{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T06:40:54Z","timestamp":1775198454318,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T00:00:00Z","timestamp":1512432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000642","name":"Iolanthe Midwifery Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000642","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of \u201cexpertise\u201d remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience\u00a0=\u00a0135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5\u201030 upright breech births). Data were pooled and analyzed using constant comparative methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Expertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Specialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12326","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T12:30:58Z","timestamp":1512477058000},"page":"202-209","source":"Crossref","is-referenced-by-count":36,"title":["Expertise in physiological breech birth: A mixed\u2010methods study"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-8988","authenticated-orcid":false,"given":"Shawn","family":"Walker","sequence":"first","affiliation":[{"name":"Florence Nightingale Faculty of Nursing and Midwifery King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0920-7804","authenticated-orcid":false,"given":"Pam","family":"Parker","sequence":"additional","affiliation":[{"name":"Department for Learning Enhancement and Development City, University of London  Northampton Square London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2770-0341","authenticated-orcid":false,"given":"Mandie","family":"Scamell","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Child Health Research City, University of London  Northampton Square London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14465"},{"key":"e_1_2_6_3_1","unstructured":"NHS Digital.Hospital Maternity Activity Tables. Hospital Maternity Activity 2015\u201016.http:\/\/www.content.digital.nhs.uk\/catalogue\/PUB22384. Published 2016. 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