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Collaborative Practice and Teaching in Perinatal Care: Certified Nurse-Midwives as Educators of Medical Residents.

INTRODUCTION
The goal of this study was to update understanding of the current roles and responsibilities of certified nurse-midwives (CNMs) in the education of resident physicians. Three subaims were to (1) examine the involvement of CNMs in the education of residents in obstetrics and gynecology and family medicine, (2) examine the typology of CNMs' collaboration with residents, and (3) describe CNMs' opinions regarding their educational roles and responsibilities.


METHODS
This descriptive study used an electronic survey sent to CNMs involved in the education of medical residents. Survey participants were identified using an online directory of CNMs involved in academic midwifery practices in the United States. Survey items included both closed-ended and open-ended questions to generate quantitative and qualitative data, respectively.


RESULTS
Of the 146 CNMs invited to participate, surveys were received from 85, a response rate of 58%. Seventy of the respondents fit inclusion criteria of working with family medicine and obstetrics and gynecology resident physician programs. Most of the midwives' educational roles included informal mentorship of residents, supervision and consultation of intrapartum care, and caring for either their own or residents' patients. All respondents agreed that incorporating CNMs into clinical teams and faculty roles improves resident education. The majority of respondents desired a greater degree of involvement in resident education, with 57% preferring a blended interaction model.


DISCUSSION
The majority of CNM respondents reported a preference to have greater involvement in the education of residents. Although CNMs desire a blended interaction or fully integrated model of collaboration with resident physicians, the current state of CNM involvement does not fulfill this degree of collaboration. Opportunities exist for further research, including surveys of resident physicians who work with CNMs, leaders in midwifery, residency program directors, and policy makers.