1. Stages of Professional Development

2. Stages of Development of a Professional Paraprofessionals receiving: specialized education designed to develop a theoretical framework, applied skills, knowledge and attitudes. I.Internal process: absorbing, internalizing, conforming to their perceptions of what professionals think, do or say. II.Practice is a mirror image of what they have observed in the world

3. Appliers - Experienced college graduates. – Apply the knowledge gathered and skills developed in a volunteer or paid staff position. – Discovering the limits imposed by the environment or institutions involved. – Internal process: challenging the commitment to the profession and will either accept the limits and conform to the setting, becoming stuck at that level OR be stimulated to challenge and question the limitations and move on to another step in the process of development. Some may become discouraged and dropout.

4. Analysts - Experienced in applying and refining knowledge with new acquisition. Analyze self and profession in whole and in parts, question their very existence and purpose, and seek new knowledge to support their practice. Internal process: stress, anger, frustration with complex issues, limits and slows process of change.

5. Integrators-Holistic thinkers, “having examined themselves and the profession and broken the wholes into parts, they’ve begun to put the parts together again, to create, organize, and design something different. – Selective about causes and issues in which they become involved. Internal process: Philosophical, Coherent between actions and beliefs, attitudes and values.

6. Midwifery as a profession? Midwifery’s pursuit of professionalization can be said to be both enabling and controlling. Enabling in terms of developing the role of the midwife as an autonomous practitioner with a specific remit, Controlling in terms of protecting the public from substandard practice professionalism has a certain appeal as a disciplinary mechanism:

7. … Professionalism acts as a mode of government of autonomous labor; the autonomy of professional practice is predicated upon its government ‘at a distance’ … through the articulation of ‘professional competence’

8. The midwife as an autonomous practitioner A key issue to be clarified in midwifery’s pursuit of professionalization is whether the midwife is an autonomous practitioner. Professional status implies a minimum level of independence within a specific role which is related to the role of other professionals on an equal partnership basis.

9. what it means to be an autonomous midwifery practitioner:  working in partnership with the woman, colleagues and other professionals  making decisions and being accountable  Using sound evidence-based knowledge and having the self-confidence and initiative to rely on the validity of judgments  knowing how and when to act, being assertive and having firm moral Convictions  having managing skills and the ability to remain flexible

10. Definitions of competence ‘The ability to perform a particular activity to a prescribed standard’. ENB, 1990 Midwifery as an occupation is very complex, involving a broad range of tasks, abilities and clinical situations, and in such occupations it can be argued that there is no ‘single right way to define competence’ It involves not only observable behavior which can be measured, but also unobservable attributes including attitudes, values, judgmental ability and personal dispositions; that is, not only performance but capability. This, along with the statutory requirements

11. The first dimension - clinical competence, focuses on the skills and knowledge required for the role. It includes the ability to use knowledge in practice to select and apply skills appropriately to the situation and to use skills expertly.

12. In the second dimension - the professional/ friend approach, the emphasis is on the midwife as a professional, autonomous, accountable and responsible practitioner. It includes professional and self-awareness, effective functioning in a team, and commitment and motivation to midwifery as a profession and to providing a good standard of care.

13. In the third dimension - the individualized approach, elements of competence enabling the midwife to work in partnership with the woman are emphasized. These include effective communication, being nonjudgmental and advocacy.

14. Clinical competency Majority of tasks unsupervised Full range of normal care Detect deviations and take appropriate action Use research-based and up to date knowledge appropriately Respond

15. Professional friend Right level of confidence Manage own workload Personal and professional awareness Right attitude Accountable Basic decisions Effective team member