Nurse-Midwifery at Shenandoah University
NM640 Comprehensive Perinatal Care
Course Overview
Welcome to NM 640 “Comprehensive Perinatal Care.” In this module, you will be learning the
midwifery management process as it relates to the perinatal period. The perinatal period extends
from 28 weeks of pregnancy up to the 28th day of the newborn’s life. This is a time of dramatic
physiological and environmental changes for the pregnant woman and her newborn, and a time of
physical, psychological and emotional changes and adjustments for the family. You have the
opportunity to promote healthy family relationships and the responsibility to assist your clients in
caring for themselves and their infants during pregnancy, birth and the postpartum-neonatal
periods. In this course you will learn to:
 Manage and conserve the normal process of labor and delivery and take the responsibility
for the outcome.
 Help the newborn adjust to life outside the womb with a minimum amount of stress. You
will be responsible for the history, physical exam and gestational age assessment of the
newborn at, or shortly after, birth. You may therefore be the first to notice difficulties
with physiological adaptation to extrauterine life or to diagnose potential or existing
problems.
 Manage the care of women during their postpartum periods. You must arrange to contact
each woman you deliver at least once in the 1st week PP. This can be on the unit or by
telephone. Your responsibility for the PP care of women and newborns does not end with
their hospital stay but includes helping them anticipate and plan for their needs at home.
NM640 is a three-credit course. Two credits are didactic consisting of 30 hours of class time.
One credit is clinical which means that there is a minimum of 60 hours of clinical time to be
completed during the semester. PLEASE NOTE THAT THE NUMBERS OF CLINICAL
HOURS SHOULD BE SUFFICIENT TO MEET YOUR LEARNING NEEDS HOWEVER,
DUE TO THE NATURE OF NURSE-MIDWIFERY PRACTICE, YOU WILL NEED
ADDITIONAL HOURS TO GAIN THE EXPERIENCES NECESSARY TO SUCCESSFULLY
MEET THE CORE COMPETENCIES FOR BASIC MIDWIFERY PRACTICE AS OUTLINED
BY ACNM. PLEASE COUNT ON BEING IN CLINICAL MORE THAN THE MINIMUM OF
60 HOURS. BEGINNING WITH NM640, IT IS THE NUMBER OF EXPERIENCES
THAT COUNT AS WELL AS THE NUMBER OF HOURS.
Student Clinical Experiences
As discussed above, the numbers of experiences each student needs depends on the acquisition of
the necessary competencies for basic midwifery practice and will be determined by the student,
the preceptors and the nurse-midwifery faculty. Clinical sites will be selected by the faculty in
consultation with the students and accordance to availability of sites and the ability of the
site/preceptor to help you attain beginning basic competencies used during the intrapartum,
postpartum and neonatal periods. Working knowledge of anatomy, physiology, and the
procedures for physical assessment of the newborn and the woman during the intrapartal and
postpartal periods is essential for practicing in the clinical area. In order to prepare for clinical
practice, it is recommended that you first review Units 1, 2, 17, and 23. You may need to review
sections of the module out of sequence in order to follow up on situations that arise during your
clinical experience. Clinical experience will be scheduled starting in the semester based on the
availability of sites and preceptors. During intrapartum, you will continue to be assigned
Antepartum and Primary Care/GYN clinical experiences.
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You are expected to make maximum use of your time while on call. If there is not an opportunity
to provide care to a woman and her family, you are expected to practice skills and review
procedures, do chart reviews, etc. Perform rounds on PP patients, help breast-feeding mothers,
observe mother-infant attachment and teach families about PP and newborn care. This is also a
good opportunity to perform newborn physical assessments in the clinical setting.
One initial newborn exam is to be done under the direct supervision of a qualified practitioner.
Students must demonstrate proficiency completing an independent exam of the normal newborn
by a qualified health professional. A newborn physical examination sheet should be filled out for
each of the required 10 newborn assessments. You are responsible for maintaining clinical
experience records on all the newborns you see by entering in Typhon as a normal newborn exam
in the Birth Record section. Additionally, current NRP CERTIFICATION IS REQUIRED for this
course, and submitted evidence of certification status must be on file.
As in your previous semester(s) during your clinical experience, online case studies will be
presented and analyzed via Blackboard. See "Guidelines for the Case Study" in Blackboard for
specific information regarding the weekly case studies. Weekly clinical SOAP notes of your
clinical experiences are maintained during this time including required Typhon competency
encounters. One SOAP note for IP/PP and Newborn encounters each week [if you cared/managed
one of these patient scenario’s]. Students may enter fewer clinical SOAP notes as guided by
faculty. Finally, each student should complete a weekly quiz on Blackboard.
In summary, students in NM640 will need to complete enough clinical hours during this semester
to progress appropriately with skills to perform the nurse-midwifery management process during
the intrapartum, postpartum and neonatal periods. Also during this semester, all students will,
submit SOAP notes/weekly journals, complete weekly quizzes, participate and/or lead weekly
case studies, complete 10 newborn assessments and 5 labor graphs. See below for more
information.
Schedule of Classes
Week
1/11-1/31/13
1/31-2/03/13
2/15/13
2/04-5/03/13
3/11-3/15/13
3/22/13
TBD
TBD
Assignments
Required Preparation
Units 1 - 38
Completion of units 1-38 as assigned
Class/Immersion
On SU Campus
Learning Objectives
Due in BB Drop Box
Clinical
See clinical objectives
SU Spring Break
Mid CET due, Cumulative Numbers of ALL Typhon tracked Clinical
experiences AND 5 neonatal exams and 5 labor graphs due
Final Exam Review
Final Exam – Must submit following by May 8th or 5% course grade deduction:
Final CET, 5 neonatal exams, Total clinical experience numbers to date, and Second
Learning Self Analysis (in BB) due at this time.
Clinical Evaluation: You will be held accountable for demonstrating appropriate use of the
nurse-midwifery management process in all clinical situations. Clinical performance is
evaluated by the preceptor, faculty, and student using the Clinical Evaluation Tool (CET).
The CET is an ongoing tool that is used in all of the courses in the nurse-midwifery specialty.
Blank copies of the CET form can be found under “Course Information” in each midwifery
course that has a clinical component (NM610, 620, 630, 640, and 650). The purpose of this
ongoing measurement is to assess whether you have achieved the competencies listed, or if
you are progressing towards achievement.
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As discussed above, the nurse-midwifery curriculum is "competency based," i.e. you must
achieve all of the competencies before you graduate from the program. Appropriate progression
in the achievement of each competency is documented throughout the courses in the CET. TO
REPEAT: YOU NEED NOT ACHIEVE EACH COMPETENCY AT THE COMPLETION OF
EACH COURSE, HOWEVER YOU MUST PROGRESS APPROPRIATELY
THROUGHOUT EACH COURSE. ACHIEVEMENT OF EACH COMPETENCY AND
HALLMARK MUST OCCUR BEFORE GRADUATION FROM THE NURSE-MIDWIFERY
PROGRAM. It is expected that the highest score for NM610 and NM620 is a “3.” As you
improve each semester you ought to achieve a “4” as the highest score in NM630 and NM640
and finally a “5” for the highest score in NM650. This style of grading reflects progression in
achievement of nurse-midwifery competencies.
The CET consists of the "Core Competencies for Basic Midwifery Practice" and the "Hallmarks
of Midwifery" outlined by the ACNM (revised and approved, ACNM, 2003). As you will note,
the Core Competencies that are introduced during a specific course will be listed under that
course's heading on the CET form. Although all of the competencies are listed on the CET, those
that are specific to the course you are taking are the only ones that should be addressed during the
clinical evaluation. For instance, when you take NM610, only those competencies for NM610
are to be addressed in your clinical evaluation in that course. When taking NM640 you will
evaluate only those competencies listed under NM640.
A suggested way to utilize the CET as an evaluation and learning tool, is to pick several
competencies and hallmarks that you would like to work on each clinical day (or time period).
Notify your preceptor of those competencies and hallmarks and emphasize them during the
clinical day (or time period). Each clinical day (or time period) pick the specific competencies
you would like to address. Of course, as other competencies may present themselves in the time
period, take advantage of them also. At the end of the day, allow your preceptor to comment on
these specific competencies. Either you or the preceptor may write comments as needed. If the
student writes the preceptor’s grade or comment, the preceptor must verify with a signature.
Typhon Tracking
You will be required to produce required clinical experience numbers at the end of the semester.
If you feel you are not getting enough experiences to meet your objectives, please discuss this
with the nurse-midwifery faculty. It may be possible to assign additional clinical time or a
different clinical site. Please calculate your TOTAL number of experiences in each category
prior to turning in your numbers at mid-term and final!
Weekly Journal: For NM640, you will write 3 weekly clinical SOAP notes on ONE patient per
each category: IP, PP, Neo (you will turn in 3 notes/week IF you cared for a patient in that
category). Remember to include a primary care issue when there are multiple diagnoses. You
will be allowed to decrease entries as recommended by faculty reviewing your SOAP notes.
Conferences: Your weekly SOAP entry is one forum by which you should be conferring with an
instructor for your course. Please use this as a mechanism for receiving feedback on your
knowledge and skills in midwifery. Additionally, phone calls with course faculty will be
scheduled monthly throughout the semester.
Send your Clinical Evaluation Tool, Cumulative Clinical Experience numbers, labor charts and
neonatal exams to the midwifery office PRIOR to taking the final exam. The Learning Self
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Analysis is created from your Learning Objectives that you completed at the beginning of this
course and can be uploaded to Black board.
Course and Faculty Evaluation: It is sincerely appreciated that you fill out the final Course and
Faculty Evaluation at the end of the course as it is one of the mechanisms by which we
continually improve the dissemination of our curricula. You will receive instructions on how to
complete this online form.
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