Development and piloting the Woman Centred Care Scale (WCCS)

Abstract

Problem/background In midwifery we espouse a woman centred care approach to practice, yet in midwifery education no valid instrument exists with which to measure the performance of these behaviours in midwifery students. Aim To develop and validate an instrument to measure woman centred care behaviours in midwifery students. Method We identified four core concepts; woman's sphere, holism, self-determination and the shared power relationship. We mapped 18 individual descriptive care behaviours (from the Australian National Competency Standards for the Midwife) to these concepts to create an instrument to articulate and measure care behaviours that are specifically woman centred. Review by expert midwifery clinicians ensured face, content and construct validity of the scale and predictive validity and reliability were tested in a simulated learning environment. Midwifery students were video recorded performing a clinical skill and the videos were reviewed and rated by two expert clinicians who assessed the woman centred care behaviours demonstrated by the students (n = 69). Findings/discussion Test and re-test reliability of the instrument was high for each of the individual raters (Kappa 0.946 and 0.849 respectively p < 0.001). However, when raters were compared there were differences between their scores suggesting variation in their expectations of woman centred care behaviours (Kappa 0.470, p < 0.001). Midwifery students who had repeated exposures to higher levels of simulation fidelity demonstrated higher levels of woman centred care behaviours. Conclusion The WCCS has implications for education and the wider midwifery profession in recognising and maintaining practice consistent with the underlying philosophy of woman centred care.