Transforming the Ontario Midwifery Education Program through social justice curriculum: a modified Delphi study

Abstract

Introduction: Social justice education aims for transformative, liberatory, democratic classrooms and curriculum. From inception, the Ontario Midwifery Education Program (OMEP) has included curriculum that reinforced key principles of Ontario midwifery, including informed choice, continuity of care and choice of birthplace. Despite the social justice underpinnings of these principles, the OMEP has not formally defined social justice in the context of midwifery education or formalized a social justice-based curriculum linked to the Canadian Midwifery Competencies (CMCs) set out by the Canadian Midwifery Regulators Council (CMRC).

Methods: A modified Delphi design was utilized that involved focus groups, interviews, two rounds of surveys and a member checking session. Participants were recruited through purposeful and snowball sampling. Open coding was used to analyse qualitative data and identify themes, and quantitative data was analyzed using descriptive statistics.

Results: Three key findings were elicited. First, qualitative data was used to articulate a definition of ‘social justice’ in the context of midwifery education based on the OMEP’s social justice values, goals, and actions. Second, 86 social justice-based elements (grouped in three thematic areas) and 32 social justice-related CMCs were identified which gave way to 26 corresponding learning outcomes and 6 program level learning outcomes. Third, it was noted that the thematic categories, ‘legal and economic structures’, and ‘policy and health service structures’, were not captured in any of the 32 CMCs suggesting the need for a paradigmatic shift in social justice education in midwifery.

Conclusion: Recommendations to the OMEP are: 1. develop social justice curriculum using constructive alignment and social justice education pedagogies, 2. incorporate social justice curriculum throughout the program to be a global exemplar, and 3. add additional competencies to the existing CMRC’s roles-based framework to support structural competency education. Future work could involve the development of a Canadian midwifery education framework that centres social justice pedagogies and curriculum.