Development of a tool to enhance midwifery desision-making

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Publication details

Smyth, AM, Provost, S & Jefford, E 2018, 'Development of a tool to enhance midwifery desision-making', paper presented to Southern Cross University 15th Annual Psychology Honours Research Conference, Coffs Harbour, NSW, 4-5 October.

Peer Reviewed



Aim: Decision-making is an integral aspect of midwifery practice. Despite the crucial role it plays in childbirth, there is a significant lack of research into the factors involved in midwives’ clinical decision-making. The current study sought to determine whether several personality characteristics, such as impulsivity, influenced the judgements that midwives made on clinical decisions, and whether these judgements were modified through the use of a midwifery-specific enhanced decision-making and assessment (EDAM) tool.
Method: Midwives (N = 89) recruited through the Australian College of Midwives and the international Midwifery and Reproductive Health Research Forum completed a survey containing three childbirth vignettes and a number of instruments including the Behavioural Inhibition/ Activation Scales (BIS/BAS). Participants were asked to rate the midwives’ clinical reasoning and midwifery practice in the vignettes on a 7-point Likert scale. One group of participants (N = 30) were asked to make these judgements after they had completed the EDAM tool, and another group (N = 59) did not.
Results: There was some evidence for a relation between participants’ scores on the BIS/BAS and their judgements in some of the scenarios. In two of the scenarios, when following the use of the EDAM tool, mean judgments of midwifery practice and decision-making were higher than without the tool. In these scenarios, subscales of the EDAM tool correlated with judgements. In the third scenario, use of the EDAM tool did not impact judgements, and these were uncorrelated with any of its subscales.
Conclusions: Use of the EDAM tool influences midwives’ judgements, but this is dependent on the specific factors involved in the vignette. The role of sensitivity to reward in decision-making tasks such as this is not well recognised, and future efforts to further explore this factor may enhance training for effective decision-making.