University of Kwa-Zulu Natal, South Africa
Title: A Middle-Range Theory For Developing Clinical Reasoning Skills In Undergraduate Midwifery Students
Dr. Baloyi is a faculty member in the School of Nursing, College of Health Sciences at the University of Kwa-Zulu Natal, Durban, South Africa. Her research focusses on midwifery with specific interest midwifery education. In her Ph.D., she developed a model to guide the development of clinical reasoning skills within undergraduate midwifery students. She also has a passion for qualitative and grounded theory research. Dr. Baloyi is the author of 4 peer-reviewed articles all published in International Journals. As an emerging academic, Dr. Baloyi is supervising two (2) Ph.D. students and four (4) Masters.
Clinical reasoning (CR) remains central in midwifery care in the light of uncontrollable high maternal mortality rates and errors in midwifery practice. However, there is no consensus, locally and internationally, on how clinical reasoning skills can be developed in undergraduate students particularly within midwifery context. Aim: This study analysed the processes used to develop clinical reasoning skills within undergraduate midwifery students with the aim of generating a middle-range theory for the production of competent midwifery graduates for optimum patient outcomes. Qualitative and grounded theory approach, underpinned by Social Constructivism Paradigm, was used. Data were collected over twelve months, using multiple methods of observations, interviews and document analysis. The participants comprised of midwifery nursing students, the 2016 and 2017 cohorts as well as midwifery educators. A total of 16 focus group discussions and 12 individual in depth interviews were conducted. Methods and analysis: Data collection and initial data analysis occurred simultaneously using coding process, which comprised of three distinct phases (open coding, axial coding and selective coding), with constant comparative analysis at each phase. Ethical clearance was obtained from the University Ethics Committee, with the Protocol reference number HSS/1288/016D. Findings: Developing clinical reasoning skills emerged as the main concept in the middle-range theory that was generated in this study. This main concept was supported by major concepts, which included context, nature of the curriculum, clinical reasoning process, pillars including individual and system related outcomes. Discussion and Conclusion: Quality midwifery care is what is founded on the clinical reasoning abilities of the midwives. The process of developing clinical reasoning skills is a hypothesis-oriented inquiry, hinged by process-product, relevant and responsive curriculum.