Postgraduate Diploma in Midwifery

Purpose

The Postgraduate Diploma in Midwifery aims to strengthen and deepen the learners' knowledge in midwifery. It further aims to enable working professional nurses to undertake advanced reflection and development by means of a systematic survey of current thinking, practice, and research methods in midwifery. This qualification provides a career path for professional midwives who want to stay within the field but would like to specialize, focus on an area and add to their depth of knowledge and skill. Persons in scholarship for this qualification will become experts in Midwifery and Neonatal Nursing. The public and private sectors need qualified specialists to improve practice, decrease mortality and morbidity of childbearing women and their babies and facilitate the professional development of other midwives. The focus of the qualification will be to extend theory and its application in the Midwifery and Neonatal Nursing field. Typical learning activities should include study of appropriate specialist knowledge, case studies and integrated work-based learning.

Upon completion of this qualification qualifying learners will be able to

• Produce high-quality and competent specialist midwifery practitioners in the Midwifery and Neonatal Nursing field.
• Provide midwifery and nurse specialists with a range of skills, knowledge and attitudes that will enable them to set trends and take leadership roles in a meaningful and sustained contribution to health services.
• Equip specialists with a developed sense of equity, justice and service ethics that will ensure accountability irrespective of their workplace and a human rights-based approach to maternal and child healthcare.
• Offer a wide range of transferable skills for application in other professions, disciplines, and general life. These include:
• The ability to influence areas of policy change, development, and implementation.
• The ability to plan, implement and manage projects of a varied nature.
• The ability to work independently and as part of a team.
• The identification and solution of complex midwifery problems by using a variety of problem-solving techniques.

Rationale

This new qualification will enable the learner to function as a leader who is a clinically focused, service-orientated, autonomous, innovative nurse or midwife accoucheur specialist who can render comprehensive, scientific nursing or midwifery care in multidisciplinary teams. The rationale behind the qualification is to develop a midwife practitioner with a Postgraduate Diploma in Midwifery with advanced knowledge and expert clinical skills in line with the National and Provincial Healthcare Plans and Sustainable Development Goals as guided by the World Health Organization (WHO).

Maternal and child health is a priority in national and international developmental issues with both the Millennium Development Goals and the Sustainable Development Goals focusing on this important link to improve life for all. In South Africa however, the latest report issued on Confidential Enquiries into Maternal Deaths in South Africa stated that maternal deaths in SA increased from 2777 mothers in the 1999-2001 triennium to 3406 maternal deaths in 2002-2004, and in the latest report (2011) 4867 women died (DOH, 2006:2, 2011: iii).

The World Health Organization (WHO), International Confederation of Midwives (ICM) and the International Federation of Gynaecology and Obstetrics (FIGO) state that pre-service education, as well as continuing education of the skilled attendant, is needed to reduce maternal deaths. This qualification is therefore needed to scale up maternal and child health in SA by producing specialist midwives to ensure a skills mix that would support the local priorities.

A qualified midwifery specialist will have access to more senior practitioners and be able to affect policy in the local setting. They will function as leaders, consultants, educators, change agents and specialist practitioners in providing evidence-based care to team members of childbearing families. Qualified learners will be able to work as midwives and specialists in the public and private sectors. They will often set the level of care and participate in/or lead interprofessional teams to execute midwifery healthcare. On completion of the midwifery qualification, the nurse specialist will be able to participate in providing collaborative family-centred midwifery healthcare based on the best available evidence within an ethical-legal framework.

Recognition of Prior Learning (RPL)

The institution has an approved Recognition of Prior Learning (RPL) policy applicable to equivalent qualifications for admission into the qualification. RPL will be applied to accommodate applicants who qualify. RPL thus provides alternative access and admission to qualifications, as well as advancement within qualifications.

RPL for access

Applicants must provide evidence of prior learning by means of portfolios, other forms of appropriate evidence and/or challenging theoretical and practicum examinations, as agreed to between the School of Nursing, the institution and the Council on Higher Education (CHE).

RPL for credits

Applicants may receive credits towards a qualification depending on the outcome of the RPL process. Prior learning is recognized according to the RPL policy and procedures of the institution.

The following documentation is to be uploaded as it pertains to this qualification

• Admission policy for this programme
• RPL policy
• Any other documentation, including advertising of the programme, which will indicate your compliance with this criterion.

Entry Requirements

The minimum entry requirement for this qualification is

• Bachelor of Nursing, NQF Level 7.

Or

• Advanced Diploma in Midwifery, NQF Level 7.

And

• Registered Professional Nurse and Midwife with SANC.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8 totalling 120 Credits.

Compulsory Modules, Level 8, 120 Credits

• Midwifery Theory, 32 Credits.
• Midwifery Practicum, 32 Credits.
• Professional Ethical-Legal Practice (Midwifery), 8 Credits.
• Professional Development (Midwifery), 8 Credits.
• Management (Midwifery) 8 Credits.
• Research Methodology (Midwifery), 32 Credits.

1. Practice and facilitate specialist midwifery within the ethical and legal parameters of the profession.
2. Facilitate advocacy for the profession and provision of specialist professional support for personnel, child-bearing families, including the pregnant person or person in the childbearing continuum, and communities.
3. Apply the knowledge of and facilitate evidence-based practice, in midwifery to solve contextual problems and develop policies and guidelines.
4. Engage in scholarly activities to inform evidence-based midwifery practice.
5. Utilize, manage and communicate data to support decision-making and research.
6. Appraise and develop self, peers, and midwifery learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
7. Engage in planning, commissioning, and managing a midwifery setting
8. Render and coordinate family-centred specialist midwifery care within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences, including advanced pharmacology.
9. Mobilise appropriate resources to implement standards of practice relevant to midwifery to ensure quality child-bearing family care and safety.
10. Collaborate within the inter- and intra-professional team by engaging in health dialogue, shared leadership, decision-making, and sound clinical judgment.
11. Participate in the design, development, implementation, and evaluation of specialised midwifery policies, programmes, and projects at the provincial or national level.

Associated Assessment Criteria for Exit Level Outcome 1

• Apply personal attributes and behaviour to demonstrate conformity to the relevant code of ethics in the practice of specialist midwifery.
• Apply critical decision-making and moral reasoning models and principles to make clinical judgements and resolve ethical dilemmas within the specialist midwifery practice.
• Account for own professional judgement, actions, outcomes of specialist midwifery and continued competence.
• Identify and apply the relevant current legislation, policies, regulations and guidelines pertaining to specialist midwifery practice.
• Document all care activities accurately, comprehensively and timeously, considering the legal requirements for record-keeping.
• Discuss the midwife specialist's role in the management of professional misconduct and risks, taking into consideration the institutional protocols.

Associated Assessment Criteria for Exit Level Outcome 2

• Discuss the purpose of the advocacy role of a midwife specialist.
• Apply advocacy principles to ensure safe and quality care in midwifery settings.
• Apply appropriate communication skills and channels in facilitating advocacy.
• Lobby and/or participate in interest groups to influence legislation and policy affecting the role performance.

Associated Assessment Criteria for Exit Level Outcome 3

• Engage in specialist midwifery practice and demonstrate an understanding of the process of evidence-based practice.
• Apply evidence-based midwifery practice and appropriate methodology of gathering evidence for specialist midwifery practice, for example, systematic or scoping reviews, and appraisal of articles, practice-based-research publications.
• Use of evidence-based midwifery practice demonstrates knowledge of critical analysis of the various levels of evidence.

Associated Assessment Criteria for Exit Level Outcome 4

• Apply knowledge of appropriate search engines and databases for review of the literature to inform evidence-based midwifery practice.
• Utilize appropriate methods to generate evidence for utilization in specialist midwifery practice (e.g., research, systematic reviews, etc.)
• Peer-review journals and share evidence.
• Base activities on scientifically proven evidence in the midwifery specialist practice.
• Actively participate in inter and intra-professional dialogues, debates or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 5

• Document all data or information gathered in the context of specialist midwifery practice for utilisation and storage in accordance with the set standards.
• Utilise comprehensive data, information, and emerging evidence pertinent to specialist midwifery practice.
• Identify problems and diagnose opportunities for improvement based on gathered

and critically analysed assessment data from the patients/clients, families, communities, learners or employees, including current scientific evidence.

Associated Assessment Criteria for Exit Level Outcome 6

• Apply leadership skills appropriate to leadership styles, principles and theories of health services management.
• Effectively facilitate continuous Professional Development (CPD) for self and others as well as lifelong learning by creating a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, and performance appraisal.
• Conduct the performance appraisal processes as part of the performance management and development system.
• Utilize feedback gained from self-reflection, peers, learners, management and other relevant stakeholders to improve effectiveness in the specialist midwife role.
• Examine various risk factors that impact health and wellness within the workplace and apply strategies to care for self, peers, employees and learners.

Associated Assessment Criteria for Exit Level Outcome 7

• Critically analyse the levels and or classification of the respective specialist midwifery units.
• Commission tasks and consider the burden of diseases and priority services as determined by current events.
• Participate in the evaluation of the existing midwifery specialist unit.
• Engage in planning and commissioning roles and responsibilities of tasks within the inter and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 8

• Discuss the position of own specialist service within the healthcare system.
• Perform the full range of services within midwifery practice.
• Render specialised midwifery care that integrates promotive, preventive, curative, rehabilitative, and palliative care in a healthcare continuum.
• Apply knowledge, skill, and attitudes to render specialised midwifery care in accordance with national and international standards and protocols of specialist midwifery.
• Formulate midwifery diagnoses congruent with the patient/client's clinical manifestations or data based on accurate analysis and interpretation of data obtained from scientific, laboratory, diagnostic, technological and psycho-sociocultural assessment, including consultation of relevant/current literature/evidence.
• Plan individualised midwifery interventions considering the childbearing family's midwifery needs, values, beliefs, preferences, culture and contextual variables, for example, disease burden, health risks, national priorities, etc.
• Plan midwifery interventions based on formulated diagnoses and specialised knowledge and skills (competencies), including advanced pharmacology, in collaboration with the inter and intra-professional team.
• Implement planned midwifery interventions timeously, accurately, safely and effectively under evidence-based standards, guidelines, protocols, algorithms etc.
• Plan healthcare interventions in collaboration with the patient or client, family and relevant members of the healthcare team.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify the infrastructure and equipment needed in specialised midwifery.
• Render care, operate, and monitor the equipment used in the midwifery area.
• Employ sound asset management principles to ensure appropriate, adequate, well maintained and up-to-date equipment.
• Assign staff to midwifery care considering the specialist midwifery qualification and its competencies, experience, standard midwife-patient/client ratios for the area of specialization, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Collaboratively solve practice problems in specialist midwifery by applying informed decisions and sound clinical judgement.
• Provide appropriate and timely provision of holistic midwifery care in a healthcare continuum through awareness of one's competence.
• Carry out patient referrals appropriately and timeously as dictated by the patient's condition and under the referral guidelines.
• Participate in the interprofessional and intra-professional team is promoted, visible and recognised by members of the team.

Associated Assessment Criteria for Exit Level Outcome 11

• Participate in the development of policies, programmes and projects that demonstrate an understanding of the steps in and or levels of the development of policies, programmes and projects.
• Engage in project and policy development, demonstrates knowledge of own role and responsibilities within the inter and intra-professional policy/project team.
• Partake in policy development demonstrates advocacy for the midwifery profession and patients/clients, families and communities in specialist midwifery.
• Participate in project development including appropriate communication, negotiation, bargaining, assertiveness, persuasion, etc.).
• Provide timely and adequate feedback to relevant stakeholders as necessary.

INTEGRATED ASSESSMENT

Assessment will take place within the context of the quality assurance policies, procedures and processes of the institution and in a guided and supported learning environment. A baseline assessment will be done during contact sessions by means of introductory questions to determine the prior knowledge of learners. Questioning will be used to determine if difficult concepts and information were successfully mastered. Group participation, organisational skills, leadership, cooperation, initiative and creativity of individual learners will be assessed within group activities.

The assessment policy of the institution aims to support the development of learners, promote learning within context, promote teaching and learning practices and measure learner performance that guides certification. Faculty and School-specific rules and regulations are aligned with the institution's assessment framework and stipulate the standard procedures and regulations that are applicable to each faculty/school. Specific attention is paid to the development of academic writing and academic misconduct.

All modules in the qualification incorporate a continuous assessment approach and therefore strive to have a balance between formative and summative assessment tasks.

Description of the number and types of tests, assignments, projects and case studies.

Midwifery Theory.

Assessment is done by the learner, peers and registered assessors. Evidence of learning are

• Two to three written tests per semester.
• Three to four electronic pre-tests.
• Two assignments.
• One three-hour examination per semester.

Midwifery Practicum.

Assessment is done by the student self, peers and registered assessors. Evidence of learning are

• Completion of logbooks.
• Two written case studies included community service-learning activities
• Two informal case presentations
• One formal case presentation; and proficiency tests.
• Integrated assessments.
• Objective Structured Clinical Evaluation (OSCE).

A combination of different assessment methods allows for testing a wide variety of outcomes and is indicative of learners' progress. An effort is also made to constructively align the assessment methods, assessment tasks, learning opportunities and learning outcomes. The evidence will be compiled in a portfolio.

Professional Ethical-Legal Practice (Midwifery)

Learning outcomes will be assessed by means of continuous assessment through

• Completion of workbook activities per contact session.
• One individual assignment.
• Two tests; and one group assignment.

Professional Development (Midwifery).

Evidence of attaining the competencies for the module on professional development are

• A comprehensive individual report on precepting novices in clinical practice; and
• A performance improvement plan and self-evaluation report.

Management (Midwifery)

Learning outcomes will be assessed by means of continuous assessment through

• An audit report.
• A written test; and
• A comprehensive report on participation in an interprofessional team.

Research Methodology (Midwifery)

Continuous assessment of individual learners is done by means of assignments.

Formative Assessment

Formative assessment will be done by means of the completion of

• Workbook activities,
• Group discussion,
• Immersive simulation, and reflection after clinical learning experiences. Constructive feedback will be given following academic interaction with learners.

Summative Assessment

A combination of different summative assessment methods allows for testing a wide variety of outcomes. The learning outcomes, learning opportunities and assessment tasks are constructively aligned. Examples of summative assessment tasks are:

• Written tests,
• Written examinations.
• Proficiency tests.
• Case presentations. case studies,
• Project reports.
• Written assignments.

All modules will use continuous assessment activities which will accumulate into a general portfolio. Learners will write one three-hour examination at the end of each semester in midwifery. Continuous assessment will be used for the other four modules.