MIDWIFERY IN BRITISH COLUMBIA: IS IT TIME FOR AN EXPANDED SCOPE OF PRACTICE? FINDINGS FROM A QUESTIONNAIRE ON PRACTICE ISSUES IN BRITISH COLUMBIA
Bibliographic record
Abstract
Canada is currently facing a shortage of physicians providing maternity care in both urban centres and rural environments. Although midwives have been regulated in five Canadian provinces, they are currently unable to meet the needs of a diversity of childbearing women. An expanded scope of practice may address some of the current obstacles to the provision of care. A 145-item questionnaire on current practice issues faced by midwives in British Columbia was administered to all registered midwives in the province in March 2002 (n=65). Thirty-five questionnaires were returned for a response rate of 54%. One component of the questionnaire focused on respondents' views of an expanded scope of practice. Out of a possible 32 items, the majority of respondents advocated including an additional 17 items into their current scope of practice. Desired functions included increased prescribing authority and an increase in some technical skills. Conversely, the majority of respondents were not interested in including15 additional items including gynecological surgery and advanced procedures. In order to be a viable long-term contributor to maternity care in Canada, midwives must engage in a dialogue with each other over future directions for their profession, begin consultations with other players in maternity care, and develop a mechanism for evaluating any changes to their scope of practice. The results of this study indicate an interest on the part of some midwives to increase their scope of practice. However, findings may not be representative of the opinions and attitudes of all registered midwives in British Columbia. More research is needed into the nature and implications of such changes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".