title: Development and piloting the Woman Centred Care Scale (WCCS).
abstract: OBJECTIVE
  In midwifery we espouse a woman centred care approach to practice, yet in midwifery education no valid instrument exists with which to measure the performance of these behaviours in midwifery students.
  
  
  OBJECTIVE
  To develop and validate an instrument to measure woman centred care behaviours in midwifery students.
  
  
  METHODS
  We identified four core concepts; woman's sphere, holism, self-determination and the shared power relationship. We mapped 18 individual descriptive care behaviours (from the Australian National Competency Standards for the Midwife) to these concepts to create an instrument to articulate and measure care behaviours that are specifically woman centred. Review by expert midwifery clinicians ensured face, content and construct validity of the scale and predictive validity and reliability were tested in a simulated learning environment. Midwifery students were video recorded performing a clinical skill and the videos were reviewed and rated by two expert clinicians who assessed the woman centred care behaviours demonstrated by the students (n=69).
  
  
  RESULTS
  Test and re-test reliability of the instrument was high for each of the individual raters (Kappa 0.946 and 0.849 respectively p<0.001). However, when raters were compared there were differences between their scores suggesting variation in their expectations of woman centred care behaviours (Kappa 0.470, p<0.001). Midwifery students who had repeated exposures to higher levels of simulation fidelity demonstrated higher levels of woman centred care behaviours.
  
  
  CONCLUSIONS
  The WCCS has implications for education and the wider midwifery profession in recognising and maintaining practice consistent with the underlying philosophy of woman centred care.
authors.affiliation: The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia. Electronic address: s.brady@uq.edu.au.
authors.forename: Susannah
authors.initials: S
authors.lastname: Brady
authors.affiliation: The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia. Electronic address: f.bogossian@uq.edu.au.
authors.forename: Fiona
authors.initials: F
authors.lastname: Bogossian
authors.affiliation: The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia; Mater Research Office, Rm 255, Level 2, Aubigny Place, South Brisbane, QLD 4101, Australia. Electronic address: kristen.gibbons@mater.uq.edu.au.
authors.forename: Kristen
authors.initials: K
authors.lastname: Gibbons
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006801:Humans; D008880:Midwifery / Q000592:standards*; D009721:Nurse Midwives / Q000193:education* / Q000523:psychology*; D018802:Patient-Centered Care / Q000592:standards*; D010865:Pilot Projects; D011247:Pregnancy; D016730:Program Development; D015203:Reproducibility of Results
keywords: Education; Midwifery; Practice behaviours; Simulation; Woman centred care