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Expertise in physiological breech birth: A mixed-methods study.

Shawn Walker1, Pam Parker2, Mandie Scamell3

  • 1Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.

Birth (Berkeley, Calif.)
|December 6, 2017
PubMed
Summary
This summary is machine-generated.

Expertise in vaginal breech birth is defined by successful outcomes and colleague confidence, not just experience. Developing specialist teams supports clinicians in roles like mentor and specialist to improve care.

Keywords:
breech presentationexpertisespecialist

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Healthcare Professional Development

Background:

  • Vaginal breech birth safety relies on attendant expertise, but 'expertise' lacks a clear definition.
  • Current definitions of expertise are subjective, hindering consistent training and practice.
  • Understanding expertise is crucial for expanding access to skilled vaginal breech birth attendants.

Purpose of the Study:

  • To define expertise in the context of physiological breech birth.
  • To identify the roles experts play in facilitating access to vaginal breech birth services.
  • To inform the development of specialist teams for improved breech birth care.

Main Methods:

  • Integrative analysis of Delphi study survey data (26 experienced clinicians, 2 service users).
  • Grounded theory interview data from 14 clinicians with moderate physiological breech birth experience.
  • Constant comparative methods used for pooled data analysis.

Main Results:

  • Expertise is characterized by functional roles, positive outcomes, and peer-recognized competence.
  • Clinical experience is foundational, but expertise evolves through social clinical roles (clinician, mentor, specialist, expert).
  • Supporting clinicians in these roles within specialist teams is key to developing expertise.

Conclusions:

  • Specialist breech teams can foster expertise development in maternity settings.
  • Evaluating expertise by enablement and outcomes avoids issues associated with specialist authority.
  • A structured approach to developing expertise can enhance safety and access for vaginal breech birth.