Midwives' views of the importance of genetics and their confidence with genetic activities in clinical practice: implications for the delivery of genetics education

Aims and objectives. The aim of the study was to ascertain the level of importance midwives attach to integrating genetics into midwifery care and to compare that with their self-reported level of confidence in incorporating genetics into their clinical practice. Background. Previous work has shown that many midwives feel ill-prepared for the increased integration of genetics into clinical practice and often only limited genetics education provision is in place. With the application of genetics to midwifery practice increasing, it is important that midwives develop their knowledge and skills to meet this growing clinical role. This study was therefore developed to ascertain the attitudes and educational needs of midwives by exploring genetic issues likely to arise in clinical practice and the confidence individuals felt in dealing with them. Design. A survey questionnaire with open and closed questions. Methods. All midwives working in four National Health Service trusts (n = 817) were invited to self-complete the validated questionnaire anonymously. Data were collected on demographics and preferred continued professional development options for future educational programme development. Likert scales were used to rate the importance of genetic activities and midwives' confidence to perform them based on the genetic activities which were first listed and then presented embedded within specific clinical scenarios. Results. The response rate was 51% (n = 416). The majority of midwives felt that genetics was important but many did not feel confident about integrating it into their clinical practice. Across all scenarios > 60% of midwives were not confident on any risk identification or risk communication activities. The majority of midwives were receptive to genetics education particularly if delivered from a clinical rather than a psychosocial or scientific perspective. Conclusion. This study demonstrates the need for midwives' pre- and postregistration education to include clinically relevant genetics. The evidence presented here can inform the design, development and delivery of future educational initiatives. What this study adds. This study was the first to identify the educational needs of midwives related to integrating genetics into midwifery clinical practice. It provides evidence of key topics to be included in educational programmes: referring to specialist genetics services, genetic testing, risk and communicating genetic information. It shows the type and format of course preferred by clinically based midwives: interactive workshops and lectures using clinical patient-based case examples will attract midwives to participate and will be better received by their managers. Relevance to clinical practice. Midwives view genetics as important in their clinical practice. However, they have little confidence in their ability to integrate genetic activities in their current clinical practice. Midwives are receptive to additional genetics education and training. Antenatal and community-based midwives could be targeted initially. Organizers must be responsive to work patterns in planning education sessions, and encourage and support champions from previous courses and specialist areas to promote genetics education in maternity units.