Experiences Of Student Midwives Research Articles

Exploring student midwives’ experiences regarding completion of the midwifery register at a nursing college in Eastern Cape Province, South Africa

Background. The midwifery register forms part of basic nursing education. Notably, student midwives struggle with completion of the prescribed midwifery register.Objective. To explore and describe the experiences of student midwives regarding their completion of the midwifery register at a nursing college in Eastern Cape Province, South Africa.Methods. This qualitative study had an exploratory, descriptive, contextual design, and in-depth individual interviews were held. Tesch’s method was used to analyse data.Results. Three themes emerged, i.e. positive experiences related to completion of the midwifery register; negative experiences regarding completion of the midwifery register; and factors that contributed to the lack of completion of the midwifery register.Conclusion. The study findings recommend greater collaboration between different stakeholders to improve skills acquisition and completion of the midwifery register.

A study to evaluate the introduction of the Newborn Infant Physical Examination knowledge and skills into an undergraduate pre-registration midwifery education programme

Newborn Infant Physical Examination is recommended between six to 72 h from birth and the midwife is ideally placed to undertake this screening examination. In the United Kingdom only a small percentage of midwives are competent to undertake this screening, and is usually taught once qualified. The aim of this qualitative study was to explore the experiences of student midwives in relation to the impact and effectiveness of introducing the theory of Newborn Infant Physical Examination into an undergraduate midwifery curriculum and the opportunity to apply the skills in practice. Two focus groups with final year student midwives (n = 11) were undertaken. The transcribed interviews were reviewed by the researchers and thematically analysed. Three themes emerged: i) timing of the theoretical content, ii) applying theory to practice iii) holistic care. Recommendations include the importance of incorporating the theoretical elements into the programme even if students do not have the opportunity to become competent in the required skills. Most students favoured the theory elements to be threaded throughout the three year programme rather than having a single dedicated module. Students identified that when midwives completed the newborn examination, holistic care was improved.

Exploring the experiences of student midwives completing the newborn infant physical examination: part 2

Background This is the second part of a series of two papers which explores the use of interpretative phenomenological analysis (IPA) within midwifery education in order to examine students' perspectives of the newborn infant physical examination (NIPE). Part one, featured in the British Journal of Midwifery volume 28, no 2, explains the background to the development of the study and explores the use of IPA within an emerging aspect of midwifery education. Part two of the series will present the research findings and implications for practice. Objectives This study aims to explore the experiences of student midwives completing the theory and practice aspects of the NIPE within a pre-registration midwifery programme. Design A qualitative design was utilised to analyse data collected by semi-structured interviews. Setting A large university in the West Midlands geographical area. Participants Five student midwives were purposively selected to participate in the study. Methods This study was conducted using IPA. Findings Three superordinate themes were generated: learning by doing, mentorship and transition to qualification. The findings demonstrate the significance of student midwives being exposed to the practical aspect of the NIPE during their training. Conclusions The study findings indicate that standardisation is required within preparation to undertake the NIPE within clinical practice. Higher educational institutes must also provide greater support with regards to the mentorship of student midwife NIPE practitioners. Further research should examine the maintenance of the NIPE role within newly qualified midwives.

Exploring the experiences of student midwives completing the newborn infant physical examination

Background The newborn and infant physical examination (NIPE) is a screening programme now undertaken by specially trained midwives. It is increasingly a feature within pre-registration midwifery educational programmes. Objectives To explore the experiences of student midwives completing the theory and practice aspects of the NIPE within a pre-registration midwifery programme. Design A qualitative design was utilised to analyse data collected by semi-structured interviews. Method This study was conducted using interpretative phenomenological analysis (IPA). Findings Three superordinate themes were generated: learning by doing, mentorship and transition to qualification. The findings demonstrate the benefits of student midwife exposure to practical aspects of NIPE. Conclusions Findings indicate that standardisation is required with NIPE education and clinical practice. Preceptorship programmes must effectively prepare newly qualified midwives to undertake the NIPE role. Higher educational institutes must provide greater support to the midwives providing mentorship of student midwife NIPE practitioners. Further research should examine the maintenance of the NIPE role following qualification as a midwife.

An Exploration of Student Midwives’ Lived Experiences Regarding Confidence and Satisfaction in Medium-Fidelity Simulation

Background Newly qualified midwives are expected to exhibit some level of confidence in practice when they enter the clinical environment. Objective To explore the lived experiences of student midwives after exposure to medium-fidelity simulation concerning confidence and satisfaction. Methods This qualitative, interpretive, phenomenological analysis study was conducted on a purposive sample of five, fourth-year Baccalaureate of Nursing Science student midwives at the University of Fort Hare. In-depth semi-structured interviews were conducted. Data analysis applied the interpretative phenomenological analysis approach. Results Superordinate theme sense of fulfilment elicited six sub-ordinate themes namely 1) Transferability of skills 2) Knowledgeable 3) Equipment used during simulation 4) Realism of simulation 4) Sense of accomplishment 5) Sure/unsure of performance. The use of a standardised patient during the simulation instead of a mannequin prepared participants for the real clinical environment. After being involved in the simulation, participants became more inquisitive regarding the management of the simulated condition. Satisfaction with simulation depended on whether the simulation activity met the student’s expectations, and if the simulation equipment resembled real clinical equipment. Post-partum haemorrhage simulation bridged the gap between theory and practice. Conclusion Confidence and satisfaction of student midwives during simulation is depended on the realism of the simulated activity. Exposure to simulated activity increases student knowledge. The student acknowledged that simulation can bridge the gap between theory and practice.

“Am I too emotional for this job?” An exploration of student midwives' experiences of coping with traumatic events in the labour ward

Backgroundmidwifery is emotionally challenging work, and learning to be a midwife brings its own particular challenges. For the student midwife, clinical placement in a hospital labour ward is especially demanding. In the context of organisational tensions and pressures the experience of supporting women through the unpredictable intensity of the labour process can be a significant source of stress for student midwives. Although increasing attention is now being paid to midwives’ traumatic experiences and wellbeing few researchers have examined the traumatic experiences of student midwives. Such research is necessary to support the women in their care as well as to protect and retain future midwives. Aimthis paper develops themes from a research study by Davies and Coldridge (2015) which explored student midwives’ sense of what was traumatic for them during their undergraduate midwifery education and how they were supported with such events. It examines the psychological tensions and anxieties that students face from a psychotherapeutic perspective. Designa qualitative descriptive study using semi-structured interviews. Settinga midwifery undergraduate programme in one university in the North West of England. Participants11second and third year students. Analysisinterviews were analysed using interpretative phenomenological analysis. Findingsthe study found five themes related to what the students found traumatic. The first theme Wearing the Blues referred to their enculturation within the profession and experiences within practice environments. A second theme No Man's Land explored students’ role in the existential space between the woman and the qualified midwives. Three further themes described the experiences of engaging with emergency or unforeseen events in practice and how they coped with them (“Get the Red Box!”, The Aftermath and Learning to Cope).This paper re-examines aspects of the themes from a psychotherapeutic perspective. Key conclusionsresearchers have suggested that midwives’ empathic relationships with women may leave them particularly vulnerable to secondary traumatic stress. For student midwives in the study the close relationships they formed with women, coupled with their diminished control as learners may have amplified their personal vulnerability. The profession as a whole is seen by them as struggling to help them to safely and creatively articulate the emotional freight of the role. Implications for practicefor midwifery educators, a focus on the psychological complexities in the midwifery role could assist in giving voice to and normalising the inevitable anxieties and difficulties inherent in the role. Further research could explore whether assisting students to have a psychological language with which to reflect upon this emotionally challenging work may promote safety, resilience and self-care.

Experiences of student midwives learning and working abroad in Europe: The value of an Erasmus undergraduate midwifery education programme

Backgrounduniversities in the United Kingdom are being challenged to modify policies and curricula that reflect the changing global reality through internationalisation. An aspect of internationalisation is study abroad which the European Commission Erasmus exchange programme is just one means of addressing this. Objectiveto explore the experiences of student midwives who are engaged in the Erasmus exchange programme and the effect it has on their learning and working in an international context. Designapproval for the small phenomenological cohort study was obtained from two participating universities: the University of Malta and University of Nottingham. Data were collected from 13 student midwives from a total of five cohorts in the form of diaries to explore their experiences of learning and working in another country. Thematic analysis supported by Computer-Assisted Qualitative Data Analysis Software was used to identify five recurrent themes emerging from the data: the findings of which have served further in developing this programme. Findingsstudents valued the opportunity of undertaking study and midwifery practice in another culture and healthcare system, extending their knowledge and development of clinical competence and confidence. For some, this was the first time outside of their home country and adaptation to a new environment took time. Support from their contemporaries, lecturers and midwife mentors however, was overwhelmingly positive, enabling the students to feel ‘part of the local university / midwifery team’ By the end of the programme, the students recognised that they had become more independent and felt empowered to facilitate developments in practice when they returned home. Implications for Education / Practicethis innovative development embracing internationalisation within the curricula has the potential to increase students’ employability and further study within Europe and beyond. It can be used as a vehicle to share best practice within an international context, ultimately making a difference to the quality of care childbearing women, their babies and families experience worldwide.

Experiences of student midwives in the care of women with perinatal loss: A qualitative descriptive study

Background: Student midwives often encounter perinatal loss, such as stillbirth and neonatal death, as part of their experience of clinical practice. Coping with these events can be challenging because loss and death are the antitheses of birth, which predominates midwifery practice. There has been limited research on how student midwives are supported when caring for women with bereavement; however, poor support may have repercussions for future practice. Aim: The aim of this study is to explore the experiences of final-year student midwives when caring for women with perinatal loss. Methods: Two focus groups were conducted with 10 final-year BSc (Hons) Midwifery students. The focus groups lasted approximately 1 hour and used a semi-structured interview schedule. Data were analysed using thematic analysis. Findings: Four key themes were identified from the data: preparation for perinatal loss; ‘just dealing with it’; contradiction and challenges with the role of the midwife; and emotional impact and coping strategies. Conclusions: Final-year student midwives believed they were ill-prepared in caring for women with perinatal loss, reported difficulties in communicating with women and believed they were excluded from their care. Students valued support from the bereavement midwife and identified effective strategies which helped them cope with bereavement and loss.

Student midwives' perspectives on efficacy of feedback after objective structured clinical examination

Students' experience of feedback is considered an indicator of the efficacy of the assessment process. Negative experiences of feedback are unproductive in terms of the likelihood that students will act on and learn from assessment. To understand the impact of feedback on learning, this study explored the experiences of student midwives after receiving feedback following objective structured clinical examination (OSCE). Data were collected from second-year undergraduate student midwives who had recently completed OSCE, via a focus group. Students reported raised stress levels, concerns around legitimacy of feedback, and inconsistencies in the manner in which feedback was articulated. Assessment feedback in higher education should be used to empower students to become self-regulated learners. This is important for student midwives, for whom a considerable amount of learning is spent in practice. The study has implications for midwifery academics concerned with modes of assessment and quality of assessment feedback in midwifery education.

‘No Man׳s Land’: An exploration of the traumatic experiences of student midwives in practice

Backgroundthe role of being ‘with woman’ during traumatic birth has been identified as having an emotional cost for midwives, but to date no research has explored traumatic experiences of student midwives. Aimto explore student midwives׳ perceptions of what was traumatic for them and how they were supported with such events. Designa qualitative descriptive approach, using semi structured interviews. Settingone university in the North West of England. Participants11 student midwives recruited by poster campaign. Findingsfive main themes emerged from the analysis. Wearing your Blues depicted what participants described as the ‘bleak’ landscape of practice. No Man’s Land was concerned with traumatic tensions in the student role. ‘Get the Red Box! ’ and The Aftermath concerned traumatic events in practice and the impact of these on students. Learning to cope related to the way students coped with such incidents, as well as other stresses in the role. Key conclusionsthe student midwife inhabits a vulnerable position in the ‘No Man’s Land’ of hospital practice. Her11In this paper we refer to the student midwife as female, because all the participants were women. strong identification with the woman renders her potentially more vulnerable in traumatic situations. The study revealed a paradigmatic clash between the manualised care of a busy obstetric unit and the individualised woman-led approach they were expecting. Implications for practiceit seems important for the profession to recognise that distressing events are not always the obvious critical incidents in care, and that a culture of support and/or debriefing after adverse events may assist students to articulate their needs and develop resilience. Educators may need to appreciate that the student midwife role in an emergency may heighten her vulnerability.This study also highlighted the potential alienation of students when placed in the maelstrom of a busy obstetric unit. The Birthplace study (Brocklehurst et al., 2011), NHS England’s Five Year Forward View (NHS England, 2014) and NICE (2014) all recommend increasing the numbers of out-of-hospital births: it seems likely that such a reorganisation of care would improve the experiences of mothers and those who care for them during birth. As part of a ‘design for compassionate care’ (Crawford et al., 2014) it is important to foster spaces, processes and resources which are compassionate to practitioners and students.

‘Mutual newness’: mothers' experiences of student midwives

Women describe establishing a trusting relationship with the midwives caring for them as a key feature of effective care. In most maternity settings, women will frequently receive this care from student midwives, yet their contribution has not been explored from the women's perspective, or its value discussed. This is part 2 of an article exploring the application of phenomenology in midwifery research. This article critically discusses the key findings from a small study that explored the experiences of 7 women, both primigravid and multigravid, who received care from student midwives during labour and birth. The meaning, or essence, of the encounter between woman and student midwife was sought and described. Women rated their care from the student midwives very highly and found them to be consistently kind, supportive and helpful. In particular, women valued the uniqueness of their relationship with the students. The essence of the experience has been conceptualized as ‘mutual newness’; both women and learners are on separate journeys to motherhood and professional status, yet encounter similar losses and gains along their respective paths.

Who am I now? The experience of being a post-registration children’s student nurse in the first clinical placement

Role transition from staff nurse to post-registration student is not a well researched area of nursing. Two previous Irish studies have been reported of the experiences of post-registration midwifery students [McCrea, H., Thompson, K., Carswell, L., Whittington, D., 1994. Student midwives' learning experience on the wards. Journal of Clinical Nursing 3, 97-102; Begley, C., 1997. Midwives in the making: a longitudinal study of the experiences of student midwives during their two-year training in Ireland. Unpublished PhD Thesis, School of Nursing and Midwifery, Trinity College, Dublin.] but there is limited research into post-registration children's student nurses experiences. A broadly phenomenological approach was employed to interpret what it means to be a post-registration children's student nurse during the first clinical placement. Data was collected from a purposive sample of six students, using unstructured tape recorded interviews. Thematic content analysis was utilised to produce an interpretation of nurses' experience within the first clinical placement. The findings reflect the participants' role confusion when changing from being a staff nurse in one discipline of nursing to being a post-registration student in another. They find previous experience is not recognised and that students originating from different disciplines in nursing have different experiences within the first placement. Coping mechanisms are discussed along with preparation for and supports available in the clinical area.

'Great fleas have little fleas': Irish student midwives' views of the hierarchy in midwifery.

Many studies have investigated the world of the student nurse, but there is little work into the lives and experiences of student midwives. Studies of Irish midwives' provision of care have demonstrated that they are not fulfilling their complete role, and research into their education was deemed to be necessary. To explore the opinions, feelings and views of student midwives as they progressed through their 2-year education programme in Ireland. Both quantitative and qualitative methods were used and the qualitative sections of the study were guided by the phenomenological approach. Ethical approval was granted. All students in the first intake of 1995 in all seven midwifery schools in Southern Ireland agreed to take part (n=125). Individual and group interviews, diary-keeping and questionnaires collected data. The findings presented in this paper describe the students' views of the hierarchical structures in midwifery, and the role and behaviours of the 'Matron'. The data describes a subculture of nursing/midwifery subordination. One reason for the hierarchical nature of the midwifery profession may be because it is an almost totally female-dominated profession, with the female hierarchy exercising control over other women within a male-based power structure. Many hospitals preferred to employ their own students as staff, ensuring a continuation of the hierarchical regime. The recurring nature of this problem may be because midwives now fear change more than they desire it. Further research is required to ascertain whether the reason for the strong hierarchy is because of the continuation of midwifery from the male-dominated profession of nursing, to the existence of the industrial/economic model of maternity care or to the impact of the medicalization of childbirth.

Student midwives' learning experience on the wards

This paper is based on an investigation into the learning experiences of student midwives in the clinical setting in one maternity unit in the Republic of Ireland. A questionnaire approach was adopted for the data collection and 42 student midwives participated in the study. A number of factors were identified which appear to influence students' experiences of 'learning on the job'. The quality of their clinical teaching and their observations of the way in which trained staff practise midwifery may influence their decision to continue practising midwifery following registration. These findings clearly point to the importance for midwives to reassert their true role as 'independent practitioners' of normal maternity care.

Students of midwifery: ‘Doing the obs’ and other coping strategies

The paper is based on qualitative research on the early experiences of student midwives in one school of midwifery. During their initial encounters the students go through a status passage from experienced nurse to novice midwife. Student diaries and ethnographic data were used to explore how students manage the transition and to document their coping strategies. In particular it is shown how, in response to the uncertainties of their new status, student midwives may revert to routinised nursing activities.