title: "Working towards being ready": A grounded theory study of how practising midwives maintain their ongoing competence to practise their profession.
abstract: OBJECTIVE
  to present a grounded theory research study explaining how New Zealand midwives maintain their ongoing competence to practise their profession.
  
  
  METHODS
  grounded theory, an interpretive emergent research methodology was used to examine the process of maintaining competence in midwifery practice.
  
  
  METHODS
  New Zealand urban and rural practice settings.
  
  
  METHODS
  twenty-six midwives from across New Zealand were interviewed and asked about maintaining their competence to practise. Five midwives were interviewed twice, to explore the emerging findings and as one method of member checking.
  
  
  RESULTS
  the grounded theory of 'working towards being ready' describes a continuous process in which midwives engage as they work to maintain practice competence. The component parts comprise professional positioning, identifying needs, strategizing solutions and reflecting on practice. The process is contextual, diverse and is influenced by the practice setting where the salient conditions of resourcing, availability and opportunity for engagement in activities are significant.
  
  
  CONCLUSIONS
  across the midwifery profession, midwives in New Zealand are currently working under the generic umbrella of midwifery practice. Midwives work across a range of practice arenas in diverse ways focussed on providing safe care and require a range of professional development activities germane to their area of practice. When the midwife has access to professional development pertinent to their practice, women and the profession benefit. As there is diversity of practice, then mandated processes for ongoing competence need to have flexibility to reflect that diversity.
  
  
  CONCLUSIONS
  midwives engage in development that allows them to remain current in practice and that enables them to provide appropriate care to women and their babies. As a consequence they can develop expertise in certain aspects of midwifery. Mandated processes that require engagement in activities aimed at demonstration of competence should be evaluated and tailored to ensure they meet the needs of the developing profession.
authors.affiliation: Auckland University of Technology, PO Box 92006, Auckland 1142, New Zealand. Electronic address: suecalv1018@gmail.com.
authors.forename: Susan
authors.initials: S
authors.lastname: Calvert
authors.affiliation: Auckland University of Technology, PO Box 92006, Auckland 1142, New Zealand.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Smythe
authors.affiliation: Auckland University of Technology, PO Box 92006, Auckland 1142, New Zealand.
authors.forename: Barbara
authors.initials: B
authors.lastname: McKenzie-Green
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004509:Education, Nursing, Continuing / Q000379:methods; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008880:Midwifery / Q000379:methods*; D009520:New Zealand; D009721:Nurse Midwives / Q000523:psychology* / Q000592:standards; D036301:Qualitative Research
keywords: Grounded theory; Midwifery practice; Ongoing competence; Regulation