Through the resident lens: examining knowledge and attitudes about midwifery among physician trainees

ABSTRACT

Interprofessional collaboration optimizes maternal-newborn outcomes and satisfaction with care. Since 2002, midwives have provided an increasing proportion of maternity care in British Columbia (BC). Midwives often collaborate with and/or refer to physicians; but no study to date has explored Canadian medical trainees’ exposure to, knowledge of, and attitudes towards midwifery practice.

We designed an online cross-sectional questionnaire that included a scale to measure attitudes towards midwifery (13 items) and residents’ knowledge of midwifery (94 items across 5 domains). A multi-disciplinary expert panel rated each item for importance, relevance, and clarity. The survey was distributed to family medicine (n = 338) and obstetric (n = 40) residents in BC.

We analyzed responses from 114 residents. Residents with more favourable exposures to midwifery during their education had significantly more positive attitudes towards midwives (r_s = 0.32, p = 0.007). We also found a significant positive correlation between residents’ attitudes towards midwifery and four of five knowledge domains: scope of practice (r_s = 0.41, p < 0.001); content of education (r_s = 0.30, p = 0.002), equipment midwives carry to home births (r_s = 0.30, p = 0.004) and tests that midwives can order (r_s = 0.39, p < 0.001). The most unfavourable exposures were observing interprofessional conversations (66.2%), and providing inpatient consultations for midwives (61.4%). Findings suggest increased interprofessional education may foster improved midwife-physician collaboration.

Abbreviations: BC – British Columbia; UBC – University of British Columbia

KEYWORDS:

• Physicians
• residents
• midwifery
• interprofessional collaboration
• provider attitudes
• interprofessional education

Acknowledgments

We would like to acknowledge Dr. Evelyn Cornelissen, UBC Rural Okanagan Family Medicine Residency Program, Faculty for Scholarship, for her contribution to the completion of our research project. We would like to thank Shirley Tam, with the Department of Family Practice at UBC, and Scott Lewis, with the Department of Obstetrics and Gynecology at UBC, for helping to distribute our survey to the study population. We would also like to thank Michelle Main at the medical library, Clinical Academic Campus - UBC, Kelowna General Hospital, for her assistance with resources for our literature review.

Disclosure Statement

The authors report no conflict of interest

Additional information

Funding

The University of British Columbia provided $200 of funding to each family medicine resident completing a graduation research project in 2016. Dr. Kathryn Lefebvre and Dr. Jennifer Wild were awarded the Lloyd Collins Jones Award for outstanding resident scholarship project in 2016. This award, through the University of British Columbia, Faculty of Medicine, Department of Family Practice, is to assist with the cost of publishing scholarship papers;Lloyd Collins Jones Award, Department of Family Practice, University of British Columbia [NA].