Basic educational needs of midwifery students for taking the role of an assistance in disaster situations: A cross-sectional study in Iran
Introduction
Disasters are destructive events that occur suddenly and are divided into the following categories: (i) natural such as earthquakes, floods, and (ii) man-made such as war. Disasters occur frequently and lead to the death of 75,000 people in each year (Zarea et al., 2014). Disasters are more common in Asia. In other words, 40% of the world's disasters occur in Asian countries (IFRC, 2010). Disasters are accompanied with damages to the economic, social and environmental resources of the community. They also lead to emergency conditions and hinder the provision of healthcare services (Al Khalaileh et al., 2010). Since, saving the life of people in disasters is a priority, there is a need to the preparation of healthcare professionals for disaster management (Ranse et al., 2013).
The disaster medical assistance team is dispatched to disasters' sites for addressing the healthcare needs of affected communities. The members of the disaster team are healthcare professionals who have appropriate knowledge and skills for providing specialized care to people. They should have abilities such as flexibility and stress management, working in difficult conditions, providing emotional support and performing the triage (Abbasi and Salehnia, 2013).
The members of the disaster team is varied based on the needs of societies. In this respect, the presence of a midwife or a nurse-midwife in the disaster medical assistance team is important, because of the importance of the role played by midwives in this situation (Jorgensen et al., 2010). The midwife as a member of the disaster management team has the responsibility for providing care to vulnerable peoples (Giarratano et al., 2010). In disaster situations, waiting for the arrival of medical teams from the outside the region (national or international) is not cost effective. In this respect, skilled midwives should be present at disaster sites to play their role if needed (Lalonde and Adrien, 2015). The role of midwives in all phases of the disaster including prevention, preparedness, response and recovery is important (Chan et al., 2010). Pregnant women and their infants need especial care besides ordinary trauma care (Harville et al., 2010). Midwives are the successor of gynaecologists who are not present in disasters and can manage issues that women face in disasters. Women's issues, pregnancy, delivery, lactation, family planning, the prevention of sexual violence and AIDS are the specialized areas of midwives practice (Abbasi and Salehnia, 2013).
In many emergencies, physical and emotional losses are severe. Therefore, particular qualifications for healthcare providers are necessary for a rapid response in disasters (Turner, 2015). The world health organization (WHO) stated that coping with disaster situations, improving necessary skills, identifying the needs of vulnerable people and performing triage are essential for nurses and midwives (WHO, 2009). When an individual does not have the resilience to manage disasters and cannot apply the triage system, the disaster team is faced with a large population of casualties and the provision of healthcare services becomes difficult (Panicker and Chitra, 2014). The triage is an efficient way for making the use of limited resources and maximizing care to critically ill patients (Nypaver, 2011).
In Asian countries, the education of disaster management to healthcare professionals is a necessity (Kako et al., 2010). A few studies have addressed the education of students in disaster situations. Appropriate education to students for the application of knowledge is an important aspects of planning for disaster management. Students always can be used as the potential sources for increasing the response power in disasters (Cusack et al., 2010).
Midwifery education in Iran is independent from nursing education and midwifery students are specifically educated in the field of reproductive healthcare services. A bachelor degree in midwifery is granted to those students who pass all theoretical and practical courses during a four-year education process. However, no education is provided on disasters to midwifery students unless a course that is not mandatory during the degree education. While the number of studies on disaster education has increased in recent years, a few studies specifically have addressed the educational needs of midwives (Nypaver, 2011). Also, the specific required education for midwives and midwifery students has not been well described. Therefore, there is a need to the development of education programmes and guidelines on disaster management in the field midwifery (Pinkert et al., 2013).
The first step for developing educational programmes for students in disasters is the identification of their educational needs (Selby and Kagawa, 2012). Educational need assessment strategies can improve the designation and implementation of midwifery disaster education. However, little is known on the basic educational needs of midwifery students and related priorities in Iran. This study was conducted to investigate the midwifery students' basic educational needs for taking the role of an assistant in disaster situations.
Section snippets
Design
This cross-sectional descriptive study was conducted in Tehran, Iran in 2015.
Participants
The samples were 235 final-year midwifery students studying in nursing and midwifery schools in four medical sciences universities in Tehran, Iran. Using a census sampling method, all final-year midwifery students were invited to participate in this study. The inclusion criteria were: being a student in the bachelor or master degrees of midwifery and willingness to participate in this study. Out of 235 students invited
The Demographic Characteristics of the Students
All participants were female and the majority of them were in the age group of 20–25 years. The majority of the participants (62.3%) were studying in the bachelor's degree. The average work experience among master degree students was 3 years (SD = 2.4). The demographic characteristics of the participants were showed in Table 1.
Only 11.5% of the students had previous experiences of participation in disasters and 86.8% of them claimed that degree education did not prepare them to deal with disaster
The Midwifery Students' Education About Disasters
In this study, most students reported that they were not sufficiently prepared for disasters situations and did not participate in any course relevant to disasters in the past. Although it seemed that midwifery students received basic reproductive healthcare education in their degree education, the majority of them did not receive systematic education on disaster management. In a similar study in Ghana, Rominski et al. (2011) stated that 80% of samples did not receive previous education on
Conclusions
Our findings showed that the midwifery students felt high needs for education regarding disaster situations. Therefore, the incorporation of relevant content in the midwifery degree education is suggested.
Ability to provide healthcare services with limited resources, time management, psychological adaptation and the ability to perform the triage accurately were the educational priorities of the midwifery students. Since no statistically significant differences between students' educational
Conflicts of Interest
No conflicts of interest were declared by the authors.
Funding and Acknowledgment
This work was supported by the Tehran University of Medical Science, Faculty of Nursing and Midwifery grant number: 21685.
Authors appreciate of all midwives for their cooperation and time provided during data collection process.
Authorship
Taghizadeh Z: Study conception and design, final approval of the version to be submitted.
Khoshnam Rad M: Acquisition of data, Drafting of manuscript.
Montazeri A: Analysis and interpretation of data.
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