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Learning Objective 1: The learner will be able to identify the changes in attitudes towards interdisciplinary health care teams after medical students are placed with CNMs.
Learning Objective 2: The learner will be able to describe the effects of IPE on attitudes of future physicians towards non-physician providers such as CNMs.
The national rate of cesarean delivery in the United States has reached 33 %. According to the WHO (2009) the optimum rate is unknown, however very low and very high rates can increase negative outcomes. Despite findings that an increased cesarean delivery rate does not improve outcomes, upward trends have not changed. A rising cesarean delivery rate has multiple levels of societal impact including the utilization of human and financial resources and increased maternal and neonatal morbidity. Certified Nurse-Midwives (CNMs) are Master’s prepared Advanced Practice Nurses (APN) that are specialists in women’s health care across the lifespan. The training of a CNM and a philosophy of care that supports the normal physiologic process of birth lend themselves to supporting the CNM as a natural leader in addressing this national concern. Unfortunately, the training of most physicians in the United States lacks training in normal physiologic birth and exposure to CNM care. With this in mind, a program was developed to match third year medical students with a CNM in the intrapartum setting.
Project Activities
Prior to their first day of obstetrical patient care, medical students were assigned a clinical site, only one of which included CNM clinical preceptors, and received lectures from a CNM on normal birth and on electronic fetal monitoring. A survey titled, “Attitudes towards health care teams scale”, was administered to four groups of ob/gyn clerkship medical students from 10/2012 to 4/2013 before the lectures were given and at the conclusion of the clerkship experience. The six students placed at University Colorado Hospital (UCH) in each clerkship group spent four days with the CNM service in the obstetric triage unit, and one night on labor and delivery. As well, students wrote written evaluations of the lectures and of their time working with the CNM preceptors.
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