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Expertise in physiological breech birth: A mixed-methods study

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Expertise in physiological breech birth : A mixed-methods study. / Walker, Shawn; Parker, Pam; Scamell, Mandie.

In: BIRTH, Vol. 45, No. 2, 01.06.2018, p. 202-209.

Research output: Contribution to journalArticle

Harvard

Walker, S, Parker, P & Scamell, M 2018, 'Expertise in physiological breech birth: A mixed-methods study', BIRTH, vol. 45, no. 2, pp. 202-209. https://doi.org/10.1111/birt.12326

APA

Walker, S., Parker, P., & Scamell, M. (2018). Expertise in physiological breech birth: A mixed-methods study. BIRTH, 45(2), 202-209. https://doi.org/10.1111/birt.12326

Vancouver

Walker S, Parker P, Scamell M. Expertise in physiological breech birth: A mixed-methods study. BIRTH. 2018 Jun 1;45(2):202-209. https://doi.org/10.1111/birt.12326

Author

Walker, Shawn ; Parker, Pam ; Scamell, Mandie. / Expertise in physiological breech birth : A mixed-methods study. In: BIRTH. 2018 ; Vol. 45, No. 2. pp. 202-209.

Bibtex Download

@article{c910484194b842f1b19a0752f140c5d3,
title = "Expertise in physiological breech birth: A mixed-methods study",
abstract = "BackgroundThe safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of “expertise” remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.MethodsWe performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births). Data were pooled and analyzed using constant comparative methods.ResultsExpertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams.ConclusionsSpecialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority.",
keywords = "breech presentation, expertise, specialist",
author = "Shawn Walker and Pam Parker and Mandie Scamell",
year = "2018",
month = jun,
day = "1",
doi = "10.1111/birt.12326",
language = "English",
volume = "45",
pages = "202--209",
journal = "BIRTH",
issn = "0730-7659",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Expertise in physiological breech birth

T2 - A mixed-methods study

AU - Walker, Shawn

AU - Parker, Pam

AU - Scamell, Mandie

PY - 2018/6/1

Y1 - 2018/6/1

N2 - BackgroundThe safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of “expertise” remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.MethodsWe performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births). Data were pooled and analyzed using constant comparative methods.ResultsExpertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams.ConclusionsSpecialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority.

AB - BackgroundThe safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of “expertise” remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.MethodsWe performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births). Data were pooled and analyzed using constant comparative methods.ResultsExpertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams.ConclusionsSpecialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority.

KW - breech presentation

KW - expertise

KW - specialist

UR - http://www.scopus.com/inward/record.url?scp=85037614490&partnerID=8YFLogxK

U2 - 10.1111/birt.12326

DO - 10.1111/birt.12326

M3 - Article

AN - SCOPUS:85037614490

VL - 45

SP - 202

EP - 209

JO - BIRTH

JF - BIRTH

SN - 0730-7659

IS - 2

ER -

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