Identify demographic and or socioeconomic factors associated with the health disparity or key indicator.

Final Oral PowerPoint Presentation

In this final module, students are required to review and critically integrate all that they have learned throughout this course in order to evaluate the maternity health care needs of their community and create a plan to develop a birthing center, home birth or a midwifery owned private hospital practice to serve women and families in the community. Students are expected to build upon previous assignments including the maternal child health indicator, community assessment, the checklist for certification, licensure, education, and practice and the google chats.

In evaluating the MCH data, students should indicate if they found a health disparity and report on the percentage of people affected in their community. i.e. if there is a race-related disparity which affects African Americans you could note this fact and also describe what % of the community is African American. i.e. If the % of Blacks is only 3%, while important, would you as a CNM want to devote your resources and time to focus on this small percent of the population. Focusing on this subgroup might be more sustainable for your practice if 25%-30% of the population were African American. On the other hand, are there special programs such as “Easy Access Clinics” or Group Care that you may develop to reach out and serve the MCH needs of a small subpopulation. Analysis of the data is expected. Identify a key health indicator, which could be the same as the disparity. Provide a rationale for your choice. What kind of practice and social collaborations might you develop to address this key indicator as a midwife?.

Students must discuss which aspects of the Hallmarks of Midwifery they will integrate as a baseline to guide their practice. Attention must be given to the cultural, ethical, political and financial barriers or enables to provide care to members of your community. i.e. if your community has a large Hispanic or growing LGBTQI population, what efforts will you take to be become more culturally aware and sensitive to the beliefs, needs or religious practices of these populations. Keep in mind that cultural differences are not limited to race and ethnicity. While race and ethnicity may display specific cultural norms, acting in a culturally competent manner to all people may also require mindfulness and respect for their religion, diet, gender orientation, education or financial status and more.

Each student will develop a comprehensive ppt. to present to your small group and section faculty member during weeks 10 and 11. The ppt. presentation should contain a maximum of 18 slides excluding the title and reference slides. Correct APA guidelines must be followed. See NM700 Tool Box. Slides should use images and bullets and should not be wordy. (25-30 words per slide is an acceptable guideline) Each student will have 12 minutes to deliver their presentation. Please practice your timing. HINT: (Pay attention to point values for each section. Plan to spend more time covering areas that are worth 15 points rather than those that are worth 5 points)You may be asked to stop if you go over by 1 additional minute. A period of 5-10 minutes of student and faculty critique and comment will follow. 20% of your final grade will be based upon peer review from your team members.

Submit slides as a pdf file to the dropbox AND to your section faculty by email at least 90 minutes before your final presentation time for which you signed up so faculty can upload slides to the BBB. How to Compress a PDF.

Step one. Describe your community-1-2 slides

General Description of the community

Location (County where the community is located)

Topography rural, urban, elevation etc. Does the environment pose any access problems for patients?

Major employers – seasonal? implications for health insurance coverage

Other significant characteristics i.e. birth options, types of birth attendants or interesting facts.

Step 2. Community Demographics (2 slides-many students submit and cite their CA table or excerpts with )

The racial and ethnic makeup

Percent for whom English is a second language

Educational level – % high school and college graduates

Economic level – (home values, % home ownership, median income, % below the poverty level, unemployment level, % state Medicaid reimbursed births)

How does this data compare to state and national data?

Other significant or interesting demographic findings in your community.

Step 3, Maternal Child Health Indicators (2-3 slides-many students submit and cite their MCH table or excerpts)

Compare MCH indicators to state, national HP2020 data

Highlight significant findings within any of the MCH indicators -i.e. health disparities. Other interesting findings?

Identify local health disparity(s) Is this subpopulation large enough to devote your time and practice to? Would focusing on this population alone sustain your CNM practice?

Identify key health indicator in need of attention. What is the rationale for your choice? Do you want to focus your practice to address this key indicator?

Identify demographic and or socioeconomic factors associated with the health disparity or key indicator.

Step 4. What are the general population needs?
You have gathered a lot of data about your community largely from online sources. When you are establishing a new midwifery practice or birth center, it is important for you to reach out to community members and listen to them as they express their views about midwifery and what they desire or need from a midwifery practice or birth center. They are many ways that you can open discussion with clients. Dr. Ruth Lubic held focus groups with members from a largely low-income Black population in D.C to learn about their needs and desires for services and programs from the proposed DC developing family health center. NM700 faculty urge you to reach out and speak directly to members of your community to determine their knowledge about midwives, the types of health services they need or desire, and their interest in a midwifery practice. We have set aside week 8 and 9 with no due dates where you could gather this grassroots feedback, however, you can reach out to your community at any time during the semester. Be aware that you might first need to provide a brief explanation of the following:

1. What is a nurse-midwife? (i.e. how does a CNM differ from a CPM)

2. What is a birthing center?

3. Are birth centers safe?

4. Significant MCH community findings

5. Your plans to open a midwifery practice

Faculty suggests the following ways you might utilize to outreach to your community for grassroots feedback. Of course, we encourage you to be creative in gathering this important information. Some students have conducted informal surveys to over 100 people, asked patients, visitors or friends, while others have held focus groups. Do what works best for you.

*Hold a small focus group with members from your community

*Collaborate with a local childbirth educator, lactation consultant, doula group to survey their clients.

*You may plan to interview individual women or groups at a local WIC office, women’s group at a church, synagogue or mosque etc.

*Attend a local street fair etc. and talk to women/persons at a booth or roam through the crowd to survey women/persons of childbearing age.

Step 5. Background issues (3 slides)

Economic funding, forms of reimbursement, payor mix.

Political i.e. legislative barriers to practice. Pending legislation.

Professional collaborating physician, midwifery or other APRN partners? Do state regulations require a collaborating or supervisory physician for CNM/APRN practice or prescriptive privileges? How far is the nearest hospital for birth center for transfers?

Cultural special needs or characteristics of your general population or targeted subgroup. How do you intend to become more culturally competent in providing care for clients from your community?

Ethical What ethical principles or aspects of the code of ethics will you establish to guide your practice and promote among all staff members and or partners.

Social services which social support agencies will you partner with in your community to meet the needs of women and families. Are there home visitation programs that you would want to engage? Does the health department have special programs? How accessible is WIC? Where can poor women go to sign up for Medicaid or insurance via the ACA? How accessible and affordable is public transportation? How will any of these social issues impact which part of town you will seek to locate your office?

Step 6. Identify how you plan to serve this community as a CNM. (1-2 slides).

After gathering all of the information about your community and its members, identify your plan to open a birth center, home or hospital-based practice to serve women and families of this community. If you plan to join an existing midwifery practice what argument would you provide to the hospital administrator, OB/GYN or Department Chair to convince them to hire you as a new grad? What skills, knowledge or niche would you offer to enhance the financial health of the practice? (Remember Kitty’s advice “Follow or show them the money”)

Once you have identified your target population and their MCH needs, you must decide upon the best location and transportation considerations to facilitate access to care.

Step 7. Practice model (1-2 slides)

Which Hallmarks of Midwifery will you choose to guide the philosophy of your practice?. Identify the manner in which care will be delivered. i.e. traditional 1 on one, centering or group care, paternalistic, shared decision making, traditional clinic care where everyone is told to come at 8 am or 1 pm or specific appointment times to your office. Flexible office hours on weekends or evenings? Other creative models? How will you balance office vs. on-call time? How will you balance work, life, family? Why is it important to consider that balance?

Step 8. Office management (staffing-partners) (1-2 slides)

Staffing – What types of other providers might you consider partnering within your practice? NPs, MDs. How many? How will the additional providers expand the scope of services within your practice? What type of support staff will you hire? Is there a need for bilingual staff? Will your staff need special training to care for certain subgroups? i.e. LBGTQI populations? or members from certain ethnic, racial or religious groups?. Keep in mind that yours will be a small business, you cannot run it like a well-financed hospital clinic or L+D unit. You may have to begin with limited staff with multiple roles for each staffer, including yourself.

Education How will you provide education? What level of educational materials will you provide to your clients? Would you consider centering pregnancy? why? Other best practices?

Outreach What community resources will you employ to outreach to your target population?

Summary (1 slide)

Catchy name and slogan for your practice or birth center! (Be creative)

Remember to send slides as a pdf file to dropbox and email to faculty at least 90 minutes before presentation time.

Peer Review

Click this link and fill out the form for EACH of your team members. This form will open and you will fill it out for one team member >> then submit. You will see a link on the next screen to fill out another form. You will do this for each team member.

Click here for the
Peer Eval Form
(Links to an external site.)

Rubric
Final ppt. rubric
Final ppt. rubric
Criteria Ratings Pts

This criterion is linked to a Learning Outcome
Community characteristics

5.0 pts
Distinguished
General characteristics of the community are described in a comprehensive and detailed manner.

3.0 pts
Proficient
General community characteristics are described in detail.

1.0 pts
Apprentice
General community characteristics are described in a superficial manner.

0.0 pts
Novice
Student omits description of community characteristics.

5.0 pts

This criterion is linked to a Learning Outcome
Community demographics

9.0 pts
Distinguished
Community demographics, econmics, and education etc. are described in a comprehensive and detailed manner.

6.0 pts
Proficient
Community demographics, econmics, and education etc. are described in a detailed manner.

3.0 pts
Apprentice
Community demographics, econmics, and education etc. are described in a superficial manner.

1.0 pts
Student omits description of community demographics

9.0 pts

This criterion is linked to a Learning Outcome
MCH indicator, health disparity, key indicator

12.0 pts
Distinguished
The significant maternal child health indicators, local health disparity and key health indicator are clearly identified and well explained.

9.0 pts
Proficient
The significant MCH indicators, local health disparity or key health indicator are inadequately identified or explained.

6.0 pts
Apprentice
Student omits to identify or explain one or two of the following; significant MCH indicators, local health disparity or key indicator.

2.0 pts
Novice
Student omits to identify or explain all of the following; significant MCH indicators, local health disparity or key health indicator.

12.0 pts

This criterion is linked to a Learning Outcome
General population needs

5.0 pts
Distinguished
Student integrates community and MCH data in addition to feedback from community members and personal knowledge to critically assess its MCH needs. Incorporates detailed and direct feedback from community surveys, groups and or individuals.

3.0 pts
Proficient
Student integrates community, MCH data and personal knowledge but omits member feedback to critically assess its MCH needs. Incorporates direct input from community in a vague or superficial manner.

1.0 pts
Apprentice
Student integrates community, MCH data and personal knowledge but omits member feedback to superficially assess its MCH needs. Omits to Incorporate direct input from community.

0.0 pts
Novice
Student fails to integrate community or MCH data to assess its MCH needs.

5.0 pts

This criterion is linked to a Learning Outcome
Background issues. a. Professional and legal requirements for practice b. Financial concerns c. Cultural considerations d. Ethical issues e. Social needs of the target population
a. Professional and legal requirements for practice b. Financial concerns c. Cultural considerations d. Ethical issues e. Social needs of the target population

15.0 pts
Distinguished
All five background issue were addressed in a comprehensive and thoughtful manner.

12.0 pts
Proficient
1-2 background issues are missing or addressed in a superficial manner.

9.0 pts
Apprentice
3-4 background issues are missing.

0.0 pts
Apprentice
None of the background issues are addressed.

15.0 pts

This criterion is linked to a Learning Outcome
Practice model

8.0 pts
Distinguished
The practice model for the birth center thoughtfully integrates aspects of the Hallmarks of Midwifery. The model is consistent to meet the needs of the community and address the key MCH indicator.

6.0 pts
Proficient
The practice model for the birth center mentions the Hallmarks of Midwifery in a vague manner. It is not consistent to meet the needs of either the community or key MCH indicator.

4.0 pts
Apprentice
The practice model for the birth center or practice does not address the Hallmarks of Midwifery. The plan is inconsistent with the needs of both the community and the key MCH indicator.

1.0 pts
Novice
Office management and staffing plans were unrealistic or unresponsive to special needs of the target population but not unsafe.

8.0 pts

This criterion is linked to a Learning Outcome
Office management

5.0 pts
Distinguished
Office management and staffing plans are realistic for a small business and are responsive to special needs of the target population and the key indicator.

3.0 pts
Proficient
Office management and staffing plans are unrealistic for a small business and are unresponsive to special needs of the target population.

1.0 pts
Apprentice
Office management and staffing plans are unrealistic for a small business and or unresponsive to special needs of the target population but not unsafe.

0.5 pts
Novice
Office management and staffing plans were unrealistic or unresponsive to special needs of the target population and pose concerns of safety.

5.0 pts

This criterion is linked to a Learning Outcome
Responses

5.0 pts
Distinguished
Provides thoughtful and in depth responses to all questions posed by peers or faculty.

3.0 pts
Proficient
Provides limited or simple responses posed by peers or faculty.

1.0 pts
Apprentice
Has difficulty answering 1 or 2 questions posed by peers or faculty.

0.5 pts
Novice
Unable to provide accurate responses to more than 2 questions posed by peers or faculty.

5.0 pts

This criterion is linked to a Learning Outcome
Professional appearance and delivery of content.

5.0 pts
Distinguished
Professional appearance, demeanor and excellent delivery of content. Realistic and thoughtful plans for work, life balance.

3.0 pts
Proficient
Professional appearance, demeanor and good delivery of content. Thoughtful but unrealistic plans to address work life balance.

1.0 pts
Distinguished
Unprofessional appearance demeanor. Fair delivery of content. Vague and unrealistic plans to address work life balance.

0.5 pts
Novice
Unprofessional appearance demeanor. Frequently stumbles with delivery of content.

5.0 pts

This criterion is linked to a Learning Outcome
Slide presentation

9.0 pts
Distinguished
Slides contain content appropriate to topic. Bullets are used efficiently, creative graphics support message.

6.0 pts
Proficient
Slides contain content appropriate to topic. Wordy, busy graphics.

3.0 pts
Apprentice
Slides lack content appropriate to topic. Wordy, busy graphics.

1.0 pts
Novice
Content in slides disorganized. Wordy, no logical flow.

9.0 pts

This criterion is linked to a Learning Outcome
Mechanics

2.0 pts
Distinguished
The writing is free of grammatical, spelling, and syntax errors. APA formatting is flawless.

1.0 pts
Proficient
The writing may exhibit a few minor errors in grammar, spelling, syntax, and/or APA format but the errors do not impede the flow of reading.

0.5 pts
Apprentice
The writing could benefit from additional proofreading, as some spelling or grammar errors impede the flow of the reading. There are several errors in APA format.

0.0 pts
Novice
The writing exhibits substantial errors in grammar and spelling so that the basic ideas are lost. There are numerous errors in APA format.

2.0 pts

This criterion is linked to a Learning Outcome
Student Peer evaluation

20.0 pts
Distinguished
All criteria met in full.

15.0 pts
Proficient
Most criteria met in part.

5.0 pts
Apprentice
Criteria met in part.

0.0 pts
Novice
Criteria minimally met.

20.0 pts

Total Points: 100.0