Objective: There are two integrated pre-service education programmes for nurses and midwives in India; a diploma in General Nursing and Midwifery (GNM) and bachelor's in nursing (B.Sc. nursing). This study assessed and compared confidence of final-year students from these two programmes for selected midwifery skills from the list of midwifery competencies given by the International Confederation of Midwives (ICM).
Design: A cross-sectional survey.
Participants: 633 final-year students, from 25 educational institutions randomly selected, stratified by the type of programme (diploma/bachelor), and ownership (private/government) from the Gujarat province.
Data collection and analysis: Students assessed their confidence on a 4-point scale, in four midwifery competency domains-antepartum, intrapartum, postpartum, and newborn care. Skill statements were reduced to subscales for each competency domain separately through Principle Component Analysis. Crude and adjusted odds ratios with 95% CI were calculated for students with high confidence (≥75th percentile on each subscale) and not high (all others) between diploma and bachelor students.
Findings: The diploma students were 2-4 times more likely to have high confidence on all subscales under antepartum, intrapartum, postpartum and newborn care compared to the bachelor students. Though both groups had less hands-on clinical practice during their education, more diploma students could fulfil the requirements of attending recommended number of births compared to the bachelor students.
Conclusion: Overall the students of the general nursing and midwifery (GNM) programme have higher confidence in skills for antepartum, intrapartum, newborn and postpartum care. One important reason is more hands-on clinical practice for the diploma compared to the bachelor students.
Keywords: Confidence; India; Low and middle income countries; Midwifery skills; Nurses.
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