Background: For most women, participation in decision-making during maternity care has a positive impact on their childbirth experiences. Shared decision-making (SDM) is widely advocated as a way to support people in their healthcare choices. The aim of this study was to identify quality criteria and professional competencies for applying shared decision-making in maternity care. We focused on decision-making in everyday maternity care practice for healthy women. Methods: An international three-round web-based Delphi study was conducted. The Delphi panel included international experts in SDM and in maternity care: mostly midwives, and additionally obstetricians, educators, researchers, policy makers and representatives of care users. Round 1 contained open-ended questions to explore relevant ingredients for SDM in maternity care and to identify the competencies needed for this. In rounds 2 and 3, experts rated statements on quality criteria and competencies on a 1 to 7 Likert-scale. A priori, positive consensus was defined as 70% or more of the experts scoring ≥6 (70% panel agreement). Results: Consensus was reached on 45 quality criteria statements and 4 competency statements. SDM in maternity care is a dynamic process that starts in antenatal care and ends after birth. Experts agreed that the regular visits during pregnancy offer opportunities to build a relationship, anticipate situations and revisit complex decisions. Professionals need to prepare women antenatally for unexpected, urgent decisions in birth and revisit these decisions postnatally. Open and respectful communication between women and care professionals is essential; information needs to be accurate, evidence-based and understandable to women. Experts were divided about the contribution of professional advice in shared decision-making and about the partner’s role. Conclusions: SDM in maternity care is a dynamic process that takes into consideration women’s individual needs and the context of the pregnancy or birth. The identified ingredients for good quality SDM will help practitioners to apply SDM in practice and educators to prepare (future) professionals for SDM, contributing to women’s positive birth experience and satisfaction with care.
MULTIFILE
Increasingly, internationalisation at home and internationalisation of the curriculum are adopted by universities across the globe but their systemic implementation is a complex process. For instance, academics and academic disciplines understand and approach internationalisation differently, as previous studies have shown. However, there is little research on the role of such disciplinary perspectives in relation to different internationalisation practices and interventions. Using the Becher-Biglan framework of academic tribes, this exploratory study compares 12 undergraduate programmes at a Dutch university of applied sciences and addresses the question if the different disciplinary approaches to internationalisation as identified in previous studies are also reflected in the choices of internationalisation at home activities. The findings show there is more variation in the range of activities rather than in the types of activities and that it is within the rationales underlying those choices where the influence of disciplinary perspectives is more visible.
DOCUMENT
Both within the Netherlands and beyond, young people often start their formal foreign language (FL) education just as they reach adolescence. Speaking the FL in class can be intimidating, and this challenge is often exacerbated as teachers lack ready access to engaging speaking activities. In language classrooms around the world, improvisational drama techniques (IDTs) have been shown to engender positive affective reactions (e.g. enjoyment) and spoken interaction. Yet little research has been conducted on how to train FL teachers to implement IDTs. With this doctoral research project, the goal was to discover which characteristics of a professional development program (PDP) can foster integration of IDTs in the FL classroom and in turn stimulate affective factors related to willingness to communicate among secondary school pupils. The first three studies focused on developing design principles for the PDP and consequently a prototype for this training. The following two studies involved testing and refining this prototype by offering this training to FL teachers. Finally, the impact of the PDP was evaluated among trained teachers’ pupils. The collective findings revealed that the PDP design was viable in its relevance to teachers in galvanizing them to implement IDTs. Their pupils found drama activities to be engaging and fun, and they expressed greater willingness to communicate than during other types of speaking activities. This project was conducted through the Multilingualism and Education Research Group at the University of Applied Sciences Utrecht in conjunction with Utrecht University, Faculty of Humanities.
DOCUMENT
