Development and Initial Psychometric Testing of the Midwifery Practice Climate Scale

Introduction Perinatal care in the United States is plagued with a high maternal mortality rate and shortages of perinatal care providers. A supportive practice climate is a theoretically based and empirically demonstrated means of improving the quality of care and stabilizing the workforce; however, there has been limited research into the qualities and measurement of a supportive practice climate for midwives. Methods We developed a self-report instrument, the Midwifery Practice Climate Scale, to measure midwives' perceptions of the supportiveness of their work environments. We tested content and face validity with 2 samples of content experts (n = 6 and n = 14, respectively). Results Thirty-four items were created or adapted from nursing instruments. Two items that included language about physicians were removed based upon relevance and redundancy as a result of content and face validity testing. Discussion The findings indicate that the Midwifery Practice Climate Scale is relevant to midwifery and addresses the intended concept of a supportive practice climate for midwives. Challenges of creating the scale identified were language regarding leadership and the varying relationships with physicians across diverse settings. The next stages in testing the Midwifery Practice Climate Scale will address these challenges, as well as test the reliability and construct validity.