1. Evaluation of the draft Spiritual Care Education Standard in Nursing and Midwifery Education in Higher Education Institutions in Denmark
Christina Prinds
Midwife, PhD, assistent professor
University South Denmark/University College South Denmark

2. Midwifery Education in Denmark – BA and MA

3. Bachelor in Midwifery Denmark
Bachelor program in midwifery: 210 ECTS.
In line with similar programs for nurses, physiotherapists and other health professionals. Direct entry
3½ years program
50 % theoretical studies / 50 % clinical placement
Taking place in three different university colleges with individueal curricula.
App midwives are now bachelors out of 2200 active midwives.
Bachelor in Midwifery Denmark

4. Master in midwifery Science
Master programme in midwifery: 120 ECTS
2 year full time theoretical studies
1 year co teaching with nurses/occupational therapists/physiotherapists etc. Theory of science, research methodologies in eg. epidemiology/biostat/qualitiative methods
½ year midwifery disciplines
½ year master thesis
Master in midwifery Science

5. Objective: to gain knowledge of intuituve reflexions of the standard
Is the standard relevant for midwifery students in Denmark
Do the standard make sense – how?
What are your thoughts on systematic goals of competencies of spiritual care?
 Probing the climate for teaching spiritual care standards in midwifery in Denmark
I apologize for not having used the Standard among students yet. In my estimation, time is not up for it yet – but hopefully it will be to come.
I have not used the Standard in full systematized form in education of students. However I have sent it to colleagues across the country to obtain knowledge about spontaneous reflexions from colleagues about the Standard.
The whole Standard as part of an “evaluation” or temperature measurement regarding the “climate for teaching spiritual care standards in midwifery in Denmark

6. Informants
Fellow researchers, assistent and associate professors, administrators and leaders.
12 mails, of which some were ”snowballed” sent in mid-June
6 returns
6 ”yes in deed – later…”
Informal responses in network/personal talks, ”… it is so difficult to answer in a simple way…”
Different age/positions/geographical sites and aciennitet.

7. 1. Relevancy of the standard for midwifery students in Denmark
Yes, but….
Yes, of course, as long as it has nothing religious attached
Good – although very plentiful
Of course – very relevant

8. 2. Do the standard make sense – how?
“Much is already integrated, but in another ”language” in e.g. goals of teaching in health promotion and de-medicalisation, cultural awareness, patient-centred care, communication, and psychology and sociology broadly speaking…”
“Many years will pass until the the quite good intention in this work will flow, I guess… because of the words. The sectarian glow will overrule these intentions.”
“The word spiritual is somehow unnecessary…”
“Of course we need to work on spiritual care… as long as it does not carry anything ”religuos”. There are many aspects of religion that I would like to keep far away from midwifery care. Fine, that some midwives may be religious but in maternity care, there must be room for everybody at a “real” level!”
“In the 9 competencies I find many aspects, which we touch upon in other subjects: Ethics, philosophy, psychology, pedagogy and midwifery, but we sure need to be aware of spiritual care as something specific. We must encompass some of the competencies in our next curriculum.”

9. 2. Do the standard make sense – how?
“None of us know the future and we are in a constant societal interchange – and perhaps more lights are requested related to spiritual aspects of childbirth and parenthood. Perhaps your research will bring new awareness – it is exiting."
“I think this is an important area, which is important to approach systematically although the standards are very rich and includes some overlapping aspects.”
“Very meaningful. The systematic overview clarifies differences between competencies, knowledge and attitude, of which I think the latter is well explicated. I think attitude – to be a good person in the relation with the patient and relatives is very important.”

10. 3. What are your thoughts on systematic goals of competencies of spiritual care?
“Fine… although they do not explain any taxonomic level. I think most is encompassed on other learning outcomes. There needs to be some attention towards administration of systematics and how it is done (long didactic discussion).”
“It needs to be integrated in the existing health professional communication, and not something dis-connected from it. And how about time restraints?”
“Think it will work fine – both the overview, but also the underpinning of, that it takes self-insight and reflexion. It is complex, and it needs rightly to be taught and expressed as a complex phenomenon."
“(Can I use the overview in my own teaching related to the field of palliative care – when will you publish, so that it can get into use?)”
“We have to systematize it, otherwise it does not get in to our curriculum…”

11. Overall
Several express hesitation from the word “spiritual” – or as they say “… as long it has nothing to do with anything religious or spiritual…”
It is looked at, as an “add on” to all the other tasks in maternity services, that they find more important, but which are already not priorities.
Some sees it as competencies detached from everyday care perhaps invented by some academics…
It is seen as competencies already being embedded in other subjects as psychology, sociology, health promotive parts of care, or as part of traumatic- event-care.
Some find the points in the standard to be overlapping.
Some find them to be lacking straight taxonomic levels each.
One liked the humility embedded in the language of the Standard.

12. Challenges to face Standard of spiritual care competencies
Cultural sensitivity - secularity
Health professional sensitivity in stead of resistance (objectivity)
Midwifery sensitivity (womens rights, opposition)
Communication - administrative level
Research - explorative and interventional

13. Comments/questions/ideas
What does findings like this mean to us as midwives in trying to improve women’s health? With all the limitations inherited in a questionnaire study and analyses, what does it mean to us as midwives, that the majority of first time mothers eve in a secular society experience existential issues related to the moment of birth?
How do we in maternity care acknowledge this moment of life – giving birth - as an existential transition as well?
Is research related to meaning-making at all relevant in a context very occupied with morbidity and mortality?
3. Should we – at all - provide what we could call spiritual care as well as midwives in relation to Beginning of life? (as it is the case in relation to end-of-life?) and how?
There are lots of questions to answer and lots of research to be done…
Christina Prinds