Conectar
To examine the concept of midwifery agency when using Maternity Early Warning Tools.
Concept analysis using Rogers' evolutionary method.
Data were collected from interviews with midwives working in various Australian maternity settings. A subset of the dataset was collected and analysed (2021–2022) to examine how agency functions when midwives use Maternity Early Warning Tools.
Three conceptual attributes fundamental to agency were identified: considered judgement, reasoned clinical decision-making, and collaborative action. These attributes reveal how midwives navigate the interface between structured risk management tools and relational, woman-centred care.
Maternity Early Warning Tools can either limit or enhance professional agency. When used reflexively, they become artefacts that support learning, communication, and sound clinical judgement. Viewing these tools as enablers rather than enforcers sustains midwifery expertise and strengthens interdisciplinary collaboration.
Sustaining midwifery agency protects both professional integrity and the quality of woman-centred care.
What problem did the study address? How the use of Maternity Early Warning Tools influences midwives' agency.
To evaluate the implementation process of a novel program focused on improving interactive (dialogic) feedback between clinicians and students during placement.
Quantitative cross-sectional hybrid type 3 effectiveness–implementation study driven by a federated model of social learning theory and implementation theory.
From June to November 2018, feedback approaches supported by socio-constructive learning theory and Normalisation Process Theory were enacted in four clinical units of a healthcare facility in southeast Queensland, Australia. The study involved 16 clinical instructors/supervisors, 94 bedside nurses, and 85 final-year nursing students. Engagement was evaluated using the Normalisation Measure Development survey. Situated learning encounters were constructed based on the needs of each group.
Survey results of the four Normalisation Process Theory constructs identified variable adoption by participant groups. Engagement in situated learning encounters that facilitate dialogic feedback was greatest in clinical instructors/supervisors, followed by students. Bedside registered nurses, while indicating they understood purposeful feedback behaviours, did not demonstrate them in practice.
The extent to which each group practiced dialogic feedback depended on their perceptions of their influence, whether they saw it as part of their role, and the effort and time required, regardless of the activity's importance, role statements, and codes of conduct.
Understanding the norms that shape communication, engagement, and nurses' role priorities is crucial for guiding practice and ongoing engagement with feedback.
The research provides valuable insights for leaders aiming to enhance the integration of evidence into practice. It guides leaders to understand that participants prioritise the reach, relevance, and resources of evidence over formal role descriptions, responsibilities, policies, and codes of conduct. This research encourages leaders to scrutinise existing beliefs, norms, and routines when implementing evidence-based practices.
Standards for Reporting Implementation Studies (StaRI) reporting guidelines were used.
None.
FreshRSS 