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Challenges of creating the scale identified were language regarding leadership and the varying relationships with physicians across diverse settings. The next stages in testing the Midwifery Practice Climate Scale will address these challenges, as well as test the reliability and construct validity. The findings indicate that the Midwifery Practice Climate Scale is relevant to midwifery and addresses the intended concept of a supportive practice climate for midwives. Challenges of creating the scale identified were language regarding lead
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