Bachelor Of Midwifery Students Research Articles

Learning through relationships: The transformative learning experience of midwifery continuity of care for students: A qualitative study

BackgroundMidwifery curricula in Australia incorporate ‘Continuity of care experiences’ (CoCE) as an educational strategy based on an assumption that midwifery students will learn skills and knowledge about woman-centred care that they may not learn in the typical fragmented care system. However, exactly what skills and knowledge they are expected to ‘learn’ and how these can be assessed have never been specifically identified. AimTo explore midwifery students’ continuity of care learning experiences within pre-registration midwifery education. MethodsFocus groups were conducted with first, second and third year Bachelor of Midwifery students (n = 12), who were undertaking CoCE in rural and regional tertiary hospitals in NSW, Australia. FindingsThe overarching theme, ‘Learning through relationships’, was made up of three interrelated themes: Meeting women and making connections, Being known, and Understanding holistic care. DiscussionThe findings from this study contribute to understanding the educational effects of CoCE. The CoCE relationship provided safety and freedom to learn which was seen as foundational for midwifery students’ vision of their future practice and can be seen as a self-determined transformational approach to learning. ConclusionThis study adds insight into midwifery students’ experience of CoCE, and demonstrates that transformative learning occurs through developing a relationship with both the woman and the midwife. For midwifery to develop as a profession and maintain its focus on woman-centredness, it is important that this aspect of midwifery education remains embedded within midwifery program philosophies and learning outcomes.

The impact of three-dimensional visualisation on midwifery student learning, compared with traditional education for teaching the third stage of labour: A pilot randomised controlled trial

BackgroundComplex physiological processes are often difficult for midwifery students to comprehend when using traditional teaching and learning approaches. Face to face instructional workshops using simulation have had some impact on improving understanding. However, in the 21st century new technologies offer the opportunity to provide alternative learning approaches. AimTo investigate the impact of using three-dimensional (3D) visualisation in midwifery education on student's experience of learning, and retention of knowledge at three points in time. DesignA pilot study involving a two-armed parallel Randomised Controlled Trial (RCT) comparing the retention of knowledge scores between the control and intervention groups. SettingAn Australian University in the Northern Territory. ParticipantsThe sample included second year Bachelor of Midwifery students (n = 38). All received traditional midwifery education before being randomly allocated to either the intervention (n = 20) or control (n = 18) group. MethodsA new immersive virtual environment was introduced to complement existing traditional midwifery education on the third stage of labour. This intervention was evaluated using a demographic survey and multiple-choice questionnaire to collect baseline information via Qualtrics. To measure change in knowledge and comprehension, participants completed the same multiple-choice knowledge questionnaire at three time points; pre, immediately post and at 1 month post intervention. In addition, the intervention group completed a 3D student satisfaction survey. ResultsBaseline knowledge scores were similar between the groups. A statistically significant increase in knowledge score was evident immediately post intervention for the intervention group, however there was no significant difference in knowledge score at one month. ConclusionsThe results support the creation of further three-dimensional visualisation teaching resources for midwifery education. However, a larger randomised controlled study is needed to seek generalisation of these findings to confirm enhanced student learning and retention of knowledge post 3DMVR, beyond the immediate exposure time.

Evaluation of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis

ProblemQuantitative feedback from students about their clinical learning experiences is used to inform program quality, but the extent to which tools are reliable, valid and refined receives less attention. AimTo evaluate the psychometric properties of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis. MethodsThe Midwifery Student Evaluation of Practice tool was completed by Bachelor of Midwifery students (n = 901) attending seven universities in Australia and New Zealand. The tool consists of the Clinical Learning Environment Scale (16 items) and Impact of the Midwifery Preceptor Scale (10 items), each with two subscales. Rasch analysis was conducted on all subscales separately using the partial credit model of RUMM2030. Response format, item fit, dimensionality of the scale and its targeting were assessed. ResultsRasch analysis confirmed the internal construct validity of the Clinical Learning Environment and Impact of the Midwifery Preceptor subscales, with no evidence of mis-fitting items, local dependency or multidimensionality. The 4-point response scale was found to be appropriate, and internal consistency reliability of each subscale was good. DiscussionResults provide support for the reliability and validity of the Midwifery Student Evaluation of Practice tool. The four subscales can confidently be used in undergraduate midwifery clinical education. The use of Rasch analysis is consistent with growing awareness in health and education of the need to apply more advanced, sophisticated psychometric techniques to ensure measures are suitable for their intended use. Tweetable abstractMidwifery students clinical learning experiences should be measured using robust tools. MidSTEP is reliable and valid.

Feasibility of a novel framework to routinely survey women online about their continuity of care experiences with midwifery students

AimThis study describes a novel framework used to evaluate the feasibility of an online survey to routinely collect women’s feedback about their continuity of care experiences with Bachelor of Midwifery students during the clinical practicum. BackgroundThe extent to which secure online platforms can efficiently distribute surveys and collect routine feedback from women receiving continuity of midwifery care experiences by Bachelor of Midwifery students needs to be effectively assessed and evaluated. MethodsUsing a co-design approach, the teaching team, program software developers, information technology and cybersecurity experts, students, consumers and clinical placement officers were consulted in development of survey content and processes. ResultsA novel framework for evaluating online surveys was developed with a focus on survey content, processes, web technology and outcomes. ConclusionsThe online survey was found to be reliable, valid, reproducible, efficient and easy to access by women with a response rate of 56% achieved. Only 0.4% of surveys were opened and not completed. Accuracy of electronic addresses was increased by adding two text-match fields in the consent form and sending a confirmation email when first completed. Application of this novel framework is recommended when developing and evaluating online surveys for educational and research purposes.

Learning to be a midwife: Midwifery students’ experiences of an extended placement within a midwifery group practice

AimTo investigate the experiences, perspectives and plans of students who had a six-month placement with the midwifery group practice. MethodsFocus groups were conducted with fifteen third – year Bachelor of Midwifery students who had undertaken an extended placement at a midwifery group practice in a large tertiary referral hospital in Queensland, Australia. ResultsFour main themes were identified in the data: Expectations of the Placement; Facilitating learning within a midwifery group practice model; Transitioning between models of care and Philosophy and culture of midwifery group practice. Discussion and conclusionThird-year midwifery students valued the experience of working one-on-one for an extended placement with a midwife providing continuity of care within a caseload model. The experience was the highlight of their degree and they learned ‘how to be a midwife’. Most students found reintegrating back into the hospital system of care challenging, reporting that their developed skills of supporting women holistically and facilitating normal birth were not fully utilised when returning to the task-orientated birth suite. Students valued thoughtful, kind and supportive midwifery preceptors who supported them to transition back into the hospital. Implications and recommendationsUndertaking an extended placement within a midwifery group practice provides students with a rich and holistic learning experience and helps them develop a sense of professional identity. Student placements situated within models of care which provide continuity of midwifery care should be proactively enabled by health services and universities. Research of the longer-term impacts of an extended midwifery group practice clinical placement on midwifery graduates’ capabilities and competencies 3–5 years post registration should be conducted.

Emergency scenarios in maternity: An exploratory study of a midwifery and medical student simulation-based learning collaboration

Background and problemIn Australia, interprofessional education has been embedded into pre-registration course accreditation standards. Little is known about Australian midwifery and medical students experiences of interprofessional learning when the focus is on emergency scenarios during birth. AimThis study aimed to evaluate student experience of Interprofessional Simulation-Based Learning workshops focused on emergency scenarios with midwifery and medical students. MethodsThis was a descriptive, exploratory study of an educational activity designed to enhance inter-professional and collaborative learning between Bachelor of Midwifery students and Bachelor of Medicine students at a Simulation Centre in Sydney, Australia. A pre and post survey design enabled data collection before and after the 6-h simulation-based workshop. FindingsA total of 45 students attended two interprofessional simulation learning days, 14 were midwifery students and 31 medical students. Students disclosed a level of apprehension in the pre workshop survey and ambivalence towards the values of collaborative simulation-based learning. Following the workshop students reported that the workshop enhanced their ability to work collaboratively in practice. Both student cohorts commented on a perceived power imbalance and a sense of each profession having to ‘prove’ their knowledge levels. Students stated that learning to work together in a safe environment allowed them to develop an appreciation for each other’s scope of practice and responsibilities in an emergency situation. ConclusionThis form of collaborative learning has the potential to improve new graduate experience in the workplace, especially during emergency situations, and ultimately improve care for women and babies.

Evaluation of a student-led midwifery group practice: A woman's perspective

Background. ObjectiveTo evaluate women's experiences of a student-led midwifery group practice. DesignA mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students.Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes. SettingA tertiary teaching public hospital in New South Wales (NSW). ParticipantsFifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey. Measurements and findingsAnalysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students’ presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events. Key conclusionsFor a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care. Implications for practiceThis model of care provides evidence that women do value the students’ support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.

Satisfaction with simulation-based education among Bachelor of Midwifery students in public universities and colleges in Harar and Dire Dawa cities, Ethiopia.

INTRODUCTIONSimulation-based education using low to high fidelity techniques are common in midwifery professionals’ education, and it is found to be an excellent alternative to fill the gaps in skills teaching and learning. The aim of this study was to assess the students’ satisfaction with simulation-based education and associated factors.METHODSA cross-sectional study in academic settings was conducted from March to May 2018. The data were collected through a self-administered questionnaire. Bivariate and multivariate logistic regressions were used to identify factors associated with student satisfaction with simulation-based education and the degree of association was measured by using odds ratios with 95% confidence interval.RESULTSStudents who were assisted by their teachers during skills demonstration and practice were 5.6 times more satisfied than those who were not assisted (adjusted odds ratio, AOR=5.62; 95% CI: 2.36–13.40, p<0.001). The students who perceived that the way their teachers conducted the skills demonstration was suitable to their learning styles were 22.4 times more satisfied with the simulation-based education (AOR=22.4; 95% CI: 10.8–37.5, p<0.023). Students who perceived that the number of skills practices per semester was enough were 2.3 times more likely to be satisfied with simulation-based education (AOR=2.3; 95% CI: 1.0–5.3, p<0.042).CONCLUSIONSThe efforts of teachers in assisting their students during skills demonstration, the suitability of the way of teaching to the learning styles of students, and the number of scheduled programs per semester for skills practising were statistically significant factors with satisfaction in simulation-based education.

Midwifery Student Evaluation of Practice: The MidSTEP tool — Perceptions of clinical learning experiences

BackgroundLittle emphasis has been given to the standardised measurement of midwifery students’ perceptions of their clinical learning experiences. AimTo develop a tool that evaluates students’ perceptions of their clinical learning experiences according to environment and impact of preceptors on professional development. MethodsA cross-sectional design was used. Tool development had three phases: item generation; expert review to assess clarity, apparent internal consistency and content validity; and psychometric testing. All Bachelor of Midwifery students at one university in Australia were invited to complete the online survey. Psychometric testing included dimensionality, internal consistency and test-retest reliability. ResultsA 74% (n=279) response rate was achieved. Factor analysis revealed the Clinical Learning Environment Scale and Impact of the Midwifery Preceptor Scale accounting for 53.6% and 71.5% of variance respectively. Both scales were reliable (Cronbach’s alpha=.92 and .94) and valid. Overall, students positively rated the clinical learning environment and preceptors’ abilities to foster their sense of identity as a midwife. Students were less satisfied with preceptors’ understanding of the academic program. DiscussionThe new tool consists of two scales that reliably measure midwifery students’ perceptions of how the clinical learning environment develops their skills and reflects a midwifery philosophy. Preceptors had a positive influence on students’ skills and professional development. ConclusionsThe Midwifery Student Evaluation of Practice tool is the first valid and reliable measure of students’ perceptions of their clinical learning experiences. Students’ feedback provides valuable information to educators and preceptors on how best to optimise clinical learning.

Midwifery students’ experiences of working within a midwifery caseload model

BackgroundWork integrated learning opportunities account for approximately half of the Bachelor of Midwifery program with the goal being to ensure that on graduation students are skilled to provide woman centred evidenced based midwifery care within any environment. There is increasing concern, however, over the quality of clinical experiences students are afforded. ObjectiveThis study explored the experiences of third year Bachelor of Midwifery students in South East Queensland undertaking a clinical placement within a midwifery caseload model. DesignA qualitative descriptive approach was adopted. Data were collected using semi-structured, digitally recorded telephone interviews. Thematic analysis was used to analyse the data set. SettingMidwifery student clinical placement in caseload practice ParticipantsTwelve third year Bachelor of Midwifery students from one university who had experienced a clinical placement in a caseload midwifery model of between 4 and 8 weeks. FindingsFive themes emerged. These were labelled ‘stepping in her shoes’, ‘bringing it all together’, ‘my own captive educator’, ‘knowing the woman’, and ‘it was hard – but it was worth it’. The three-way relationship between midwife, woman and student facilitated deep and active learning leading to a growth in confidence and readiness for practice. Students were afforded the opportunity to constantly integrate theory into practice within a woman centred social model of care where they also grew to understand how midwives operationalise caseload practice in a sustainable way. Students acknowledged the challenges they faced undertaking the placement, but all confirmed the value it had afforded them. Key conclusions and implications for practiceThis study has provided evidence that situating midwifery students within a continuity of care model facilitated a rich holistic learning experience for students. Not only did the placement enhance student's confidence and competence it also provided a real-world view of what working in that a caseload model could be like on graduation. This is vital if the profession is to support system level change ensuring all women have access to evidence informed maternity care.

Evaluation of strategies designed to enhance student engagement and success of indigenous midwifery students in an Away-From-Base Bachelor of Midwifery Program in Australia: A qualitative research study

BackgroundA strategy to close the gap in relation to Indigenous health is the employment of more Indigenous health professionals. However, despite government reviews, research studies and educational initiatives, Indigenous students' retention and completion rates of tertiary education remains below those of non-Indigenous Australians. ObjectiveTo evaluate two enhancements to an Away-from-Base Bachelor of Midwifery program for Indigenous students, namely the appointment of an Indigenous Academic Liaison Midwife to provide academic and cultural support and an additional clinical placement in a high-volume tertiary hospital. MethodIn this qualitative study, 10 Indigenous students enrolled in the Away-from-Base Bachelor of Midwifery program participated in one of two focus groups. Focus group transcriptions were subjected to a manual thematic analysis, and key themes were identified and explored. FindingsThe role of the Indigenous Academic Liaison Midwife was highly valued as students had access to a resource who provided cultural and academic support, and who encouraged and advocated for them. Regular contact with the Indigenous Academic Liaison Midwife enabled students to stay connected with and focussed on their study. Students were overwhelmingly positive about the opportunity to undertake the additional clinical placement, as it exposed them to complex clinical cases they may not have seen in their home communities. ConclusionsThe introduction of an Indigenous Academic Liaison Midwife and an additional clinical placement in a high-volume tertiary hospital were perceived as valuable additions to the range of support mechanisms already in place for Indigenous Away-from-Base Bachelor of Midwifery students. These interventions have had a direct impact on retention, course progression and completion rates for Indigenous students. Students expressed enhanced clinical learning and knowledge retention as a result of the additional clinical placement, and the Indigenous Academic Liaison Midwife provided culturally sensitive support for students undertaking remote learning, and during on-campus intensive sessions.

Culturally capable and culturally safe: Caseload care for Indigenous women by Indigenous midwifery students.

Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. To explore Indigenous students' perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. Indigenous Bachelor of Midwifery students' experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. Three interconnected themes; facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives.

The challenges of creating an online undergraduate community of practice

Purpose – With less time spent on campus, students are increasingly forming peer friendship and study groups either face to face or online. Communities of practice (CoP) with academic support in the wings could benefit students, but little is known in the about their use in the undergraduate space, or how best they may be structured and facilitated (Andrew et al., 2008). The purpose of this paper is to discuss these issues. Design/methodology/approach – An online CoP was created in partnership with undergraduate bachelor of midwifery students at the University of South Australia using an action research model. This provided an ongoing ability to continuously plan, act, observe and evaluate all aspects of the community created, so that adjustments could be made during the two cycles of the study. Findings – The time paucity of the cohort impacted on their ability to participate fully as partners in the project, and in the community itself. The Facebook community received more visitation than the Weebly community. The student panel reported that despite the online CoP fitting better with their schedules, they would prefer more opportunities to interact face to face with their peers. Research limitations/implications – Students who spend limited time on campus may prefer more real life social contact and support, despite the convenience of an online community. A larger cohort, drawing from a non-professional degree would have allowed greater membership and community participation for a prospective study such as this. Practical implications – Remote study is a growing phenomenon, and students need to feel socially connected and supported to remain enroled and engaged. Social implications – There has been much discussion around the amount of time individuals spend online, and whether support groups formed by students on social media support student learning, or encourage unprofessional behaviours without academic support present. Originality/value – This study reports that online communities are not always a logical solution to time poor students, and they may prefer face to face interactions to build their social and professional relationship.

SANDS – The power of peer support

.To evaluate women's experiences of a student-led midwifery group practice.A mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students.Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes.A tertiary teaching public hospital in New South Wales (NSW).Fifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey.Analysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students’ presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events.For a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care.This model of care provides evidence that women do value the students’ support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.

Setting up a student group practice for continuity of care experiences

.To evaluate women's experiences of a student-led midwifery group practice.A mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students.Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes.A tertiary teaching public hospital in New South Wales (NSW).Fifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey.Analysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students’ presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events.For a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care.This model of care provides evidence that women do value the students’ support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.

Complementary medicine and maternity care; informed midwives make a difference

.To evaluate women's experiences of a student-led midwifery group practice.A mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students.Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes.A tertiary teaching public hospital in New South Wales (NSW).Fifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey.Analysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students’ presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events.For a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care.This model of care provides evidence that women do value the students’ support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.

Midwifery students’ evaluation of team-based academic assignments involving peer-marking

Midwives should be skilled team workers in maternity units and in group practices. Poor teamwork skills are a significant cause of adverse maternity care outcomes. Despite Australian and International regulatory requirements that all midwifery graduates are competent in teamwork, the systematic teaching and assessment of teamwork skills is lacking in higher education. How do midwifery students evaluate participation in team-based academic assignments, which include giving and receiving peer feedback? First and third year Bachelor of Midwifery students who volunteered (24 of 56 students). Participatory Action Research with data collection via anonymous online surveys. There was general agreement that team based assignments; (i) should have peer-marking, (ii) help clarify what is meant by teamwork, (iii) develop communication skills, (iv) promote student-to-student learning. Third year students strongly agreed that teams: (i) are valuable preparation for teamwork in practice, (ii) help meet Australian midwifery competency 8, and (iii) were enjoyable. The majority of third year students agreed with statements that their teams were effectively coordinated and team members shared responsibility for work equally; first year students strongly disagreed with these statements. Students' qualitative comments substantiated and expanded on these findings. The majority of students valued teacher feedback on well-developed drafts of the team's assignment prior to marking. Based on these findings we changed practice and created more clearly structured team-based assignments with specific marking criteria. We are developing supporting lessons to teach specific teamwork skills: together these resources are called "TeamUP". TeamUP should be implemented in all pre-registration Midwifery courses to foster students' teamwork skills and readiness for practice.

Using root cause analysis to promote critical thinking in final year Bachelor of Midwifery students

Midwives require well developed critical thinking to practice autonomously. However, multiple factors impinge on students' deep learning in the clinical context. Analysis of actual case scenarios using root cause analysis may foster students' critical thinking and application of 'best practice' principles in complex clinical situations. To examine the effectiveness of an innovative teaching strategy involving root cause analysis to develop students' perceptions of their critical thinking abilities. A descriptive, mixed methods design was used. Final 3rd year undergraduate midwifery students (n=22) worked in teams to complete and present an assessment item based on root cause analysis. The cases were adapted from coroners' reports. After graduation, 17 (77%) students evaluated the course using a standard university assessment tool. In addition 12 (54%) students provided specific feedback on the teaching strategy using a 16-item survey tool based on the domain concepts of Educational Acceptability, Educational Impact, and Preparation for Practice. Survey responses were on a 5-point Likert scale and analysed using descriptive statistics. Open-ended responses were analysed using content analysis. The majority of students perceived the course and this teaching strategy positively. The domain mean scores were high for Educational Acceptability (mean=4.3, SD=.49) and Educational Impact (mean=4.19, SD=.75) but slightly lower for Preparation for Practice (mean=3.7, SD=.77). Overall student responses to each item were positive with no item mean less than 3.42. Students found the root cause analysis challenging and time consuming but reported development of critical thinking skills about the complexity of practice, clinical governance and risk management principles. Analysing complex real life clinical cases to determine a root cause enhanced midwifery students' perceptions of their critical thinking. Teaching and assessment strategies to promote critical thinking need to be made explicit to students in order to foster ongoing development.

The Who, What and Why: Weight management support for obese women during pregnancy

Effective collaboration is essential for optimal maternity care provision and is expected of all midwifery graduates. One way to teach these skills is through student participation in team-based academic assignments.Aim: To evaluateMidwifery students’ experiences of being involved in team-based academic assignments including giving and receiving peer feedback on teamwork skills. Participants: First and third year Bachelor of Midwifery students who each undertook two team-based assignments in the same semester of the course; participantswere allocated to teams. This is a multi-method Participatory Action Research project. Teamwork was begun during study block but was primarily conducted online. Specific written instructions about teamwork skills were provided along with very specific marking criteria. Teams submitted draft versions of their work to Blackboard for academic guidance. Individual student marks differed according to amount and quality of team contributions. Students’ experiences were evaluated by voluntary, anonymous online surveys; 42.8% response rate. Peer marking criteria was deemed appropriate by 100% of students. Participation in team-based assignments was valued because it (1) improved understanding of effective teamwork (96%), (2) prepared students for teamwork in practice (91%) and (3) assisted students to develop communication (100%) and social skills (91%). The team-based approach was viewed as fitting for different types of assignments (88%), even essays. Team based assignments were enjoyable (76%) although stark divisions were evident between first year students resistant to undertaking team-based assignments and those who were willing. Students identified problems with power issues, unprofessional communication, and with team coordination.Well structured and supported team-based academic assignments are a valuable way to teach teamwork skills to midwifery students. Teamwork skills need to be actively taught and practised in lectures and tutorials so that students clearly know what is required.

Final year students' learning experiences of the Bachelor of Midwifery course

Aimthe aim of the study was to explore the concerns of 3rd year Bachelor of Midwifery students. Backgroundearlier research indicates that midwifery students experience a number of conflicting learning demands and expectations, during their student years. These difficulties can lead to anxiety and a lack of confidence, which have implications for student integration and socialisation into the profession. Methodsa qualitative method was used, underpinned by Smith and Osborn's (2008) approach to interpretative phenomenological analysis IPA. In-depth interviews were conducted among 10 senior midwifery students as they looked back over their three year course. Data were analysed using steps proposed by Smith and Osborn (2008). Key findingsmore than two-thirds of participants were over 35 years, and had two or more children. More than half were living with a spouse/partner and the majority worked 16 hours or less per week. Themes emerging from the data included (1) linking theory to practice; (2) a focus on clinical skills; (3) learning expectations and experiences; and (4) the role of midwifery lecturers/educators. Conclusions and implications for practicemidwifery students experience a number of challenges associated with their pre-registration midwifery education, including difficulty understanding the relevance of some study units to midwifery practice. A strong focus on practical skills may inhibit the development of cognitive skills such as critical evaluation and reflection.