Midwives’ views of the importance of genetics and their confidence with genetic activities in clinical practice: implications for the delivery of genetics education

Abstract

2 0 0 8 ) Journal of Clinical Nursing 17, 519-530Midwives' views of the importance of genetics and their confidence with genetic activities in clinical practice: implications for the delivery of genetics education Aims and objectives. The aim of the study was to ascertain the level of importance midwives attach to integrating genetics into midwifery care and to compare that with their self-reported level of confidence in incorporating genetics into their clinical practice. Background. Previous work has shown that many midwives feel ill-prepared for the increased integration of genetics into clinical practice and often only limited genetics education provision is in place. With the application of genetics to midwifery practice increasing, it is important that midwives develop their knowledge and skills to meet this growing clinical role. This study was therefore developed to ascertain the attitudes and educational needs of midwives by exploring genetic issues likely to arise in clinical practice and the confidence individuals felt in dealing with them. Design. A survey questionnaire with open and closed questions. Methods. All midwives working in four National Health Service trusts (n ¼ 817) were invited to self-complete the validated questionnaire anonymously. Data were collected on demographics and preferred continued professional development options for future educational programme development. Likert scales were used to rate the importance of genetic activities and midwives' confidence to perform them based on the genetic activities which were first listed and then presented embedded within specific clinical scenarios. Results. The response rate was 51% (n ¼ 416). The majority of midwives felt that genetics was important but many did not feel confident about integrating it into their clinical practice. Across all scenarios >60% of midwives were not confident on any risk identification or risk communication activities. The majority of midwives were receptive to genetics education particularly if delivered from a clinical rather than a psychosocial or scientific perspective. Conclusion. This study demonstrates the need for midwives' pre-and postregistration education to include clinically relevant genetics. The evidence presented here can inform the design, development and delivery of future educational initiatives. What this study adds. This study was the first to identify the educational needs of midwives related to integrating genetics into midwifery clinical practice. It provides evidence of key topics to be included in educational programmes: referring to specialist genetics services, genetic testing, risk and communicating genetic information. It shows the type and format of course preferred by clinically based midwives: interactive workshops and lectures using clinical patient-based case examples will attract midwives to participate and will be better received by their managers. Relevance to clinical practice. Midwives view genetics as important in their clinical practice. However, they have little confid...

Genetic educational needs and the role of genetics in primary care: a focus group study with multiple perspectives

“…The results of this study are in line with some studies and differ from others with regard to the need for increased genetics knowledge among midwives [8,13] and general practitioners [5,10,12,14,16,19,20]. The midwives in our study seemed more confident of their basic knowledge and did not perceive as strong a need to adapt existing educational programmes as was expressed by midwives in studies by Benjamin et al .…”

“…and Metcalfe et al . [8,13]. This difference may be due to differences between master programmes in midwifery or between health care systems.…”

“…taking a family history, referral to appropriate regional genetics services and non-directive counselling) [8,13]. It may be problematic for primary care providers to take appropriate steps in response to the perceived shift in the importance of genetics in primary care, such as taking enough time to discuss the family history or non-directive counselling.…”

Prioritization of future genetics education for general practitioners: a Delphi study

“…However, our previous focus-group results 8 are supported by the outcomes of the aforementioned studies regarding deficiency in skills (e.g., taking a family history, referral to appropriate regional genetics services, and nondirective counseling). 17,18 It may be problematic for primary-care providers to take appropriate steps in response to the perceived shift in the importance of genetics in primary care, such as taking enough time to discuss the family history or to perform nondirective counseling.…”

Working with publishers: a novel approach to ascertaining practitioners' needs in genetics education

“…Metcalfe et al (2007) found that senior managers see genetics as less important to midwifery practice than did their colleagues. In a small-scale study of senior nurses within a regional group of health Trusts, researchers concluded that nurse managers did not see genetics as a priority and that it was 'a distinct and highly specialized area that only occasionally touches the work of the Trust' (Pfeil andChi-Meih, 2005: 1130).…”