Barriers and enablers in implementing strategies to maintain clinical competence of midwife educators: a scoping review

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BACKGROUND: Well-educated and prepared midwife educators are crucial in the provision of high-quality midwifery education, ensuring that midwifery students are equipped with the essential competencies to improve maternal and neonatal health outcomes. The International Confederation of Midwives (ICM) Global Standards for Midwifery Education set out an expectation for midwife educators to remain clinically competent. However, little is known about strategies used by midwives to achieve this, and the factors that influence their ability to maintain clinical competence. AIM: To identify how midwifery educators maintain clinical competence, and the barriers and enablers that influence this process. METHODS: A scoping review was conducted following Joanna Briggs Institute guidance. Six databases were searched for peer-reviewed articles, published from 2004 to 2024, to explore how midwifery educators maintain clinical competence. Grey literature was also included. Titles and abstracts were reviewed, data was extracted, and key concepts were mapped. Content analysis was used to report findings. RESULTS: Twenty-one articles were included in the final review. Three main strategies used by midwifery educators to maintain clinical competence were identified: (1) incorporating clinical practice into educator's roles at education institutes; (2) workshops and training programs; and (3) midwifery educators engaging in hands-on clinical practice at hospitals. Barriers to maintaining clinical competence among educators included high workload and insufficient support from employers. Conversely, enablers included opportunities for regular time in clinical practice, and ongoing workshops and trainings. CONCLUSIONS AND SIGNIFICANCE: Midwifery educators face a range of barriers to maintaining clinical competence, including limited time, insufficient institutional support, and challenges engaging in clinical practice environments. Several studies from low- and middle-income settings described additional barriers related to workforce and resource constraints. Educators who engaged in clinical practice or ongoing professional development reported perceived benefits including improved confidence, updated clinical knowledge, and strengthened links between theory and practice. However, evidence evaluating the direct impact of educator clinical competence on student or clinical outcomes was limited. Further research is needed to identify effective and sustainable approaches to supporting midwifery educators to maintain clinical competence across different settings.

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