Challenges and opportunities in competency-based midwifery education: Insights from Moroccan educators

Loubna Naji, Samia Boussaa, Ahmed Rhassane El Adib

Abstract

This study explores midwifery educators' perceptions of implementing the competency-based approach (CBA) in Morocco’s Higher Institutes of Nursing and Health Technical Professions (ISPITS), following national reforms to align training with international standards. Using a qualitative design based on semi-structured interviews with midwife’s educators in the Marrakech Safi region, the research highlights the transformative impact of CBA on pedagogical practices. Thematic analysis revealed five major themes: pedagogical transformation, holistic perspective, objectives and imperatives, competency development and assessment, and institutional and pedagogical constraints. Educators recognize CBA as enhancing student engagement, adaptability, and clinical judgment, yet face challenges including infrastructure gaps, workload, and language barriers. The study underscores the need for institutional support, formative assessments, faculty training, and the use of simulation and mentorship to bridge theory and practice. These findings contribute to optimizing CBA implementation and strengthening midwifery education to meet Morocco’s healthcare needs.

Full Text:

PDF

References

Huang J, Lu H, Li J, Zhou N, Zang Y and Ren L.

Comparison of midwives’ self‐perceived essential

competencies between low and high maternal

mortality ratio provinces in China. J Clin Nurs. déc

;29(23‑24):4733‑47.

Hoope-Bender P ten, Lopes STC, Nove A, Michel-Schuldt

M, Moyo N and Bokosi M. Midwifery 2030: a

woman’s pathway to health. What does this mean?

Midwifery. janv 2016;32:1‑6.

World Health Organization. Strengthening quality

midwifery education for universal health coverage

[Internet]. Geneva: World Health Organization;

[cité 12 mai 2024]. Disponible sur:

https://iris.who.int/handle/10665/324738

Bradfield Z, Hauck Y, Kelly M and Duggan R. “It’s what

midwifery is all about”: Western Australian

midwives’ experiences of being ‘with woman’ during

labour and birth in the known midwife model. BMC

Pregnancy Childbirth. déc 2019;19(1):29.

Abouzaj S. Competency-Based Approach in Training Nurses

and Midwives in Morocco Demystify to Better Use.

AMEP. déc 2019;Volume 10:1069‑79.

Nove A, Ten Hoope-Bender P, Boyce M, Bar-Zeev S, De

Bernis L and Lal G. The State of the World’s

Midwifery 2021 report: findings to drive global

policy and practice. Hum Resour Health. déc

;19(1):146.

Abou Malham S, Hatem M and Leduc N. A case study

evaluation of an intervention aiming to strengthen the

midwifery professional role in Morocco: anticipated

barriers to reaching outcomes. JMDH. sept

;419.

Chuang LL, Hsieh MC. A competency-based approach to

critical care education. Ci Ji Yi Xue Za Zhi.

;30(3):148‑51.

McMullen J, Arakawa N, Anderson C, Pattison L and

McGrath S. A systematic review of contemporary

competency-based education and training for

pharmacy practitioners and students. Research in

Social and Administrative Pharmacy. 1 févr

;19(2):192‑217.

Nyoni CN and Botma Y. Sustaining a newly implemented

competence-based midwifery programme in

Lesotho: Emerging issues. Midwifery. avr 2018;59:115‑7.

Butler MM, Fraser DM and Murphy RJL. What are the

essential competencies required of a midwife at the point

of

registration?

;24(3):260‑9.

Midwifery.

sept

Fleming V, Pehlke-Milde Hebamme J, Davies S and

Zaksek T. Developing and validating scenarios to

compare midwives’ knowledge and skills with the

International Confederation of Midwives’ essential

competencies in four European countries. Midwifery.

déc 2011;27(6):854‑60.

Shikuku DN, Jebet J, Nandikove P, Tallam E, Ogoti E and

Nyaga L. Improving midwifery educators’ capacity

to teach emergency obstetrics and newborn care in

Kenya universities: a pre-post study. BMC Med

Educ. 31 oct 2022;22(1):749.

Western Sussex Hospitals NHS Foundation Trust, UK,

Bell C, also funded by NIHR 70@70 Senior Nurse &

Midwife Research Leaders Programme, UK,

Colleran V, Western Sussex Hospitals NHS

Foundation Trust, UK. Empowering Nurses,

Midwives and Allied Health Professionals to Gain an

Academic, Research and Quality Improvement

Experience within Clinical Practice. IJPBLHSC. 17

déc 2019;7(2):69‑79.

Tatachar A, Wettergreen S and Summers S. Reflective

metacognition and objective structured clinical

examination performance in introductory pharmacy

practice experiences. Currents in Pharmacy Teaching

and Learning. oct 2020;12(10):1208‑14.

Brownie SM, Docherty C, Al-Yateem N, Gadallah MH,

Rossiter R. Developing a national competency-based

curriculum for technical nurses in Egypt. East

Mediterr Health J. 9 déc 2018;24(9):922‑32.

Avery MD, Mathiason M, Andrighetti T, Autry AM,

Cammarano D and Dau KQ. Improved Self‐Assessed

Collaboration Through Interprofessional Education:

Midwifery Students and Obstetrics and Gynecology

Residents Learning Together. J Midwife Womens

Health. sept 2022;67(5):598‑607.

Hennink MM, Kaiser BN and Marconi VC. Code

Saturation Versus Meaning Saturation: How Many

Interviews Are Enough? Qual Health Res. mars

;27(4):591‑608.

Kallio H, Pietilä A, Johnson M and Kangasniemi M.

Systematic methodological review: developing a

framework for a qualitative semi‐structured

interview guide. Journal of Advanced Nursing. déc

;72(12):2954‑65.

Nikolaevna KO, Dolievna SF and Isanbayevna YG. The

role of interactive teaching methods in the formation

of students’ professional competence. lingcure. 8 déc

;5(S2):1424‑30.

Dunagan PB. A comparison of the American Association

of Colleges of Nursing’s basic principles and benefits

of competency-based nursing education and Fink’s

taxonomy. Journal of Professional Nursing. nov

;55:140‑5.

Moffatt ME, Ford R, Lujano BN, Reed S, Singh A and

Stewart DA. Competency based medical education –

Where do I start? Current Problems in Pediatric and

Adolescent Health Care. oct 2024;54(10):101674.

Açıkgöz T and Babadoğan MC. COMPETENCY-BASED

EDUCATION: THEORY AND PRACTICE. PERR

[Internet]. 1 déc 2021 [cité 11 mai 2025]; Disponible

sur:

https://perrjournal.com/index.php/perrjournal/article

/view/15

Gruppen LD, Mangrulkar RS and Kolars JC. The promise

of competency-based education in the health

professions for improving global health. Hum Resour

Health. déc 2012;10(1):43.

Mayra K, Padmadas SS and Matthews Z. Challenges and

needed reforms in midwifery and nursing regulatory

systems in India: Implications for education and

practice. PLoS One. 2021;16(5):e0251331.

Stefaniak M and Dmoch-Gajzlerska E. Evaluation of a

Mentor training program for midwives in two

hospitals in Warsaw, Poland - a qualitative

descriptive

study.

;21(1):345.

BMC Med Educ. déc

Lukasse M, Lilleengen AM, Fylkesnes AM and Henriksen

L. Norwegian midwives’ opinion of their midwifery

education – a mixed methods study. BMC Med Educ.

déc 2017;17(1):80.

Castro Lopes S, Nove A, Ten Hoope-Bender P, De Bernis

L, Bokosi M and Moyo NT. A descriptive analysis

of midwifery education, regulation and association in

countries: the baseline for a post-2015 pathway.

Hum Resour Health. déc 2016;14(1):37.

Adnani QES, Gilkison A, McAra-Couper J. A historical

narrative of the development of midwifery education

in Indonesia. 2023;36(1):e175‑8. Women and Birth. févr

Deng L, Wu Y, Chen L and Peng Z. ‘Pursuing

competencies’ or ‘pursuing scores’? High school

teachers’ perceptions and practices of competency

based education reform in China. Teaching and

Teacher Education. avr 2024;141:104510.

Chimea TL, Kanji Z and Schmitz S. Assessment of

clinical competence in competency-based education.

Can J Dent Hyg. 1 juin 2020;54(2):83‑91.

Moller AB, Welsh J, Gross MM, Petzold M, Ayebare E

and Chipeta E. Assessment of midwifery care

providers intrapartum care competencies, in four

sub-Saharan countries: a mixed-method study

protocol. Reprod Health. déc 2021;18(1):50.

Shikuku DN, Mwaura C, Nandikove P, Uyara A, Allott H,

Waweru L, et al. An evaluation of the effectiveness

of an updated pre-service midwifery curriculum

integrated with emergency obstetric and newborn

care in Kenya: a cluster randomised controlled trial.

BMC Med Educ. 31 déc 2024;24(1):1562.

Moncrieff G, MacVicar S, Norris G and Hollins Martin

CJ. Optimising the continuity experiences of student

midwives: an integrative review. Women and Birth.

févr 2021;34(1):77‑86.

Kneebone

R.

Perspective:

Simulation

and

Transformational Change: The Paradox of Expertise:

Academic Medicine. juill 2009;84(7):954‑7.

Ahmadi G, Shahriari M, Keyvanara M and Kohan S.

Midwifery students’ experiences of learning clinical

skills in Iran: a qualitative study. Int J Med Educ. 9

mars 2018;9:64‑71.

McKellar L and Kempster C. We’re all in this together:

Midwifery student peer mentoring. Nurse Education

in Practice. mai 2017;24:112‑7

Refbacks

  • There are currently no refbacks.