PURPOSE:
Purpose: To advance the use of a measurable evaluation tool designed to facilitate reflective learning about a physiological care approach amongst novice midwives.

DISCUSSION:
Discussion: There is a large body of evidence supporting the overwhelming benefits of physiologic labour and birth. In 2018, the World Health Organization reaffirmed a commitment to a physiological care approach to birth in order to optimize health outcomes. The Physiological Practices Observation tool was developed through rigorous research identifying 6 domains and 27 items that constitute physiological care practices.

EVIDENCE WHERE RELEVANT:
Evidence: Educating students in the midwifery model of care and promotion of physiological care practices can be challenging, especially in highly medicalized environments. A novice midwife can benefit from a preceptor's evaluation and rating of his/her practice using a tool followed by reflective learning. The 27 care practices in the Physiological Practices Observation tool were identified from a critical appraisal of evidence and content validation using 7 experts and 8 women. The 27 care practices are organized into six domains of care: 1) Approach to care (“Adopts careful watching, attending and responding as labour unfolds”), 2) Environment, 3) Supporting women, 4) Ongoing care, 5) First hour of birth, and 6) Involving women in decision-making. A Delphi study is planned for further validation of the tool for use in the United States, with review by local content experts (practicing midwives) and women in Philadelphia. A future study is also planned for further psychometric testing with the purpose of gathering research data on the use of these care practices and correlating their use with outcomes.

KEY MESSAGE:
Key Message: The Physiological Practices Observation tool can assess the performance of novice midwives in their use of physiological care practices and facilitate reflection to improve practice. Poster session 3 (Group B)