The Transition to Clinical Practice for New Registrant Midwives in Ontario, Canada
Midwives in Ontario are integrated into the provincial health-care system, providing primary antenatal, intrapartum, and postpartum care to low-risk women throughout pregnancy and for 6-week postpartum. Midwives are educated through a 4-year direct-entry, university-based Bachelor of Health Science program or, if internationally trained, through a 9-month bridging program. During the first year of clinical practice, newly qualified midwives are known as new registrants and are subject to a number of practice restrictions outlined by the College of Midwives of Ontario (CMO). While there is limited research regarding the new registrant year, a qualitative study identified three phases—building, bridging, and being—through which new registrants progress as they transition to clinical practice. There is considerable variation with respect to the experience of new registrants during the transition to clinical practice; however, four elements—preparation, orientation, mentorship, and ongoing education—help new registrants navigate the experience of commencing clinical practice. In order to offer a more standardized approach to supporting Ontario midwives in the first year of clinical practice, it may be beneficial for midwifery stakeholders to look to established transitional models employed in midwifery communities outside of Canada.
KeywordsMidwifery Midwives New graduate New registrant Transition to practice Ontario Canada
Association of Ontario Midwives
Billable course of care
College of Midwives of Ontario
Canadian Midwifery Registration Exam
Midwifery Education Program
Midwifery First Year of Practice Program
List of Terms
Midwives who maintain care for low-risk clients who require oxytocin infusion for induction or augmentation of labor and/or epidural analgesia
Midwives who are required to transfer care to an obstetrician when a client requires epidural analgesia and/or oxytocin infusion for labor induction or augmentation
Registered midwife in the first year of independent clinical practice
Call model where midwives carry a caseload of four clients per month; off-call time typically includes one or two weekends off call per month and 2–3-month vacation per calendar year
Midwife who assumes responsibility for the care of a women during the intrapartum and immediate postpartum period (Ontario Regulation 168/11 1991)
Midwife in attendance at a birth who assumes responsibility for the immediate assessment and care of the newborn following birth (Canadian Midwifery Regulators Consortium 2010)
Call model where midwives work in teams of two to four and clients are assigned to a team rather than to a particular midwife; midwives within the team rotate call coverage with at least one midwife from the team on call at any time
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