A framework to facilitate self-directed learning, assessment and supervision in midwifery practice: a qualitative study of supervisors' perceptions.
BACKGROUND
Self-directed learning is an educational concept that has received increasing attention. The recent workplace literature, however, reports problems with the facilitation of self-directed learning in clinical practice. We developed the Midwifery Assessment and Feedback Instrument (MAFI) as a framework to facilitate self-directed learning. In the present study, we sought clinical supervisors' perceptions of the usefulness of MAFI.


METHODS
Interviews with fifteen clinical supervisors were audio taped, transcribed verbatim and analysed thematically using Atlas-Ti software for qualitative data analysis.


RESULTS
Four themes emerged from the analysis. (1) The competency-based educational structure promotes the setting of realistic learning outcomes and a focus on competency development, (2) instructing students to write reflections facilitates student-centred supervision, (3) creating a feedback culture is necessary to achieve continuity in supervision and (4) integrating feedback and assessment might facilitate competency development under the condition that evidence is discussed during assessment meetings. Supervisors stressed the need for direct observation, and instruction how to facilitate a self-directed learning process.


CONCLUSIONS
The MAFI appears to be a useful framework to promote self-directed learning in clinical practice. The effect can be advanced by creating a feedback and assessment culture where learners and supervisors share the responsibility for developing self-directed learning.
Midwifery Department, University College Arteveldehogeschool Ghent, Voetweg 66, 9000 Ghent, Belgium. Electronic address: mieke.embo@arteveldehs.be.
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Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 Maastricht, The Netherlands. Electronic address: E.Driessen@educ.unimaas.nl.
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Driessen
Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium. Electronic address: martin.valcke@UGent.be.
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Valcke
Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 Maastricht, The Netherlands. Electronic address: C.vanderVleuten@educ.unimaas.nl.
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van der Vleuten
D001291:Attitude of Health Personnel; D001530:Belgium; D002983:Clinical Competence; D003162:Competency-Based Education / Q000458:organization & administration*; D004521:Educational Measurement; D005246:Feedback; D005260:Female; D006801:Humans; D008880:Midwifery / Q000193:education*; D009718:Nurse Administrators / Q000523:psychology*; D011247:Pregnancy; D015397:Program Evaluation; D011380:Programmed Instructions as Topic
Assessment; Competency development; Feedback; Midwifery education; Reflection; Self-directed learning; Supervision