I’ve been reading lots of articles and blog posts lately about midwifery education and I see a lot about “standardized” education. I think that when we’re discussing midwifery educational requirements, we’re actually discussing a much larger societal issue….what is education, how does it work, does it work the same for everyone and so on.
Standardized education assumes that every person learns in the exact same way, that said learning will give the exact same knowledge in every person, that the education is necessary to perform a given task and that a certificate at the end assures every person is competent in knowledge. I see a fundamental flaw in this way of thinking, do you? Let’s look at each of these assumptions:
1. Every person learns in the exact same way
I think it’s generally accepted that every person does NOT learn in the exact same way, but our educational system (for the most part) has not yet caught up to that. Furthermore, in a typical classroom-type setting with more than a handful of students, it is nearly impossible to teach to all learning styles. If there are three types of learning styles (or we can go further and talk about the seven types of intelligence), then the teacher would need to teach three different ways.
2. Every person will get the same knowledge from the same course
Have you ever read the same book as someone else, yet your description of it is completely different? Yep, me too. Since we learn differently, it only makes sense that each of us will pick up something different from learning.
3. The education is necessary to perform a given task
I could probably have worded that better, but what I mean to say is why in the world is it “necessary” for me to have a general history course if my intended task is to help women have babies? If it were a class based upon the history of midwifery or the history of childbearing, maybe. Unfortunately, our education system seems stuck on some strange idea that we all require certain knowledge to function in our daily lives. We don’t. This becomes incredibly apparent (and even more strange) when we are speaking of higher levels of education. Since a person has fulfilled the general requirements for basic schooling (high school, GED, home school), that should be sufficient for moving on to other specific studies, right? No! Even though you’ve spent anywhere from 12-15 YEARS acquiring “necessary” knowledge, you still don’t know enough about xyz to hone your focus on one subject. If we were to take away the requirements for extraneous coursework while getting a degree in a specific major (or even lessen the extraneous during the primary/high school years), the time spent schooling would be greatly lessened.
4. A certificate at the end assures every person is competent in knowledge
Guess what? All you have to do is get through whatever course work is required and voila!, you’re prepared! In my opinion, we have become way too complacent on certificates, licenses, etc. telling us whether or not a person is capable of doing a job. In theory, every person who goes through xyz school for blah will come out proficient at blah. However, this is just not the case. There really is no guarantee, ever, that the person in front of you is any good at what you’re asking him/her to do, period.
When discussing standardization, it is also easy to overlook the fact that consumers (that is, everyone) do NOT want a one-size-fits-all product anymore…and it doesn’t matter what the product is! We, as a society, prefer personalized, one-on-one interactions, something standardized anything (including school) doesn’t produce much of. So why then, do we insist on standardized education??
I would also like to say that I have the pleasure of knowing a fair amount of midwives…CPMs, CNMs, “traditional” midwives and more. They are all wonderful ladies who faithfully serve the women of their communities. I have seen all of them work side-by-side for the good of all women, and I am humbled by their knowledge, their compassion, their ability to continue to learn throughout their careers. What I love about the variety of midwives is that there is someone for everyone. Training backgrounds produce different types of midwives, and that is OKAY. In order to serve the vast variety of women in the world, we need to have a large spectrum of care providers….working together for the betterment of all families.
I think that a rounded education–one in which there is some “generalized” information gained along with the specialized content learned–is by far more beneficial for a society in the long run. Our post-secondary schools allow for this type in the form of associates and bachelors degrees, but they also have certificated programs that serve students who don’t feel the general education is “for them”. Those certificates often don’t have the same weight in the job market, though, because many times the students who receive them are unable to calculate sums or compose a comprehensive idea in writing. There’s definitely something to be said, too, about learning of the myriad aspects of the world we live in. Certificated programs don’t allow for that.
As for learning styles, I agree with you: our system of education is based upon a style jokingly called “the banking method” wherein teachers hold the information “money” and students make withdrawals. When learning begins with the student, it’s far more easily retained. Scandinavian countries have an exploration method in their schools that is similar to our Montessori system. Students are guided through exploratory tasks and form their knowledge seemingly on their own. They’ll gain a rounded education, as they’ll discover they need the general ed skills to proceed farther in their study of their chosen field. It’s a difficult method to teach, though, as it requires instructors be constantly analyzing individual students’ thought processes. Can’t have a lazy teacher cut corners in that classroom! It’s no more expensive than our current method, but it requires a higher quality teacher, and we don’t have many of those.
If I knew how to fix it, I’d do so. Unfortunately, our system is so screwed up that we’re trying to use duct tape on a sinking ship. A massive overhaul is needed, but no one in our government has the guts enough to be so radical.
Terrific post. Interesting that our thoughts are running in the same vein on this… it’s been passing through my head more often lately.
I think it’s too simplistic, even ignorant, to think that just because there’s standardized education that everyone will come out cookie cutter the same. You even allude to the fact that two people reading the same book take away different meanings. It is that way with school.
– Schooling will *not* make all midwives the same.
– Schooling will *not* mean every midwife is competent.
– Schooling *with* compentency exams *can* mean a minimum HIGHER standard of education/knowledge will be met.
– Schooling does *not* diminish, in any way, the spectrum of differences between midwives. (Same as the first point; it bore repeating.)
– Schooling *rarely* has “nothing to teach.” Even those boring “throw away” classes teach discipline, patience, respect for time spent on a project and how to pay attention to things that are seemingly meaningless. ALL skills *highly* prized in a midwife.
It’s baffling to me that anyone would argue for less education rather than more. As far as I’m concerned, your post is one of the weaker arguments against more education for midwives.
I apologize if my thoughts were unclear. I do agree, though, that this is a simple argument for a complex and very large issue that plagues our society. I did not see where I said that everyone will come out the same, but I did say that I think the assumption is there. Isn’t that basically what standards are for, to “ensure” that a certain level of knowledge has been attained? I am in no way suggesting that there should be no education or even less education. I am, however, questioning the idea of *standardized* education, and for everyone, not just midwives.
For better or worse, you can not ‘homestudy’ to become a doctor. Regardless of how you might learn best, you are going to be shoved into a prescribed system that puts everyone through the same paces. You can be whatever kind of doctor you want (i.e., someone who goes straight to surgery or someone who pushes a less medicalized method or whatever) – that’s up to you. No one’s calling for less education for doctors.
The argument that midwives aren’t medical baffles me – we’re tracking the wellness of two human beings, administering altering substances, and responsible if one or both of them die. No, we aren’t doctors- but neither is a massage therapist. They are still held to standards and expected to be knowledgeable in their field, expected to continue their education throughout their career, etc. We are working with the health and bodies of human beings, and there should be no standards??
Is the education system perfect? Absolutely not. No matter which way you go, there are going to be flaws. Trading one problem for another, potentially more dangerous one, is not acceptable.
Higher education for midwives.
“Regardless of how you might learn best, you are going to be shoved into a prescribed system that puts everyone through the same paces.” You’re right! And, in my opinion, that is exactly the problem.
I do not believe I said midwives were not medical, nor did I say there should be no standards. I DID say that I think the idea of *standardized* education has flaws and then pointed out those flaws. Again, I apologize if I was unclear in any way.
My understanding is that you aren’t criticizing education but the current model of education- and I couldn’t agree more.
I am not a fan of standardized anything, especially education. Standardization breeds mediocrity as we can see when we step into any restaurant chain that expects the food and atmosphere to be standardized at every location. I understand that we all want to be ensured a qualified professional but, IMHO, standardization does not promote this goal, in fact it inhibits this goal.
Standardization requires that everyone be taught the same things in the same way- and this is not conducive to real learning. Programs that center on apprenticeship with classroom learning in a small, enrichment type role would not be standardized but would, again IMHO, create more competent professionals. At the end of the day I’d much rather have a mid-wife with 100 hours of experience with another competent mid-wife and a few hours of classroom instruction than one with 100 hours in a classroom and a few hours assisting another mid-wife. But this model would not be standardized because no two births are alike and therefore a program that relies on apprenticeship would result in varied experiences for all professionals. But those varied experiences would provide opportunities to problem-solve, learn to communicate well with laboring mothers and other birth attendants and confidence in one’s abilities.
I applaud you for pointing out the need to rise above the mediocrity of standardization. Keep fighting for what’s truly best for women and babies!
I liked your post. I get what you are saying.
I definitely got the impression that Summer is critiquing the US educational model, not saying that midwives do not need education–and also not saying that they don’t need formal education, nor calling for “less education.” She’s calling into question in an insightful way whether or not the current model is an appropriate one–for *anyone.* Saying all midwives need the same kind of higher education is based on an assumption that the “classic” model of university education “works” and works for everyone. It doesn’t. While I do not teach midwifery education courses, I do teach college classes and these are the kinds of things students tell me that they’ve learned in school*:
+how to “beat the system”
+how to “play the game”
+how to do the bare minimum in order to squeak by
+how to please the teacher and tell them what they want to hear
+to take no joy in the learning process
+to ask, “is this going to be on the test?” and if not, to immediately “download” the info from their brains
+to cut as many corners as they can in order to get that “piece of paper”
We can do *better* than that for mothers, babies, and families. I think requiring college education for midwives is setting our sights too low, actually.
Additionally, we find in psychotherapy education that no one type of practitioner is superior to another–i.e. psychiatrists (those with the MOST education) are no more effective than LPCs (those with the least formal education). Research indicates that regardless of training, education, degree, theory, philosophy, treatment model, or technique, what actually matters is WHO the therapist IS, not their training background. (Obviously, this is qualitatively different than midwifery/physician education because there are no “lives on the line,” so no, “but some babies DIE” comments please, I’m just pointing out that it is fully possible for effectiveness to boil down to personal qualities of the professional, rather than professional qualities of the person.)
Side note: I also find it bizarre that a CNM can legally attend a homebirth without *ever* having been to one before graduating.
*these are actual statements from students when we took time as a class to get into what education really means/teaches.