title: Developing competence and confidence in midwifery-focus groups with Swedish midwives.
abstract: BACKGROUND
  Midwives have a significant impact on the clinical outcome and the birthing experience of women. However, there has been a lack of research focusing specifically on clinical midwives' learning and development of professional competence.
  
  
  OBJECTIVE
  The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.
  
  
  METHODS
  A qualitative study based on focus groups with midwives employed in maternity services.
  
  
  RESULTS
  Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding. The meaning of competence is to feel safe and secure in their professional role. There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident. Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field. The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.
  
  
  CONCLUSIONS
  External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.
  
  
  CONCLUSIONS
  Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.
authors: Department of Nursing, Mid Sweden University, Sweden. Electronic address: lena.back@miun.se.
authors: Lena
authors: L
authors: Bäck
authors: Department of Nursing, Mid Sweden University, Sweden; Department of Women's and Children's Health, Uppsala University, Sweden. Electronic address: ingegerd.hildingsson@miun.se.
authors: Ingegerd
authors: I
authors: Hildingsson
authors: The County Hospital of Östersund, Maternity Unit, Sweden. Electronic address: carina.sjoqvist@regionjh.se.
authors: Carina
authors: C
authors: Sjöqvist
authors: Department of Nursing, Mid Sweden University, Sweden. Electronic address: annika.karlstrom@miun.se.
authors: Annika
authors: A
authors: Karlström
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007858:Learning; D008880:Midwifery / Q000193:education; D009721:Nurse Midwives / Q000193:education*; D057184:Practice Patterns, Nurses'; D011247:Pregnancy; D036301:Qualitative Research; D013548:Sweden
keywords: Competence; Confidence; Knowledge; Learning; Midwifery