title: Reviewing and reflecting on practice: the midwives experiences of credentialling.
abstract: OBJECTIVE
  What are the experiences of midwives working in midwifery-led models of care in NSW who undertake the credentialling process?
  
  
  BACKGROUND
  In 2005, the NSW Health Department issued a directive requiring midwives who worked in midwifery-led models of care to undergo a process known as credentialling. Credentialling involved a four-step process: self-assessment, face-to-face panel review of midwifery practice, assessment of emergency management skills and discussion of a case study from practice.
  
  
  METHODS
  A descriptive exploratory study examined the experiences of the midwives who undertook the credentialling process in NSW. Data were collected through in-depth, semi-structured interviews with 12 midwives who had experienced credentialling and analysed using descriptive and thematic analysis.
  
  
  RESULTS
  The themes were preparing for credentialling; doing credentialling; achieving credentialling; valuing credentialling; and, improving credentialling. Initially, the midwives were self-focused in their understanding and impressions of the value of credentialling. There were a number of contentions including seeing credentialling as another 'hoop to jump through' or a need to 'tick the box' and not as a framework for practice. Some viewed it as a necessary move to increase professionalism and facilitate practice review. Others felt they were being unfairly targeted as not all midwives were expected to undertake it. The midwives were cognisant of the need for a process that encouraged responsibility for ongoing professional development and continuing competence and believed the process would be useful in promoting deeper reflection on practice.
  
  
  CONCLUSIONS
  Credentialling was recognised as being valuable for all midwives to undertake as it encourages both a review of, and reflection on, practice. The process has further developed into Midwifery Practice Review (MPR) and is administered by the national professional association for midwifery.
authors: Centre for Midwifery, Child and Family Health, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia. Rachel.smith@uts.edu.au
authors: Rachel
authors: R
authors: Smith
authors: Patricia
authors: P
authors: Brodie
authors: Caroline S E
authors: CS
authors: Homer
mesh_terms: D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D003406:Credentialing; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery / Q000592:standards*; D009721:Nurse Midwives / Q000592:standards*; D018024:Peer Review, Health Care; D011247:Pregnancy; D036301:Qualitative Research