implicit theories. These results were refined with a second sample and trialed in the rehabilitation program. Findings suggest that several implicit theories held by violent offenders are linked to each other through the widespread normalization of violence. Few offenders experienced their violent behavior as abnormal, or completely outside of their control, once initiated. The authors make suggestions for enhancing the empirical status of this research domain, particularly through experimental investigations.