pre-enrollment requirements - atmmtp school hometexasmidwiferyschool.org/enrollment/enrollment...

ATM MIDWIFERY TRAINING PROGRAM

Application Packet

Table of Contents

Pre-Enrollment Requirements.................................................................................................................3

Qualities and Requirements of the Midwifery Student........................................................................4

ATM Midwifery Training Program Honor Code...................................................................................4

Enrollment Pathway................................................................................................................................7

Step 1:..............................................................................................................................................7

Step 2:..............................................................................................................................................7

Step 3:..............................................................................................................................................8

Application Instructions...........................................................................................................................9

Part 1:..............................................................................................................................................9

Part 2:............................................................................................................................................10

Part 3:............................................................................................................................................10

Additional Information........................................................................................................................10

Contact Information........................................................................................................................11

ATM Midwifery Training Program Refund Policy...............................................................................12

Enrollment Deadlines........................................................................................................................13

For the January class start date:...................................................................................................13

For the July class start date:..........................................................................................................13

Application Checklist.............................................................................................................................14

Application for Enrollment..................................................................................................................15

Section 1: Personal and Demographic Data..................................................................................15

Section 2: Background Information................................................................................................15

Section 3: Beliefs, Values, and Intent............................................................................................16

Section 4: Why I want to be a midwife...........................................................................................17

EA-2018-1 Email: [email protected] Phone: 432-664-8845 Page of

mailto:[email protected]

ASSOCIATION OF TEXAS MIDWIVES

MIDWIFERY TRAINING PROGRAMP.O. Box 887 Elmendorf TX 78112

Section 5: Letters of Recommendation Information.......................................................................17

Student Financial Agreement............................................................................................................19

Permission to Release Test Scores..................................................................................................21

Readiness-Commitment Survey........................................................................................................23

Applicant Midwifery Model of Care Essay.............................................................................................27

Introduction........................................................................................................................................27

Essay Criteria....................................................................................................................................27

Title Page.......................................................................................................................................28

Body of Paper................................................................................................................................28

The Content...................................................................................................................................28

Writing Skills......................................................................................................................................28

Following Instructions........................................................................................................................29

Recommended Resources............................................................................................................29

Letter of Recommendation................................................................................................................31

432-664-8845 APPLICATION FOR ENROLLMENT EA-2018-1 Page of

ASSOCIATION OF TEXAS MIDWIVESMIDWIFERY TRAINING PROGRAM

P.O. Box 887 Elmendorf TX 78112

ATM MIDWIFERY TRAINING PROGRAM

Application Packet

Dear applicant,

Thank you for applying to the ATM Midwifery Training Program (ATMMTP.) While extremely

rewarding, midwifery is a demanding career with a great deal of responsibility; be prepared to

devote a significant amount of time over the next 3 - 5 years to your education. Education is

completed via a variety of methods, including distance, classroom, and competency based

learning and demonstration.

Pre-Enrollment Requirements

For an application to be considered, proof of each of the below requirements must be included

with the application.

Must have a valid driver’s license

Must be at least 18 years of age per date of birth on driver’s license

You must have a minimum of a high school or equivalent education, with high school or

home school transcripts, or a GED certificate with exam scores. A copy of a diploma is

not adequate for enrollment. A college transcript will be accepted in lieu the above.

Proof of current healthcare provider CPR. Include a color photocopy of both front and

back of card. If e-cards are issued, send a copy with all information necessary for our

office to verify the course. *Certification must be one of the following:

☐ American Heart Association: Basic Life Support (BLS) for the Healthcare

Provider

☐ Red Cross: Basic Life Support for Health Care Providers

☐ National Safety Council: Basic Life Support for Health Care and Professional Rescuers

* Be very cautious of courses that make claims of equivalency or pretend to be one of

the above organizations. We will not accept any substitute for one of the three approved

courses.

Must be a student member of the Association of Texas Midwives (ATM)

EA-2018-1 Email: [email protected] Phone: 432-664-8845 Page of




http://www.texasmidwives.com/membershipapplication.asp

Must include the $150.00 application fee.

Not every person is well-suited for the demands of midwifery. Take note of the following statements:

Qualities and Requirements of the Midwifery Student

Midwifery is a physically, emotionally, and psychologically demanding profession.

You must have sufficient use of all cognitive, sensory and motor abilities to properly evaluate and care for mothers and babies. This includes, but is not limited to:

Good interpersonal skills; being able to develop rapport and positive interactions with clients, midwives, and other care providers

Able to learn to conduct basic office lab procedures

Learn to perform clinical care activities such as palpation, auscultation, percussion and evaluation of physical findings

Analyze and synthesize information to problem solve and reach diagnostic and therapeutic judgments

Communicate with accuracy, clarity and sensitivity both verbally and in writing

Learn to respond to emergency situations with quick and appropriate actions

Be able to receive and acknowledge evaluation and respond appropriately

ATM Midwifery Training Program Honor Code

The ATM Midwifery Training Program believes that there are multiple methods of effective learning, including collaboration with one or more peers. However, in most instances it is critical that each student read and complete the assignments herself. It is rare that someone would learn best by being given the answer. The purpose of this code is to give students a better understanding of when discussion or collaboration with another student is acceptable, and when it could be considered cheating. Students will be encouraged to contact administrative staff if they are unsure if something might be considered cheating.

EA-2018-1 EMAIL: [email protected] of 31

http://www.texasmidwives.com/membershipapplication.asp



My answers to homework, quizzes and exams will be my own work (except for assignments that explicitly permit collaboration).

I will not make solutions to homework, quizzes or exams available to anyone else. This includes both solutions written by me, as well as any official solutions provided by the course staff.

I will not engage in any other activities that will dishonestly improve my results or dishonestly improve/hurt the results of others.

Important Definitions:

Help: Helping another person to find the answer without giving them the answer; assisting one to understand the answer he/she found

Explaining a difficult concept to another student

Say, “Look in Chapter 7 in Varney.”

Asking a confused student leading questions to provide direction for learning

Collaboration: The act of one or more people working together in order to achieve something; working with others to achieve shared goals; a joint effort of multiple individuals or workgroups to achieve a task or project; working together to find an answer

Group projects

Directions say collaboration is permissible, encouraged, or required

Generally, collaboration is not allowed on homework assignments. If you are unsure about any situation, ask the staff!

Plagiarizing: Representing the words, ideas or work of another person as one’s own and not offering proper citation of the source

Cheating:

Giving or receiving, prior to an examination, any unauthorized information concerning the content of that examination

Referring to or displaying any unauthorized materials inside or outside of the examination room during the course of an examination; this would include looking up answers to questions during an online test if it has been designated a “closed-book” test

Communicating during an examination in any manner with any unauthorized person concerning the examination or any part of it

Giving or receiving substantive aid during the course of an examination




Commencing an examination before the stipulated time or continuing to work on an examination after the announced conclusion of the examination period

Taking, converting, or concealing any property related to the preparation or completion of assignments, research or examination

Submitting the same written work to fulfill the requirements for more than one course.




Enrollment Pathway

This is the usual series of events that take place during the application process.

Step 1:

The applicant:

1. Reads through all online information. If she has questions, she contacts the Course Coordinator via email or phone.

2. Downloads application and reads packet.

3. Obtains proof of necessary entrance requirements (it is preferred that transcripts be sent with application rather than mailed from the institution.)

4. Types all answers to every question into the application form and saves the form to her computer, per instructions in application packet.

5. Sends reference form requests to 2 – 4 acquaintances.

6. Prints a copy of the financial agreement, “NARM permission to release test scores”, and the signature page of the “Readiness-Commitment Survey” document.

7. Signs the above forms.

8. Scans copies of the signed forms.

9. Joins ATM as a student member from the ATM website; prints a copy of the application form to mail with application.

10. Pays application fee online, from the ATM website (preferred)

11. Emails completed application packet with scanned forms to the email address on the application.

12. Mails the original signed forms with all supporting documents to the address on the application form.

13. Applicant may work on her entrance essay while the next steps in the process take place.

Step 2:

Once the school office has received both the emailed and mailed documents:

14. The school emails the applicant to acknowledge receipt of application.

a. if there are problems or missing items the applicant will be notified.




15. When the application is complete, including references and mailed transcripts, an email will be sent to the applicant with information and instructions for submission of the essay. This will include:

a. Information on logging into the LMS.

b. Notice that she will receive an email with a login ID and temporary password.

c. Information on how to upload her essay to the LMS activity.

d. Deadline for submission.

e. An estimated time when the applicant can expect to know her results.

16. Applicant will be notified when her essay has been assessed.

a. She will be told if she has been accepted or not accepted into the program.

b. Instructions and information on the “next steps” will be given.

c. If accepted, information on paying for her first module.

Step 3:

Once the applicant receives notice of acceptance:

17. Tuition for the first module must be paid within 5 days of notice. Payment can be made online from the ATM website.

18. If tuition is not received within 5 days, the application will be set aside. It will only be re-considered if there are still openings in the class following the deadline. No application will be considered if the tuition payment has not been received by the enrollment deadline.

19. After tuition is received, the school office will process the application and enroll the applicant into the program.

a. Enrollment in the program is not fully complete until the new student completes “Orientation”.

b. School office will enroll the applicant into the Orientation to the ATMMTP course.

20. The newly enrolled student will be emailed notice that her application has been fully processed and she is ready to begin “Orientation”.

21. When the student completes Orientation, she will notify the school office.

22. Student may begin work on her first module as soon as the module is opened for the new class. This is normally about 2 weeks prior to the official class start date.




Application Instructions

Part 1:

Download the application packet and save it to your computer as a Word document. Please name, or “title” the application file with your last name as the first word of the title. E.g., “Gonzalez Enrollment Application”. Reopen the file from the location where you saved it, and then complete all sections on your computer by typing your answers in the underlined areas in the table, or “clicking” on the appropriate check boxes. Do not change the format of the application. Be sure and follow all instructions carefully.

Save your work, and then print and sign the following pages:

Student Financial Agreement NARM Permission to Release Test Scores The signature page of the “Readiness-Commitment Survey”

Scan the signed documents into your computer, re-title with your last name as the first word and brief description of the document(s), (e.g., “Gonzalez NARM release”) then email with your application to: [email protected]. All documents must be attached to the same email.

If you do not have a scanner, you may send a good quality picture of the signed documents. “Titling” requirements are the same.

The email must contain your last name as part of the subject field. Please be sure that the body of the email contains your full name.

If you have not already done so, join ATM as a student member and pay your application fee via PayPal from the ATM website:

http://www.texasmidwives.com/ecommerce/

Please note that until the school office cannot begin processing your application until it receives notice that the application fee has been paid.

Mail all the following to the ATMMP:

Signed original of the previously listed three forms All other supporting documents (see checklist) Copy of PayPal receipt showing payment of application fee. Copy of student membership application form

o Please note: the ATM membership form must be completed from the website!





Items may be sent regular or priority mail. However, do not send certified mail. Because mail is usually picked up in the evening, requiring a signature will result in a delay in receipt, or your packet may be returned to you unopened.

The ATMMTP requires two letters of recommendation from non-family individuals who have personal knowledge of the applicant and can attest to their character, educational experience and potential to succeed. The letters must be submitted to the Course Coordinator using the included ATMMTP form before enrollment can be completed. You will provide a list of names and contact information for each person from whom you have requested a letter of recommendation. (Section 5 of application.)

We suggest that you ask up to four individuals to send recommendations and provide each a stamped envelope addressed to the ATMMP. While the ATMMTP may contact respondents to clarify or ask for additional information, it is not the responsibility of the ATMMTP to follow-up when letters are not received.

Part 2:

After your application has been received and reviewed for completeness, you will complete part 2 of the acceptance process. Each applicant will write an essay using specified criteria on the midwifery model of care. After uploading the essay per provided instructions, the essay will be evaluated by members of the education committee. Assessment criteria will be on content, writing skills, and ability to follow instructions. A detailed instruction sheet is included at the end of the application packet.

Part 3:

Once your application has been accepted you will be notified via email. You must then submit payment for the first module’s tuition within 5 days. If the payment is not received within 5 days, then your application will be set aside until the application deadline. It will only be re-considered if there are still openings in the class following the deadline. No application will be considered if the tuition payment has not been received by the enrollment deadline.

Additional Information

The program is to be completed (academics and clinical training) within 5 years of enrollment. The ATMMTP is not responsible for students who do not complete the program within this time frame and will offer no refund other than those outlined in the Financial Agreement. Students who fail to finish in the allotted time will still be responsible for the financial arrangements in the




Financial Agreement. The ATMMTP is not responsible for arranging preceptors. Securing an apprenticeship may be difficult. The ATMMTP will provide a list of current approved preceptors and it will be the student’s responsibility to make acceptable arrangements for clinical training.

Out of state students selecting the academics only portion of the course must be approved by the Course Coordinator. Please contact the ATMMTP office for further instructions.

Note: Class size is limited to a maximum of 20 students.

Contact Information

Please feel free to contact the ATM Course Coordinator if you have questions. You may call

432-664-8845 or email: [email protected]




ATM Midwifery Training Program Refund Policy

Effective 3/1/17

Refund Policy:

Student membership dues are not refundable.

Application fee is not refundable1.

The following refund policy schedule includes tuition of the first module, Introduction to Midwifery. If an applicant pays future module tuition at the time of enrollment all tuition for those modules will be refunded.

Prior to enrollment completion:

Request for refund within 3 days of tuition payment based on postmark of mailed payment, or date of online PayPal payment: full refund of tuition

After enrollment processed and student has been given access to the ATMMTP Learning Management System (LMS):

After enrollment in Orientation but prior to enrollment in Module 1:

Request for withdrawal within 14 days but prior to enrollment in Module 1: 85% refund

Request for withdrawal between 15 days - 30 days: 75% refund of tuition.

After enrollment in Module 1:

Request for withdrawal between 0 – 15 days of access to the LMS Module 1: 60% refund of tuition.

Request for withdrawal between 16 days - 30 days of access to the LMS Module 1: 40% refund of tuition.

After 30 days: no refund

Note: future tuition payments are non-refundable once the student has been enrolled in the module.

Enrollment Deadlines1 Application fee is refundable if the current class is full when application is received, and applicant elects to withdraw application.EA-2018-1 EMAIL: [email protected] of 31



Applications are processed in the order they are received. A maximum of 20 applications are accepted for each class. If the class is full when an application is received, you will be contacted. We can hold your application in case there is a withdrawal, or we can immediately return/refund your application fee. It is not our policy to hold an application until the next enrollment period.

For the January class start date:

Emailed application documents: November 20th

Mailed signed originals, supporting documents, and application fee: postmarked no later than November 23rd

Reference forms and mailed transcripts must be received no later than December 3rd.

For the July class start date:

Emailed application documents: June 1st. Mailed signed originals, supporting documents, and application fee: postmarked no later

than June 10th. Reference forms and mailed transcripts must be received no later than June 15th.




Applicant’s Name:

You will need everything on the following checklist:

Application Checklist

☐ Email completed application and scanned copies of signed documents. Date emailed:

Mail all the following per previous provided instructions; please check-off each item that is included in your mailed packet:

☐ Signed Financial Agreement

☐ A legible color photocopy of your driver’s license. You must have a car and driver’s license in order to complete clinical training.

☐ Proof of at least a high school education or equivalent (transcripts required.)

☐ Copies of any other certifications or certificates (see application section 2, #2)

☐ Proof of current healthcare provider CPR. Include a photocopy of both front and back of card, or E-card with verification information. Certification must be one of the following:

☐ American Heart Association: Basic Life Support for the Healthcare Provider

☐ Red Cross: Basic Life Support for Health Care and Professional Rescuers☐ National Safety Council: Basic Life Support for Health Care and Professional Rescuers

☐ Signed original of the “Permission to Release Test Scores”

☐ Signed signature page of the “Readiness-Commitment Survey”

☐ A copy of applicant’s payment receipt for membership dues in the Association of Texas Midwives. If you

were a member prior to enrollment please note the last year in which you were enrolled: ☐ Student membership with copy of application if not paid on-line: $ 30.00 annually or prorate at $ 2.50 per

month. All memberships expire on December 31st of each year.☐ A copy of receipt for the payment of the application fee ($150.00, for U.S. students, $200.00 for students in

Mexico or Canada)☐ A copy of this completed checklist

You will also need:☐ Two letters of recommendation. Recommendations must be on the provided forms and mailed by the

referrer to the ATMMTP office. (See section 5 of application.)


Office Use OnlyEmailed application date: Mailed documents postmark date: Date received: Application fee paid by: ______________ Amount: ___________ Membership current through _______ Tuition paid on: ____________ By: __________ Amount: ________ Enrollment date: _____________ Class start date: ____________



Application for Enrollment

Please read instructions carefully prior to filling out this application. Incomplete applications will not be accepted.

Section 1: Personal and Demographic Data

Full legal name: Date:

Maiden name: Other names used:

Address:

City: State: Zip:

E-mail address:

Phone: Cell: Home:

Driver’s License #: State:

Date of birth: Age: Class start date: ☐January ☐ July

ATM membership: ☐I am already a member of ATM ☐I have included ATM membership

Type of CPR submitted: ☐AHA ☐RC ☐NSC Expiration Date:

Section 2: Background Information

1. Complete the following, as applicable: ☐ High school ☐ Home school ☐ GED Year graduated: ☐ SAT: Year Composite score: ☐ ACT: Year Composite Score: ☐ College (all core courses completed): Year: Hours: GPA: ☐ Degree: Year completed:

2. Do you have training/certification/licensure in any of the following? For each item checked, show the year you graduated or received certification. If you did not finish, indicate the percentage completed and the year (e.g., 50% 2009.) Include copies of any certifications or certificates with your mailed documents.

☐ Doula ☐ Birth Assistant ☐CNA ☐ LVN/LPN ☐ RN ☐ Medical Assistant ☐ EMT/Paramedic ☐ Lactation Consultant ☐ Childbirth Educator ☐ Other

3. Have you taken courses, received training, or done volunteer work not included in the above answer? If yes, briefly describe:

4. Marital status: ☐Single ☐ Married ☐ Separated ☐ Divorced




5. Do you have any children? ☐No ☐ Yes → If yes, what are their ages: ☐6. If you have children, give a brief description of each of your births, including location (hospital,

home, etc.) and length of breastfeeding. ☐7. What is your past experience or employment, if any, related to midwifery?

8. Are you currently employed? ☐No ☐Yes → If yes, please give the name of the company you work for, your title, a brief description of your

work, including the number of hours per week that you work.

→ If yes, is your employment flexible enough to allow for time off at will? → If yes, does your employer understand the unpredictable nature of birth? → If yes, is your family financially dependent on the income from your employment?

9. Are you involved in any activities that take a large amount of your time? ☐ No ☐ Yes → If yes, please explain how you intend to integrate your midwifery training into your schedule:

10. Study time, completing assignments, and attending workshops will be a time consuming process. Clinical training can involve long and frequently unpredictable hours away from home. How do you plan to care for your family, including childcare, and meet your work responsibilities as you train for midwifery?

→

11. What do you estimate your total expense for this program to be? Please review the education portion of our website carefully to help with this determination. $ _____

Are you financially able to meet these expenses? ______

12. Do you know a midwife with whom you can apprentice? How far away from you is the closest midwife? What are her qualifications? Do you know if she is an ATMMTP approved preceptor? If there is not a preceptor near you are you able to travel in order to obtain meet your clinical requirements?

Section 3: Beliefs, Values, and Intent

1. What is your philosophy of childbirth?

2. What was your first introduction to midwifery?

3. What one quality or requirement stated in the “Qualities and Requirements of the Midwifery Student” do you believe is your greatest strength?

4. What one quality or requirement stated in the “Qualities and Requirements of the Midwifery Student” do you believe is or will be your weakest area? Please do not select performing lab procedures or clinical skills, since these skills are learned during the program.




5. Name one book about midwifery or childbirth that you have read and relate to, or especially enjoyed, and why.

6. Do you have any religious convictions, conflicts or reservations concerning the practice of midwifery or use of medical services?

7. After licensure, what are your plans? Do you plan to have a solo midwifery practice, work in or own a birth center, work in a mission field, etc.?

8. Are you familiar with the laws governing the practice of midwifery in the state of Texas? Do you intend to comply with the Rules and Regulations set forth by the Texas Department of Licensing and Regulation?

9. How did you find out about this course?

10. Why did you select the ATM Midwifery Training Program as your pathway to midwifery education?

Section 4: Why I want to be a midwife

In the space below, write a paragraph or short essay explaining why you want to be a midwife, including why you want to attend births outside of the hospital setting. Limit your answer to approximately 500 - 600 words.

Section 5: Letters of Recommendation Information

Fill in your name, phone number, and enrollment deadline on the “Letter of Recommendation” form and give the form to those individuals that you are requesting provide you with a recommendation. In the space below, provide the following information for each person.

Letters of recommendation must be mailed to the ATMMTP office by the persons listed below. Letters of recommendation mailed with an application will not be accepted. We will accept faxed or emailed letters only from the referrers phone number or email address.

Two required.

1. Name: Phone number:

Address:


Address:


Address:




Student Financial Agreement

I understand that the Association of Texas Midwives Midwifery Training Program fee is $9580.00, or

$1195.00 per module, and there is an additional application fee of $150.00 ($200.00 if I live in Mexico or

Canada). I also understand that there may be fees associated with my apprenticeship, dependent upon

the preceptor I choose. Apprenticeship is a private arrangement between the midwife and the student.

I understand that my first payment of $1195.00 is for my first module, Introduction to Midwifery. Tuition of

$1195.00 for each subsequent module must be paid in full in advance of receipt of the following module

assignments, and is due three weeks prior to the start of the module. I understand this will be a total of

eight (8) payments of $1195.00 each. Other fees associated with the program that I may be subject to

are: re-take fee for failed exams: $100.00; fee for re-grading failing assignments: $50.00; testing fee for a

return to matriculating status following a leave of absence: $50.00; re-taking a module – full tuition

($995.00); non-sufficient funds fee: $25.00; transcript fee: $25.00. Out of state or academic only students

may have added fees for an approved Exam Proctor. Students shall be responsible for these fees.

I understand that once I begin an apprenticeship that the ATM Midwifery Training Program will provide

copies of my module grades to my primary preceptor, as indicated by me on my Apprenticeship

Notification form.

I understand I must adhere to all ATMMTP student policies, including the ATMMTP Honor Code; failure to

abide by policies may result in dismissal from the program.

I understand and agree to the above Financial Agreement Contract. I understand that all program

materials are copyrighted by ATM and are for my personal use only and are not to be re-sold, copied or

transferred in any manner. I understand that I may not share my student user ID and password or allow

any person to access the learning management system using my information. Failure to comply with this

policy can result in dismissal from the program. I understand that there are no refunds offered in

association with the program except for the one listed in the refund policies on the second page of this

application.

_________________________________________________________________________________Signature of Student Printed Name Date

_________________________________________Claudine Crews, LM________________________Signature of Course Coordinator Printed Name Date

432-664-8845 FINANCIAL AGREEMENT EA-2018-1 of 31 Table of Contents



ATM Midwifery Training Program Refund PolicyEffective 3/1/17

Refund Policy:

Student membership dues are not refundable.

Application fee is not refundable2.

The following refund policy schedule includes tuition of the first module, Introduction to Midwifery. If an applicant pays future module tuition at the time of enrollment all tuition for those modules will be refunded.

Prior to enrollment completion:

Request for refund within 3 days of tuition payment based on postmark of mailed payment, or date of online PayPal payment: full refund of tuition

After enrollment processed and student has been given access to the ATMMTP Learning Management System (LMS):

After enrollment in Orientation but prior to enrollment in Module 1:

Request for withdrawal within 14 days but prior to enrollment in Module 1: 85% refund

Request for withdrawal between 15 days - 30 days: 75% refund of tuition.

After enrollment in Module 1:

Request for withdrawal between 0 – 15 days of access to the LMS Module 1: 60% refund of tuition.

Request for withdrawal between 16 days - 30 days of access to the LMS Module 1: 40% refund of tuition.

After 30 days: no refund

Note: future tuition payments are non-refundable once the student has been enrolled in the module.

2 Application fee is refundable if the current class is full when application is received, and applicant elects to withdraw application.

432-664-8845 FINANCIAL AGREEMENT EA-2018-1 of 31 Table of Contents



Permission to Release Test Scores

The ATM Midwifery Training Program (ATMMTP) requires that a record of North

American Registry of Midwives (NARM) test scores be maintained in all graduates’

records. The below release form is required with your application. Upon graduation the

form will be mailed to NARM in order to obtain your test scores. NARM will provide you

with a copy of what information is sent to the ATMMTP.

Your signature on this letter signifies your permission for NARM to release your test scores to the school indicated below.

Please send my scores to the Association of Texas Midwives Midwifery Training

Program:

ATM Midwifery Training ProgramP. O. Box 887Elmendorf, TX. 78112

Your printed name: _____________________________________________

Address_______________________________________________________________

City _______________________________________ State_________ Zip __________

Your signature ________________________________________________________

NARM Test DeptP.O. Box 7703Little Rock, AR 72217-7703

Fax: 404-521-4052E-mail: [email protected]: 1-888-353-7089

432-664-8845 ATM Midwifery Training Program of 31Table of Contents



Readiness-Commitment Survey

Is This the Right Time in Your Life to Begin Midwifery School?

Instructions: Read the following questions carefully. Think about them. You do not need to provide written answers, but you should honestly answer them for yourself. We suggest going over the questions with your partner or other family members also, if applicable. If, after careful consideration, you decide that this is the appropriate time in your life to begin your midwifery education, and you feel able to commit the next approximately 3 or more years to your education, fill in the requested information on the last page and submit a copy with your application.

Family

Do you have children?

1. You get a call at 3:00am that a client is in active labor with contractions 3 minutes apart. She was only in labor for 2 hours with her previous baby and she lives 45 minutes from your home. You need to be out of your door in 10 minutes. Who is going to care for your children?

2. You get a call at 3:00am that a client is in active labor with contractions 3 minutes apart. She was only in labor for 2 hours with her previous baby and she lives 45 minutes from your home. You need to be out of your door in 10 minutes. Your husband is out of town. Who is going to care for your children?

3. You are with a laboring client; you can’t leave her. Your children have to be picked up from school in an hour. What will you do?

4. You have a 2-month old baby when you begin your apprenticeship. You are sure that you can pump breastmilk for your sitter to feed him. After 3 weeks you realize your milk supply is drying up. What will you do?

5. It is your 5-year old’s birthday and her party is this afternoon. Your preceptor calls and says that a client’s membranes just ruptured and you need to come to the birth center. Explain to your child that you will not be there for her party.

6. You have had 3 births in the past 5 days and have been home for only about 2 hours. You’ve just been called in to the birth center - again. Your children overhear the phone conversation and start crying. What will you say to them?

7. It is Christmas Eve and you have a special family gathering planned in your home. A client who is not due for another 4 weeks calls and reports signs of premature labor. What will you do?




8. You are at a birth and your babysitter calls and says she has run out of the pumped breastmilk you provided to feed your baby. What will you do?

9. You’ve had prenatal exams 1 day this week, and two unexpected, back-to-back births. You have had a total of 4 hours sleep in the past 48 hours. You must leave in the morning to attend the 3-day mandatory workshop and haven’t finished your final assignment, due in 16 hours. Your husband planned a surprise dinner out for you and the kids. How will you keep your family happy, take care of your assignment, and get the sleep you need?

10. Your children received their school grades and your 14-year-old has several failing grades. You had no idea he has not been doing his homework and missed an exam. You realize you missed the parent-teacher conference last week due to a birth. What are you going to do?

11. Your sitter just texted you a lovely picture of your baby, sitting up for the first time by herself! Yea! But you missed it, and may miss her first step, or her first word. Are you prepared for this?

Are you employed?

1. You work 5 days per week, Monday – Friday, but must begin your apprenticeship with the only preceptor who was accepting a new apprentice. Your preceptor expects you to work Monday and Wednesday of each week and be on call 24/7. How will you manage to keep your job and fulfill your apprenticeship requirements?

2. You are at work and your preceptor calls to say a client is in labor and you need to come now. Will your employer be OK with your need to leave with no warning?

3. It is the 4th time in 3 weeks that you’ve been called to births while at work. Is your employer still OK with you leaving with no warning?

4. You have been up all night at a birth and are supposed to be at work in an hour. Will your employer be alright with you staying home to get some sleep?

5. Your employer assured you they supported you fully in your desire to go back to school, and understand that births are unpredictable. After 8 months of apprenticeship you have called in 5 times and had to leave work with no warning twice. You are told that as much as they support what you are doing, they need someone who they can rely on to be there. You are told you must choose between your job and your apprenticeship. What will you do?

Other:

1. Your husband has taken off work 3 times over the past 2 months to care for your children while you were at births. His boss has written him up; if he calls in another day he will lose his job. What is your back-up plan?




2. Your husband just lost his job. You planned on quitting your job next month to begin your clinical training. School policy is that you must be in your apprenticeship no later than 3 months from now. What will you do?

3. Your husband tells you that he fully supports what you are doing, but he is fed up with you being gone all the time and wants you to “cut back” on your apprenticeship. You know your preceptor expects you to be at every clinical exam and on-call 24/7. You have already tried to study and complete assignments after he is asleep. How will you manage to keep both preceptor and husband happy?

Financial:

1. Are you financially able to pay the tuition? Do you have a backup plan in case of unexpected expenses such as medical bills or major auto/home repairs?

2. Can you afford the textbooks? Textbooks often cost more than $100.00 each and can be a significant expense.

3. Can you afford the expenses to travel to each workshop? Hotel, gas, meals?

4. Do you work? Can you afford to take off work for workshops and the mandatory clinical apprenticeship?

5. Do you have children? Can you afford the costs of childcare?

6. Do you have a computer? Do you have the software you will need? Internet?

7. Do you have a reliable car?

Is a self-directed distance program right for me?1. Do you have reliable internet access? If not, is it available?

2. What is your comfort level in the use of a computer?

a. Do you know how to work with files and folders? Do you know how to save documents to your computer and find them later?

b. Do you know how to download a file? Do you know how to download and extract zip files?

c. Do you know how to upload a document, file, or picture to a website? Do you know how to “attach” a file to an email?




d. Do you know how to copy and paste text?

e. Do you know how to use Microsoft Word?

f. If the answer to any of the above is no, can you learn? Are you willing to learn?

3. How well do you read? Do you usually understand what you read without any help?

a. Are you able to read and follow instructions?

b. Are you able to read books and other materials, analyze the materials, and formulate opinions on what you have read?

4. Are you self-motivated? Or do you need someone to remind you of what you need to do?

5. Are you able to prioritize and stick to a plan? Are you able to create a work/study schedule and stick to it?

6. Do you tend to finish your tasks ahead of schedule or on-time? Or do you tend to procrastinate?

7. Are you flexible enough that if the unexpected happens that you can jump right back in to your studies and pick up where you left off?

8. Are you able to complete assignments on your own, with little or no feedback?

9. If you need help with a subject are you comfortable asking for help?

10. Are you able to work independently?

11. Do you have at least a few hours every day to study and complete assignments?

Name (print): _____________________________________

I have read all of the above questions and have given them careful consideration. I acknowledge that midwifery school is a substantial commitment. I understand that I must successfully integrate my academic and clinical education with my family and other commitments outside of this program. I believe I am able to do this, and that this is the right time in my life to begin midwifery school.

Signature: ________________________________________ Date: _____________




Applicant Midwifery Model of Care Essay

Instructions and CriteriaIntroduction

Distance education is not always the best method of learning for some students. To be successful in a distance program, the student must have good reading comprehension skills, the ability to follow written instructions, and the ability to communicate in writing that the student has learned the material. In addition, midwives must be able to effectively communicate in writing in their professional practice. The profession involves a great deal of written communication with clients, in medical charts, and with other healthcare professionals.

As part of the acceptance process for enrollment into the ATM Midwifery Training Program, applicants must write an essay on the components of the Midwifery Model of Care. The essay will be evaluated by at least three ATMMTP staff members using the criteria given in these instructions.

The general criteria on which the essay will be evaluated are:

reading comprehension based on content reading comprehension based the ability to follow all instructions writing skills (grammar, spelling, “readability”, use of APA)

Essay Criteria

The following information includes what we are looking for in the essay content, and specific instructions on the presentation of the essay. Suggested resources are given at the end of these instructions.

The essay will consist of three sections:

1. Title page2. Body of the paper3. Reference page

The paper must be written using a modified APA format. A brief presentation on using the modified APA will be available in our online learning management prior to the submission. The applicant will have access to the presentation for 10 days before the essay submission is due. There are many online resources for using APA; however, we will expect our modified version to be used. The main points of the modifications are included in the following specifications.

Essay: EA-2018-1 Email: [email protected] 432-664-8845Table of Contents




Title Page

The title page of the essay will consist of all the following, using a bullet point list, in this order:

applicant's full name complete address phone number email address class start date (class for which the applicant is applying)

The body of the paper will begin on the next page.

Body of Paper

The body of the essay must be 900 - 1600 words and double-spaced. It must be typed in a 12 point sans-serif font, with 1 inch margins. Acceptable fonts are Arial or Verdana. The document must be written in and submitted in Microsoft Word.

The Content

The applicant needs to demonstrate that she understands the components that have come to be known as the Midwifery Model of Care. She will do this by identifying a minimum of 7 components, with discussion and examples, as appropriate. Examples may be from resources or personal experience.

The essay sources of information must be properly cited, and a separate reference list included.

Writing Skills

Applicant’s writing skills will be evaluated as follows:

1. "Readability"o The ease with which the content of the essay can be read and understood. Includes

organization of thoughts and clarity of writing. There should be an appropriate amount of information that is "on topic", without extraneous information that detracts from the content. If medical terminology is used, it should be used correctly.

2. Spelling3. Use of APA style for citing sources and reference list.





Following Instructions

Every essay assessment will include the ability of the applicant to read and follow written instructions. The applicant will be expected to interpret these instructions and criteria without additional input. This means that the applicant is expected to “figure it out” on her own, without contacting the school for additional instructions.

Recommended Resources

The applicant may use sources other than those given below; however, we recommend that the information on the Citizens for Midwifery website form the foundation of the essay.

1. Citizens for Midwifery http://cfmidwifery.org/index.aspx 2. MANA Statement of Values and Ethics ( http://mana.org/about-us/statement-of-values-and-

ethics) 3. Davis, Elizabeth. (2012) Heart and Hands: A Midwife’s Guide to Pregnancy and Birth , 5th edition ,

Ten Speed Press





Letter of Recommendation

Applicant’s Name: _____________________________ Phone: _____________ Enrollment Deadline:

________

The Association of Texas Midwives Midwifery Training Program requires letters of recommendation from non-

family individuals who have personal knowledge of the applicant and can attest to their character, educational

experience and potential to succeed. The ATMMTP is a rigorous course of midwifery study and the applicant

you are recommending will ultimately be responsible for the well-being of mothers and their babies. Please

thoughtfully complete this form, sign it, and mail or fax it to the ATMMTP address above. All letters are

confidential and will not be shared with the applicant.

Referee’s Name: _______________________________________________ Date: __________________

Your address: _________________________________________________________________________

Telephone Number: ___________________ Email Address: ____________________________________

Your profession: ___________________________ Length you have known the applicant? ______ Years

What is your association with the applicant?

_____________________________________________________________________________________

Please rate the applicant’s qualities from 1 – 5 by circling the number chosen, with 1 being Inadequate and 5 being Outstanding.

If you would like to comment further, please use the back of this paper.

Integrity 1 2 3 4 5 Ability to Handle Stress 1 2 3 4 5Good Judgment 1 2 3 4 5 Compassion 1 2 3 4 5Problem-Solving Skills 1 2 3 4 5 Recognizing Limitations 1 2 3 4 5Academic Aptitude 1 2 3 4 5 Flexibility 1 2 3 4 5Professionalism 1 2 3 4 5 Follow-Through 1 2 3 4 5Patience 1 2 3 4 5 Respect for Diversity 1 2 3 4 5Ability to Receive Constructive Criticism 1 2 3 4 5 Writing Skills 1 2 3 4 5

I, _________________________________ do hereby affirm that the information and personal accounts herein

contained concerning _________________________________ (name of applicant) are true.

SIGNATURE: _________________________________________ DATE: ____________________

LOR-2018-1 432-664-8845 [email protected] FAX 830-393-3927

pre-enrollment requirements - atmmtp school hometexasmidwiferyschool.org/enrollment/enrollment...

Documents