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International consensus definition of critical thinking in midwifery practice: A Delphi study

Published:February 15, 2022DOI:https://doi.org/10.1016/j.wombi.2022.02.006

      Abstract

      Problem

      Currently there is no discipline-specific definition of critical thinking in midwifery practice.

      Background

      Critical thinking in midwifery practice is the cornerstone for safe, evidence based, and woman centred clinical decision-making. Available definitions of critical thinking in other disciplines do not align with midwifery practice which is distinctive, multidimensional and complex.

      Aim

      To develop an international consensus definition of critical thinking in midwifery practice.

      Methods

      A two round Delphi study was used. Thirty-two international midwifery experts contributed to the first round which was qualitative in nature. Twenty one of these experts then ranked the relevance and clarity of concepts from round one.

      Findings

      A consensus definition of critical thinking in midwifery practice was achieved. The expert panel identified and defined 14 ‘Habits of Mind’ and 12 Skills that are the core of critical thinking in midwifery practice. Skills included; analysis, constructive application and contextualisation of best available evidence, problem solving, discriminating, predicting, evaluation of care, collect and interpret clinical cues, collaboration/ negotiation, reflexivity, facilitates shared decision-making, communication, and transforming knowledge. Habits of Mind included; intellectual curiosity, reflective, holistic view, intellectual integrity, flexibility, questioning/challenging, participatory, open mindedness, listening with understanding and empathy, cultural humility, woman centred, being brave, confidence, and creativity.

      Discussion/conclusion

      This study is an international first and delineates characteristics of critical thinking in midwifery. Development of a consensus definition provides a common and shared understanding of the skills and attributes required for critical thinking in midwifery practice and can also be applied in education and research.

      Keywords

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      References

        • Ménage D.
        Part 2: a model for evidence-based decision-making in midwifery care.
        Br. J. Midwifery. 2016; 24: 137-143
        • Jefford E.
        • Fahy K.
        • Sundin D.
        Decision-Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives.
        Int. J. Nurs. Pract. 2011; 17: 246-253
        • International Confederation of Midwives
        Philosophy and Model of Midwifery Care.
        2014 (. (Accessed 5 October 2021).)
        • Gilkison A.
        • Giddings L.
        • Smythe L.
        Real life narratives enhance learning about the ‘art and science’ of midwifery practice.
        Adv. Health Sci. Educ. 2016; 21: 19-32
        • Facione N.C.
        • Facione P.A.
        Externalizing the critical thinking in knowledge development and clinical judgment.
        Nurs. Outlook. 1996; 44: 129-136
        • Facione P.A.
        Critical Thinking: A Statement of Expert Consensus for Purposes of Educational Assessment and Instruction. Research Findings and Recommendations.
        1990 (. (Accessed 5 October 2021))
        • Thonney T.
        • Montgomery J.C.
        Defining critical thinking across disciplines: an analysis of community college faculty perspectives.
        Coll. Teach. 2019; 67: 169-176
        • Jones A.
        A disciplined approach to critical thinking.
        in: Davies M. Barnett R. The Palgrave Handbook of Critical Thinking in Higher Education. Palgrave Macmillan, New York2015
        • Scheffer B.K.
        • Rubenfeld M.G.
        A consensus statement on critical thinking in nursing.
        J. Nurs. Educ. 2000; 39: 352-359
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Critical thinking in midwifery practice: a conceptual model.
        Nurse Educ. Pract. 2018; 33: 114-120
        • Bass J.
        • Sidebotham M.
        • Creedy D.
        • Sweet L.
        Midwifery students’ experiences and expectations of using a model of holistic reflection.
        Women Birth. 2020; 33: 383-392
        • Scholes J.
        • Endacott R.
        • Biro M.
        • et al.
        Clinical decision-making: midwifery students’ recognition of, and response to, post partum haemorrhage in the simulation environment.
        BMC Pregnancy Childbirth. 2012; 12: 1-12
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: a systematic review.
        Nurs. Educ. Today. 2015; 35: 864-874
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Measuring critical thinking in pre-registration midwifery students: a multi-method approach.
        Nurs. Educ. Today. 2018; 61: 169-174
        • Humphrey-Murto S.
        • Varpio L.
        • Gonsalves C.
        • Wood T.J.
        Using consensus group methods such as Delphi and Nominal Group in medical education research.
        Med. Teach. 2017; 39: 14-19
      1. LimeSurvey: An Open Source Survey Tool.
        Limesurvey GmbH, Hamburg, Germany2021
        • Kuper A.
        • Lingard L.
        • Levinson W.
        Critically appraising qualitative research.
        BMJ. 2008; 337: a1035
        • Mead D.
        • Moseley L.
        The use of the Delphi as a research approach.
        Nurse Res. 2001; 8: 4-23
        • Graneheim U.H.
        • Lundman B.
        Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.
        Nurs. Educ. Today. 2004; 24: 105-112
        • Kyngäs H.
        Inductive content analysis.
        in: Kyngäs H. Mikkonen K. Kääriäinen M. The Application of Content Analysis in Nursing Science Research. Springer International Publishing, Cham2020: 13-21
        • Hasson F.
        • Keeney S.
        • McKenna H.
        Research guidelines for the Delphi survey technique.
        J. Adv. Nurs. 2000; 32: 1008-1015
        • Pairman S.
        • McAra-Couper J.
        Theoretical frameworks for midwifery practice.
        Midwifery: Preparation for Practice. 3rd edn. Churchill Livingstone, Chatswood, Australia2015: 383-411
        • Prusova K.
        • Churcher L.
        • Tyler A.
        • Lokugamage A.U.
        Royal College of Obstetricians and Gynaecologists guidelines: how evidence-based are they?.
        J. Obstet. Gynaecol. 2014; 34: 706-711
        • Nursing and Midwifery Board
        Midwife Standards for Practice.
        2018 (. (Accessed 5 October 2021))
        • Skinner J.P.
        • Foureur M.
        Consultation, referral, and collaboration between midwives and obstetricians: lessons from New Zealand.
        J. Midwifery Womens Health. 2010; 55: 29-37
        • Likis F.E.
        Inclusive language promotes equity: the power of words.
        J. Midwifery Womens Health. 2021; 66: 7-9
        • Van Helmond I.
        • Korstjens I.
        • Mesman J.
        • et al.
        What makes for good collaboration and communication in maternity care? A scoping study.
        Int. J. Childbirth. 2015; 5: 210-223
        • Australian Government Department of Health
        Principles That Underpin Communication Between Eligible Midwives and Obstetricians (GP or Specialist).
        2014 (. (Accessed 5 October 2021))
        • Australian Government Department of Health
        Pregnancy Care Guidelines. Providing Woman-centred Care.
        Australian Government Department of Health, 2020 (. (Accessed 5 October 2021))
        • Davis D.L.
        • Creedy D.K.
        • Bradfield Z.
        • et al.
        Development of the Woman-Centred Care Scale-Midwife Self Report (WCCS-MSR).
        BMC Pregnancy Childbirth. 2021; 21: 523
        • MacGregor K.
        Study Finds 40,000 Tertiary Jobs Lost During Pandemic.
        University World News, 2021 (Published online September 17. https://www.universityworldnews.com/post.php?story=20210917061003607. (Accessed 26 October 2021))
        • Bloor M.
        • Sampson H.
        • Baker S.
        • Kahlgren K.
        Useful but no Oracle: reflections on the use of a Delphi Group in a multi-methods policy research study.
        Qual. Res. 2015; 15: 57-70
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Critical thinking skills in midwifery practice: development of a self-assessment tool for students.
        Midwifery. 2017; 50: 184-192
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Development and psychometric testing of the Carter Assessment of Critical Thinking in Midwifery (Preceptor/Mentor version).
        Midwifery. 2016; 34: 141-149
        • Carter A.G.
        • Creedy D.K.
        • Sidebotham M.
        Critical thinking evaluation in reflective writing: development and testing of Carter Assessment of Critical Thinking in Midwifery (Reflection).
        Midwifery. 2017; 54: 73-80
        • Knight F.
        • Kokanović R.
        • Ridge D.
        • Brophy L.
        • Hill N.
        • Johnston-Ataata K.
        • Herrman H.
        Supported decision-making: the expectations held by people with experience of mental illness.
        Qual. Health Res. 2018; 28: 1002-1015