Development of a tool to measure holistic reflection in midwifery students and midwives

J. Bass, M. Sidebotham, L. Sweet, D. K. Creedy

Research output: Contribution to journalArticlepeer-review


Background: Holistic reflection encompasses reflection as a continuum, incorporating critical reflection, reflexivity, critical thinking and a whole-of-person approach. The development of holistic reflection in midwifery students and midwives is rarely measured in a standardised way. Aim: To develop and test a tool to measure holistic reflection in midwifery students and midwives, for use in pre-registration and post-graduate education, and research. Design: The eight-step approach to tool development by DeVellis was followed with psychometric testing of data from a cross-sectional survey. Participants: Midwifery students (pre-registration and postgraduate), and midwifery alumni of an Australian university. Methods: Draft items (n = 84) were generated from review of the literature, qualitative research, and a theoretical model. An expert panel (n = 19) reviewed draft items resulting in 39 items. The survey included demographic details, the draft Holistic Reflection Assessment Tool, emotional intelligence subscale, and a social desirability scale. Participants repeated the online survey at two weeks to confirm test-retest reliability. Results: The 187 responses were received. Exploratory factor analysis with varimax rotation revealed three factors accounting for 49% of variance. Internal consistency of the tool was high (α =.91) and test-retest reliability at two weeks (α =.93) demonstrated stability. There were low correlations between social desirability (r =.22, p <.001) and emotional intelligence (r =.21, p <.001) with the new holistic reflection scale. Conclusions: The Holistic Reflection Assessment Tool is the first for midwifery. The tool was reliable, stable, and valid. Further research is warranted for criterion validity.

Original languageEnglish
Number of pages9
JournalWomen and Birth
Early online date16 Oct 2021
Publication statusE-pub ahead of print - 16 Oct 2021
Externally publishedYes


  • Assessment
  • Critical reflection
  • Holistic reflection
  • Midwifery
  • Psychometric
  • Students


Dive into the research topics of 'Development of a tool to measure holistic reflection in midwifery students and midwives'. Together they form a unique fingerprint.

Cite this