Nursing Midwifery Commons^™

The Relationship Between Sleep Quality And Physical Fitness Toward The Menstrual Cycle In High School Students, Surya Adi Saputra, Raja Mohammed Firhan Bin Raja Azidin, Alifia Candra Puriastuti, Dessy Amelia, Zumroh Hasanah, Anggi Renawati

Journal of Asian Midwives (JAM)

Background: Sleep is essential for maintaining physical fitness and overall health, as it helps the body recover from intense physical activity and maintains endurance. Physical fitness is determined by heredity, gender, age, body composition, activity, and exercise. Adequate sleep positively impacts overall health, while poorer sleep can negatively affect the body. Teenagers often prefer excessive screen time and oversleep, which can affect their sleep quality. Physical fitness is related to physical activity, and the more often an individual engages in physical activities, the better their fitness. This condition can also impact reproductive health, as hormonal disorders can affect the menstrual …

Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding Early Childhood Development: A Mixed-Methods Study At Secondary Care Maternal And Child Care Hospitals In Karachi, Pakistan, Sarosh Hirani, Shelina Bhamani, Hajra Malik, Samira Lakhani, Adeeb Kanji, Khairunnissa Hooda

Journal of Asian Midwives (JAM)

Introduction: Early childhood development (ECD) is a critical period that lays the foundation for a child's future growth and overall well-being. Healthcare settings play a significant role in shaping these developmental outcomes. However, there is limited research evaluating healthcare professionals' knowledge, attitude, and practices on ECD in Pakistan. This study aims to assess the awareness, attitudes, and practices of healthcare providers working in secondary hospitals regarding ECD.
Methods: A sequential explanatory mixed-methods approach was used. The study initially recruited healthcare workers, including physicians, nurses, trainees, and midwives from two secondary care hospitals. Participants completed the Caregiver Knowledge of Child Development …

Peer Mentorship Of Midwifery Faculty In Bangladesh: A Process Evaluation, Pronita Raha, Joy Kemp, Farida Begum, Rowsan Ara, Vibhavendra S. Raghuvanshi, Nabila Purno, Daniel Novak, Hoque Emdadul Hoque

Journal of Asian Midwives (JAM)

Development of midwifery faculty is key to strengthening quality midwifery education. This article presents a process evaluation of a peer mentorship programme, implemented between 2021 and 2023, for around 370 midwifery faculty in Bangladesh, including 40 newly deployed faculty. 20 peer mentors, prepared by international midwifery faculty, conducted quarterly visits to public midwifery education institutions (MEIs) to provide mentorship support to midwifery faculty and to monitor the quality of midwifery education. A digital community of practice was also created. Data were collected with a checklist based on the World Health Organization (WHO) midwifery educator competencies and entered into a digital …

Effects Of World Health Organization’S Educational Interventions On Clinical Competency Of Community Midwives In Managing Postpartum Hemorrhage, Afifah Abu-Ul-Hayat, Sarfaraz Masih, Madiha Mukhtar

Journal of Asian Midwives (JAM)

Background: Postpartum hemorrhage (PPH) is considered to be one of the most important causes of maternal mortality especially in low resource countries such as Pakistan. Community midwives (CMWs) have a very important role in the provision of midwifery care and their clinical competency are very crucial for the handling of PPH. This study evaluates the effect of a World Health Organization (WHO)-based educational intervention on the clinical competency of CMWs in Hazara Town, Quetta, in managing PPH.
Objective: This study aimed to determine the effectiveness of a WHO based educational intervention on improving the clinical competency of CMWs in managing …

Perceptions Of Risky Sexual Behavior Among Female Students: A Qualitative Analysis Of Contributing Factors, Consequences, And Prevention Strategies, Leila Bozorgian, Fatemeh Ansari, Fatemeh Janipour, Solmaz Mohammadi

Journal of Asian Midwives (JAM)

Background: Risky behaviors among young people are a significant concern for societies worldwide, leading to physical and psychosocial damage. Despite efforts to raise awareness about such risky behaviors over the past two decades, their prevalence continues to rise. Therefore, this study aimed to explain perceptions of the prevalence of risky sexual behaviors among female students.
Methods: A qualitative descriptive study using a conventional content analysis approach was conducted from August to mid-September 2024 in Yasoj, Iran. The study participants were selected using purposive sampling. The data were collected using semi-structured interviews conducted with 18 female students. Data collection …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …

Midwifery Students' Evaluation Of Midwifery Practice Experiences In Australia: A National Survey, F. Bogossian, A. Hyun, D. Bloxsome, A. Brown, S. Cooper, S. Hunter, L. Kearney

Research outputs 2022 to 2026

Aim: To report the findings of the first 12 months of a national survey of midwifery students’ evaluation of midwifery practice experiences in Australia. Background: Accreditation standards for midwifery programs globally and in Australia, require evidence of monitoring and evaluation of student midwifery practice experiences. In 2022 the National Placement Evaluation Centre was commissioned to measure and enhance the quality of nursing and midwifery practice experiences. Design: Survey Methods: A national survey of midwifery students who completed midwifery practice experience in Australia between 1 July 2023 and 30 June 2024. Results: Midwifery practice experiences (n = 871) were evaluated; most …

An Exploration Of Adventist Nursing Practice In Liberia, Lendeh E. Seboe, Erhuvwukorotu S. Kollie, Boffa L. Kollie Nyumah

Adventist Human-Subject Researchers Association

This study explored nursing practice in Liberia using the integrated global framework for nursing education and practice. A descriptive Qualitative method was used through a group interview and purposive sampling technique for participant selection. FGD utilized for data collection and theoretical sampling for data saturation. Findings highlighted for improvement at the researched hospital and other SDA health care settings.

Respectful Patient-Provider Communication And Patient Portal Usage In Pregnant People Of Color, Amy H. Goh, Christopher Lee, Chisolum Nkenke, Joyce K. Edmonds

College of Health Professions Faculty Papers

BACKGROUND: Patient-provider communication (PPC) increasingly occurs in online patient portals. Variations in portal usage might worsen communication inequities for pregnant people of color (POC), widening the digital divide. The objective of this study was to examine the relationships between respectful PPC, patient portal usage, and digital health literacy (DHL) in pregnant POC.

METHODS: A multimethod cross-sectional survey design was used. Ordered logistic regression was performed to determine the relationship between PPC and portal use, controlling for trimester prenatal care was initiated, insurance type, age, gestational age, and parity. The moderating effect of Digital Health Literacy Instrument (DHLI) was tested on …

Stakeholders' Expectations And Experiences Of Being Involved With A Global Accreditation Process For Midwifery Centres In Lmics: A Rapid Ethnography, Summer M. Aronson, Laura Batinelli, Lucia Rocca-Ihenacho, Jennifer R. Stevens

College of Health Professions Faculty Papers

BACKGROUND: This study explored the expectations and experiences of stakeholders involved in the accreditation of midwifery centres (MCs) in low- and middle-income countries (LMICs). With increasing evidence that MCs provide safe, respectful, and evidence-based care that improves maternal and neonatal outcomes, accreditation may serve as a mechanism to bridge quality gaps in maternal health systems, particularly in regions with high maternal and neonatal mortality.

METHODS: A rapid ethnographic approach, combining participant observation and semi-structured interviews, was conducted in partnership with the GoodBirth Network (GBN), which identified six pilot midwifery centres in Haiti, Uganda, and South Africa. Convenience sampling was applied, …

Small And Sick Newborn Care: Changes In Service Readiness Scoring Between Baseline And 2023 For 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Morris Ondieki Ogero, Robert Tillya, Irabi Kassim, Olabisi Dosunmu, Opeyemi Odedere, Hannah Mwaniki, Vincent Ochieng, Dolphine Mochache, William Macharia

Paediatrics and Child Health, East Africa

Health Facility Assessments (HFAs) are important for measuring and tracking service readiness for small and sick newborn care (SSNC). NEST360 Alliance aims to reduce neonatal mortality in four countries (Kenya, Malawi, Nigeria, Tanzania). NEST360 and UNICEF facilitated HFA tool design with ministries of health in four African countries and developed two complimentary approaches to summarize readiness. Using the NEST360/UNICEF HFA tool, we collected data, developed two service readiness scoring approaches for SSNC (standards-based scoring by adapted World Health Organization (WHO) health system building blocks (HSBBs) and assessing service readiness across the health system, and level-2+ scoring by WHO clinical interventions), …

Nursing Education Research In Sub-Saharan Africa: A Systematic Review And Bibliometric Analysis, Beth Waweru, Peter Gatiti, Serah Wachira

School of Nursing & Midwifery, East Africa

Nursing education is pivotal for ensuring competent healthcare professionals, and its improvement is essential for enhancing the quality of health care systems globally. This study focuses on nursing education research in Sub-Saharan Africa (SSA) over the last decade, employing both bibliometric analysis and systematic review methodologies. The bibliometric analysis reveals an evolving landscape of nursing education research in SSA, offering insights into trends, key countries, journals, and predominant research themes. Notably, the study identifies a scarcity of literature using bibliometric approaches in nursing research, addressing this gap by providing a comprehensive overview of the field.The systematic review, guided by the …

Exploration Of Advanced Practice Registered Nurses’ Perception Of Barriers To Promoting And Supporting Breastfeeding In Primary Care, Devon L. Stubblefield, Allison L. Scott, Carmel Kruse, Marilou D. Shreve, Hope A. Ballentine

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Breastfeeding is the biological way to provide active and passive immunity, as well as necessary nutrients, to infants while concurrently providing multiple health benefits for mothers. Even though evidence is readily available to support the argument to breastfeed, United States’ breastfeeding rates fall below Healthy People 2030 goals. Advanced practice registered nurses (APRNs) in primary care settings are in a prime position to give education and create care plans to support breastfeeding mothers to improve breastfeeding rates but literature supports APRNs lack confidence to do so. An APRN is likely to defer care to another provider to address …

Transformative Learning In Homebirth Settings: A Reflexive Thematic Analysis Of Midwifery Students' Experiences, Kate Buchanan, Sara Morris, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: The homebirth setting provides opportunities for midwifery students to witness autonomous midwifery practice, but these experiences are limited. Factors that limit practicum placement in the home birth setting are either logistical, with less than one percent of women having a homebirth in Australia or related to university governance, whereby approval is not granted for midwifery students attending homebirth. Objectives: To explore midwifery students' experiences in the homebirth setting and to determine how this has influenced understandings of the role and scope of practice the midwife. Methods: Qualitative methods were chosen to inform this study. Setting: A University that offers …

Indirect Evidence Of Sex-Selective Abortion Practices To The Imbalanced Sex Ratio At Birth In Australian Migrant Populations, Amanuel Tesfay Gebremedhin, Gizachew A. Tessema, Ravisha Srinivasjois, Judith A. Daire, Kevin A. Chai, Bereket Duko, Kalayu Brhane Mruts, Gavin Pereira

Research outputs 2022 to 2026

A skewed sex ratio at birth (SRB), commonly observed in countries with high son preference can be attributed to prenatal sex-selective abortion. However, the possibility of sex selection among migrants in high-income countries has received little attention. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. In this population-based study, perinatal data were obtained from all registered births in Western Australia (WA) and New South Wales (NSW) …

Labour Companionship And Respectful Treatment Of Women During Childbirth: A Cross-Sectional Study Across 16 Hospitals In Benin, Malawi, Tanzania And Uganda, Soha El-Halabi, Kristi Sidney Annerstedt, Christian Agossou, Fadhlun Al-Beity, Andrea B. Pembe, Phillip Wanduru, Bianca Kandeya, Jean-Paul Dossou, Helle Molsted-Alvesson, Claudia Hanson

Centre of Excellence in Women and Child Health

Introduction: Evidence suggests that women value and benefit from having a labour companion during childbirth. However, the applicability of the evidence to low-income and lower-middle-income countries is limited and varies. Thus, we assessed the association between the presence of labour companions and mistreatment in 16 hospitals of Benin, Malawi, Tanzania and Uganda.

Methods: We conducted a cross-sectional survey using a validated questionnaire administered to women at discharge after birth between December 2021 and March 2024. The main outcomes were factor-weighted respectful treatment score and its subscores on maintained respect and dignity, privacy and maintained confidentiality and no physical and verbal …

What Do Safety And Risk Mean To Women Who Choose To Birth At Home? A Systematic Review, Candice Chauncy, Kate Dawson, Sara Bayes

Research outputs 2022 to 2026

Introduction: Despite clear evidence to support the safety and efficacy of homebirth, the concept challenges the almost universal belief that hospital is the safest place to give birth. Homebirth remains largely unsupported around the world due to prevailing beliefs and constructs surrounding risk and safety. Despite barriers to access, women continue to choose home as a place to birth. Methods: A systematic review of qualitative research was conducted to explore and understand women's views on what constitutes risk and safety in labour and birth for those who choose to birth at home. All studies were evaluated for quality and relevance. …

Experiences Of Women In The Labour Room: The Untold Story, Emmanuel Dziwornu, Belinda Kpodo, Ophelia Anarfi, Enyonam Afi Adzato, Anita Fafa Dartey

Patient Experience Journal

Background: Childbirth experiences are some of the most sensitive indicators of the utilisation of health facilities. Women who go through the child-birthing process are reported to be faced with a range of experiences. Aim: This study described women's experiences in the labour room. Methods: The study employed a qualitative research approach with a descriptive design. Purposive sampling was used in this study and data saturation was reached after the 18^th participant. In-depth interviews were used to obtain information from recently delivered women. Interviews were audio recorded and transcribed verbatim. Thematic content analysis (TCA) was done and the results were …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Assessing The Efficacy Of Tranexamic Acid In Adjunct To Oxytocin In Reducing Blood Loss During Cesarean Deliveries: A Scoping Review, Hilary Clair Ray Bsn, Rn, Shelbie Freeman Hendrix Bsn, Rn, Lauren Elizabeth Hubbard Bsn, Rn, Helen Maisen Conley Bsn, Rn, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Capturing Women's Birth Experiences Through Photos, Kristen Montgomery, Betsy Crabtree, Samantha Grayson, Alyssa Harmon, Rachael Robbins, Sarah Shelton, Hannah Sobas, Alexis Taliaferro, Nolan Willard

Epsilon Sigma at-Large Research Conference

Purpose: Each year 3.5 to 4 million women give birth in the United States. Childbirth is a life-changing event that induces various emotions in women. Many women report having a negative experience due to short staffing, inadequate care, and a loss of autonomy. Aims: The aim of the study was to understand what factors contribute to a positive or negative birth experience.

Methods: A descriptive qualitative study was conducted using photo elicitation. Photos were collected from participants and included a description of how the photo represented the participant’s experience. Demographic data were collected through a survey. Participants …

A Jewel In The Crown Is Better Than Money In The Pocket": Historical Data On The Role Of Midwives In Caring For Families In Southern Appalachia, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

Background: Midwives have provided care to women since the beginning of time. Early midwives had little training but learned their craft from experienced women. Later, formal training became available. Midwives have a rich history in Appalachia.

Purpose: to explore the rich history of all types of midwives in Appalachia.

Methods: Materials from the Archives of Appalachia were reviewed. Both written and oral materials were evaluated. This included a review of the document, identification of themes, and then comparing those themes with previously identified themes. Documents were reviewed in a random order by two researchers who met to discuss results.

Results: …

Quality Of Perinatal Care: Experiences Of Clients And Providers In Three District Hospitals Of Western Uganda– A Mixed Methods Study, Mercy Muwema, Joaniter Nankabirwa, Dan K. Kaye, Gorrette Nalwadda, Joanita Nangendo, Gloria Odei Obeng-Amoako, Jean Claude Nkurunziza, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Grace Edwards, Emmanuel Otieno, Robert Basaza

School of Nursing & Midwifery, East Africa

Background: It is anticipated that closing the quality gap through provision of effective antenatal, intrapartum and postnatal care for mothers and newborns in facilities will reduce morbidity and mortality. Mothers’ and health care providers’ experiences play a vital role in achieving quality care during the perinatal periods.

Purpose: To assess the health care providers’ (HCPs) and clients’ experiences on quality of perinatal care at three district hospitals in Bunyoro region, Western Uganda.

Methods: A convergent parallel mixed methods study design was utilized to explore experiences of 1) mothers as they sought antenatal, intrapartum, and postnatal care; and 2) …

Scoping Review Of Algorithms For Electronic Fetal Monitoring, Katherine Sabatier, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to review the use of an algorithm in evaluating continuous external fetal heart rate (FHR) monitoring in labor as opposed to clinician judgment for improved fetal outcomes, including earlier recognition of abnormal tracings (Clark et al., 2017). FHR monitoring was created to evaluate for fetal hypoxia in labor and has become standard practice (Gyllencreutz et al., 2018). One of the goals of the use of cardiotocography is to decrease hypoxia-induced fetal metabolic acidemia and neurologic injury. There are multiple options for individual or computer-based algorithms in evaluating FHR to reduce fetal acidemia …

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

Implementation Of The Modified Early Obstetric Warning System (Meows) In Obstetric Patients Within A Level Iv Maternal Care Facility, Mei M. Stalder

Student Scholarly Projects

Practice Problem: Incidences of increasing maternal morbidity and mortality are often preceded by a period of unrecognized deterioration. The lack of an obstetric early warning system in a high-risk Level IV Maternal Care Facility further contributed to delayed identification and intervention of deteriorating mothers.

PICOT: The PICOT question that guided this DNP project was, in obstetric patients, 18-years or older (P), does the Modified Early Obstetric Warning System (MEOWS) (I), compared to current standard practice (C), affect the number of patients transferred to the ICU (O) within a six-week time frame (T)?

Evidence: Nine evidence-based articles were included in this …

Prevalence And Risk Factors Associated With Postpartum Hemorrhage Among Postpartum Women In Selected Health Facilities In Machakos County - A Case-Control Study, Daniel Kyalo Muthiani

MSc in Advanced Practice Midwifery

Background: Postpartum hemorrhage (PPH) refers to blood loss ≥500mls after vaginal birth and ≥1000mls after cesarean section. PPH is of concern in low and middle-income countries and is estimated to cause maternal mortality every 10 minutes, with a prevalence of 25% and 34% in Uganda and Kenya, respectively. Despite efforts to address this issue, the prevalence of PPH remains high and is associated with maternal and fetal risk factors that can present along the continuum of birth. Understanding the risk factors is necessary in designing appropriate interventions for their prevention.

Objective: To determine the prevalence, maternal and fetal risk factors …

Confirming The Validity And Reliability Of The Placement Evaluation Tool To Evaluate Midwifery Practice Placements (Pet-Midwifery), Fiona Bogossian, Dianne Bloxsome, Angela Brown, Robyn Cant, Susan Hunter, Lauren Kearney, Lesley Kuliukas, Carolyn Ross, Simon Cooper

Research outputs 2022 to 2026

Problem: In Australia, program accreditation requirements include that education providers monitor and evaluate teaching and learning environments and provide evidence of outcomes being used to inform program quality improvement. Yet, closing this loop has proven challenging. Background: The Australian National Placement Evaluation Centre (NPEC) functions to measure the quality of placements through student evaluations. One measure the Placement Evaluation Tool (PET) had not been tested in midwifery student cohorts. Aim: To confirm the validity and reliability of the Placement Evaluation Tool (PET) for midwifery. Design: Survey instrument development. Methods: A three-phase, sequential study involving seven Australian universities and students enrolled …