Competencies and skills for remote and rural maternity care: a review of the literature.
OBJECTIVE
This paper reports a review of the literature on skills, competencies and continuing professional development necessary for sustainable remote and rural maternity care.


BACKGROUND
There is a general sense that maternity care providers in rural areas need specific skills and competencies. However, how these differ from generic skills and competencies is often unclear.


METHODS
Approaches used to access the research studies included a comprehensive search in relevant electronic databases using relevant keywords (e.g. 'remote', 'midwifery', 'obstetrics', 'nurse-midwives', education', 'hospitals', 'skills', 'competencies', etc.). Experts were approached for (un-)published literature, and books and journals known to the authors were also used. Key journals were hand searched and references were followed up. The original search was conducted in 2004 and updated in 2006.


RESULTS
Little published literature exists on professional education, training or continuous professional development in maternity care in remote and rural settings. Although we found a large literature on competency, little was specific to competencies for rural practice or for maternity care. 'Hands-on' skills courses such as Advanced Life Support in Obstetrics and the Neonatal Resuscitation Programme increase confidence in practice, but no published evidence of effectiveness of such courses exists.


CONCLUSIONS
Educators need to be aware of the barriers facing rural practitioners, and there is potential for increasing distant learning facilitated by videoconferencing or Internet access. They should also consider other assessment methods than portfolios. More research is needed on the levels of skills and competencies required for maternity care professionals practising in remote and rural areas.
Ireland
Jillian
J
School of Nursing & Midwifery, The Robert Gordon University, Aberdeen, UK.
Bryers
Helen
H
van Teijlingen
Edwin
E
Hundley
Vanora
V
Farmer
Jane
J
Harris
Fiona
F
Tucker
Janet
J
Kiger
Alice
A
Caldow
Jan
J
D000552:Ambulances; D002983:Clinical Competence; D003142:Communication; D006801:Humans; D007318:Inservice Training; D020407:Internet; D008427:Maternal Health Services; D016389:Maternal-Child Nursing / Q000193:education*; D008880:Midwifery / Q000193:education*; D010560:Personnel Selection; D019035:Rural Health Services; D012424:Rural Population; D012606:Scotland