Four models of resident education in obstetric triage with midwifery faculty consultants are presented. Common trends in the structure and function of these models are reviewed. The four models represent diverse settings where midwives serve as clinical teachers primarily for first-year obstetric residents and residents from other subspecialties. Each model supports a growing number of midwives working in the triage setting, functioning as both teacher and consultant for new residents. This expanded midwifery teaching role extends beyond labor assessment to include a wide range of common obstetric and gynecologic conditions in the triage setting. Additional advantages include the ability of the midwife to bill for triage services and to provide a safety net to decrease medical errors which, in a busy triage unit, occur most often during patient transfers.
The threat of litigation in clinical midwifery is evident in daily practice. Although midwives have not had the same risk of claims and suits as obstetricians, all obstetric providers are potentially subject to claims of malpractice. Closed claims analysis has been used in the past to review risk patterns and to heighten awareness of certain risks. It is a methodology that can suggest corrective or preventive action for future practice and thereby minimize the risk of future errors. An analysis of nurse-midwifery closed claims can help to evaluate past risk and proactively modify future liability.
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