The Past, Present, and Future of Assessing Continuing Competency for Midwives

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Journal of Midwifery and Woman's Health

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Consumers deserve to know that health care professionals not only are competent as they begin their careers, but also that they are exerting every effort to ensure that they remain competent throughout their careers. The fundamental basis for any health profession's interaction with the public must be demonstrable competence. Health care occurs within a health care system that is continually seeing new advances in technology and science, as well as changes in health care management and consumer expectations. The critical task of maintaining and proving competence at regular intervals will remain a challenge for health care providers for the foreseeable future. According to the Institute of Medicine, the knowledge explosion in medicine is one of the factors that can reduce the quality of care to consumers.1 There always seems to be something new to learn; moreover, as we improve our understanding, some things that we used to “know” will have to be unlearned, in favor of knowledge and practices that will be of greater demonstrable benefit.

As the knowledge explosion continues within midwifery, the profession also is increasing its understanding of more effective ways to maintain and demonstrate competence. The ways of ensuring continuing competence are also subject to change, as knowledge progresses and as management policy and consumer expectations move in new directions. This commentary will discuss why and how midwives arrived at the present changes in midwifery certification, and will also explore potential future mechanisms for maintaining and demonstrating competence.