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Quality Assurance

The College’s Quality Assurance Program is designed to ensure that the knowledge, skill, and judgment of Ontario midwives remains current throughout their careers, and that they continue to provide safe, effective, appropriate, and ethical midwifery care to their clients. The program is mandated under the Regulated Health Professions Act, 1991. Its components can be found under the Quality Assurance Regulation (O. Reg. 669/20) made under the Midwifery Act, 1991.

The Quality Assurance Program is intended to be supportive in nature. It is meant to promote and enhance members’ understanding of the practice of the profession of midwifery through:

  1. Self-Assessment and Professional Development Activities (see below).
  2. Peer and Practice Assessment.

The College of Midwives of Ontario is pleased to introduce the Professional Development Portfolio.

This innovative, evidence-based program will support midwives in maintaining professional competence throughout their careers, and will replace the College’s existing Quality Assurance Program requirements. 

What’s New:

  • Midwives will develop a personalized Learning Plan based on professional skills or areas of knowledge that they have identified as in need of updating or expanding.
  • All reporting midwives, including those in the inactive class, will be required to submit a declaration of completion to the College.
  • Midwives must submit a declaration of Portfolio completion three years after they become registered with the College, and every three years thereafter upon renewal in October.
  • Expectations around case reviews have changed. Please see below for more details.

The Portfolio Program 

Every three years, midwives will develop a personalized Learning Plan based on professional skills or areas of knowledge that they have identified as in need of updating or expanding. Their unique plans will guide them as they engage in ongoing self-assessment, complete professional development activities, and take part in case reviews in group settings.   

Components of the Portfolio

The Professional Development Portfolio has two intertwined components: Self-Assessment and Continuing Education and Professional Development. Click below to learn more.

Self-Assessment

Midwives will reflect on their own strengths and weaknesses to identify learning needs, conduct a review of their performance, and reinforce new skills or behaviors.

Unlike other components of the Portfolio, self-assessment is for the midwife only and will not be accessible to, or reviewed by, the College.

Midwives are only required to report on the completion of their self-assessment every three years. However, annual completion is recommended as a way of continually assessing their knowledge and skills related to the standards of the profession.

Continuing Education and Professional Development:

There are two sections that must be completed in this part of the Portfolio:

i. Develop and complete a Learning Plan
ii. Participate in case reviews (peer and interprofessional)


i. Develop and complete a Learning Plan

Every three years, midwives will identify learning goals in need of updating or expanding. These can be identified through the self-assessment process, or they could be issues brought up during a peer case review, challenges during a client interaction, or a breakdown in communication with another health care provider. Any area of a midwife’s professional life that requires extra attention can be included as a learning goal in their Learning Plan.

A minimum of one learning goal will be met per year. Midwives will one select short term goal to be met in the first year of their reporting cycle and two long-term goals to be met in years two and three. The College does not specify the types of learning goals required. However, midwives are encouraged to choose goals that include both technical skills and non-technical skills.

Midwives will be asked to demonstrate how they will meet their learning goals, dates for expected completion, and the ways in which those goals will be achieved.

Examples of learning activities that can be used to meet learning goals:
• Participating in workshops, webinars, teleconferences
• Completing courses
• Reading recent primary research studies or reviews
• Developing protocols and practice guidelines
• Teaching, mentoring, precepting
• Research, project work, publication, presentation
• Reflecting on feedback and keeping a practice journal
• Active participation in a relevant College or Association board, council or committee
• Undertaking relevant undergraduate or graduate courses
• Participation or certification in quality assurance/improvement committees
• Peer mentoring

Note: Participating in an obstetrical emergency skills program, a neonatal resuscitation program, and a cardiopulmonary resuscitation program are continuing competencies required for registration and so cannot be
used as a learning activity for meeting a learning goal.

ii. Participate in case reviews (peer and interprofessional)

Case reviews are formal gatherings to discuss specific clinical cases with the goal of learning. The College does not specify the details of how to conduct a case review, however it is expected that case reviews be conducted in accordance with a framework that is agreed upon by the participants.

For the purpose of the Professional Development Portfolio, case reviews must be held with at least two midwifery practice groups or among a group of interprofessional colleagues. Midwives who are registered in the General, Supervised Practice, or Transitional class for 12 months or more are required to attend four case reviews per year of registration, for a total of 12 case reviews attended over the three year cycle.

Midwives who are registered in the General, Supervised Practice, or Transitional class for less than 12 months of the reporting period are not required to participate in, or obtain evidence of, attendance at case reviews.

Who Must Participate:

All reporting midwives, including those in the inactive class, will be required to submit a declaration of Portfolio completion to the College via the Member Portal by the reporting deadline. 

Reporting Deadlines:

The Professional Development Portfolio will come into effect in January 2022, with the first declaration of completion required from midwives at registration renewal in 2024.

Midwives must submit a declaration of Portfolio completion three years after they become registered with the College, and every three years thereafter.    

Compliance:

Each year, 20% of reporting midwives will be selected by the College to have their Portfolio reviewed for completion. Selected midwives will then have 30 days to submit their Portfolio and any supporting documentation such as certificates, diplomas, conference proceedings, or other materials that demonstrate their participation in learning activities. 

Midwives who submit their declaration of completion and are not randomly selected for review are considered compliant with the Professional Development Portfolio requirements.  
 
Midwives who submit their declaration of completion and are randomly selected for review and submit complete records by the assigned deadline are considered compliant with the Professional Development Portfolio.  

Midwives who are considered compliant will receive a notice of compliance. 

Non-compliance

Midwives who do not submit a declaration of completion or who are selected for review and do not submit a completed Professional Development Portfolio will receive a notice of non-compliance and must pay an administrative fee pursuant to Article 11 (9) of the College’s Fees and Remuneration By-Law. Midwives marked non-compliant may make a written submission regarding their non-compliance to the Quality Assurance Committee (QAC) within 30 days of receiving the notice. Submissions will be reviewed by a panel of the QAC.

Exemptions

Midwives who are unable to meet their Professional Development Portfolio requirements due to exceptional circumstances such as illness, parental leave, or disability leave can be granted an exemption from any, or all, of the program requirements under Section 4 of the Quality Assurance Regulation.

A full exemption means the midwife has no reporting obligations for the entire three year Professional Development Portfolio cycle for which the exemption was requested. A partial exemption means the midwife will complete some, not all of the Professional Development Portfolio requirements for the three year reporting cycle.

Midwives must apply for an exemption at least 15 business days prior to their reporting deadline by submitting an Exemption Request form. The Exemption Request form is designed to facilitate the request and not to pose a barrier for those midwives who have experienced barriers to completing their Professional Development Portfolio requirements. If the exemption is not warranted, the midwife will be considered non-compliant with the Professional Development Portfolio if they remain unable to meet the requirements.

More Information

For more details on the Professional Development Portfolio, please view our summary document.

The College is preparing to support midwives in understanding these changes. We will be organizing an online seminar and releasing guidance materials, including templates for self-assessment and the Learning Plan, in early 2022.

If you have questions in the meantime, please contact qap@cmo.on.ca