Susannah Brady, Fiona Bogossian, Kristen Gibbons

In midwifery practice we espouse a woman centred care approach to practice, yet in midwifery education no valid instrument exists with which to measure the performance of these behaviours in midwifery students. To develop and validate an instrument to measure woman centred care behaviours in midwifery students. We identified four core concepts; woman's sphere, holism, self-determination and the shared power relationship. We mapped 18 individual descriptive care behaviours (from the Australian National Competency Standards for the Midwife) to these concepts to create an instrument to articulate and measure care behaviours that are specifically woman centred. Review by expert midwifery clinicians ensured face, content and construct validity of the scale and predictive validity and reliability were tested in a simulated learning environment. Midwifery students were video recorded performing a clinical skill and the videos were reviewed and rated by two expert clinicians who assessed the woman centred care behaviours demonstrated by the students (n=69). Test and re-test reliability of the instrument was high for each of the individual raters (Kappa 0.946 and 0.849 respectively p<0.001). However, when raters were compared there were differences between their scores suggesting variation in their expectations of woman centred care behaviours (Kappa 0.470, p<0.001). Midwifery students who had repeated exposures to higher levels of simulation fidelity demonstrated higher levels of woman centred care behaviours. The WCCS has implications for education and the wider midwifery profession in recognising and maintaining practice consistent with the underlying philosophy of woman centred care.