The association of teaching-learning methods and self-confidence of nurse-midwives. A survey from one province in India.

BACKGROUND: This study aimed to investigate the association between self-confidence of final-year students in selected midwifery skills and teaching-learning methods used in the two formally recognized education programs for nurse-midwives in India.

DESIGN: A cross-sectional survey PARTICIPANTS: 633 final-year students, from 25 educational institutions randomly selected, stratified by type of program (diploma/bachelor), and ownership (private/government) in Gujarat.

DATA COLLECTION AND ANALYSIS: Students assessed their confidence on a 4-point scale, in four midwifery competency domains-antepartum, intrapartum, postpartum, and newborn care recommended by the International Confederation of Midwives (ICM). Explorative factor analysis was used to reduce skill statements into subscales separately for each domain. Odds ratios with 95% CI were calculated for students with high confidence (≥75th percentile on each subscale) and not high confidence (all others) between diploma and bachelor students.

RESULTS: Classroom teaching was the most practiced method. 'Laboratory demonstrations', 'Practice on models', 'Demonstrations at clinical sites', 'Births Attended' (Hands-on clinical practice), and 'Satisfaction with clinical supervision' were practiced less, lesser in the bachelor's compared to the diploma program. High confidence was associated with 'Births Attended' (Hands-on clinical practice), 'Practice on models', and 'Satisfaction with clinical supervision' for all subscales of all four domains of competencies.

CONCLUSIONS: Hands on skills practice in the laboratory and supervised clinical practice during clinical placements were associated with high confidence for basic clinical midwifery skills amongst students. The diploma program followed better pedagogoical approaches than the bachelor's program.