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Published on: February 13, 2020
Development and pilot test of a CTG skills test for midwives
Maija Männistö1, Kristiina Heinonen2, Marja Härkänen1
1Department of Nursing Science, University of Eastern Finland, Kuopio Finland; Research Centre for Nursing Science and Social and Health Management, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland.
Background:
High-quality obstetric care promotes maternal safety and fetal well-being. Modern cardiotocography (CTG) interpretation emphasises fetal physiology rather than isolated heart rate patterns, aiming to reduce unnecessary interventions and improve outcomes. Misinterpretation of CTG remains a key contributor to substandard perinatal care. Assessing interpretation skills is essential for evaluating competence and measuring the effects of training. Regular assessment supports clinical proficiency, identifies educational needs, and ultimately enhances the quality and safety of childbirth.
Aim:
This study aimed to develop and pilot a CTG skills test to assess midwives' interpretation skills.
Methods:
The skills test was constructed based on the existing literature and the content validity was evaluated by an expert panel (n = 8) through two rounds of online surveys. The pilot test was conducted at one birthing unit with midwives (n = 12) to assess the feasibility of the test. Data were analysed with inductive content analysis and quantitative methods, including the content validity index and descriptive statistics.
Results:
The CTG skills test was validated through expert review and a pilot study. It showed excellent content validity (S-CVI/Ave = 0.94). Experts and midwives found it relevant but challenging, especially in fetal physiology. Revisions made to the test improved the clarity and usability of the test. The skills test is suitable for assessing CTG competence and identifying training needs.
Conclusions:
CTG interpretation is crucial for safe childbirth, making midwives' competence and training essential for quality obstetric care. This validated skills test helps to assess CTG skills, identify training needs, and enhance delivery safety.
