Midwifery Program Research Articles

Life-limiting fetal conditions: Are Australian student midwives prepared? A mixed-methods survey.

To document current teaching methods, curriculum, and perceived educational preparation related to the teaching of life-limiting fetal conditions, termination, and perinatal palliative care to Australian student midwives. Australian women receiving a diagnosis of a life-limiting fetal condition are generally offered a choice between termination of pregnancy and perinatal palliative care. Midwives are often involved with caring for these women. What Australian student midwives are being taught about life-limiting fetal conditions, termination of pregnancy, and perinatal palliative care during their entry-to-practice program is unknown. This study utilised a mixed-methods descriptive approach for data collection and analysis. Academic Leads of all Australian entry-to-practice midwifery programs received a questionnaire exploring topics taught, teaching time, teacher role, and perceived effectiveness of student preparation. Data was analysed statistically and thematically. Twelve of 24 Academic Leads responded (50%); only five stated their programs taught all three areas. More respondents taught about termination of pregnancy (10/12) than perinatal palliative care (7/12). On average 5.8 (±2.8) total hours was spent teaching about life-limiting fetal conditions, termination of pregnancy, and perinatal palliative care during the entire midwifery program, with a range of 1 - 10h. The free-text data identified three central themes: lack of value within the curriculum; disconnect between the university and the placement hospital; and preparation for practice. Most (10/12) Academic Leads did not believe student midwives are prepared to care for affected families. Entry-to-practice midwifery programs vary considerably in their education surrounding life-limiting fetal conditions, however teaching hours overall were low and most Academic leads did not feel (or know if) their students were adequately prepared. Further research is required to determine if early career midwives find their university education in life-limiting fetal conditions adequate preparation for practice, and to then remediate identified deficiencies.

The use of educational technology in teaching and assessing clinical psychomotor skills in nursing and midwifery education: A state-of-the-art literature review.

An integral part of both undergraduate and postgraduate nursing and midwifery programmes, is the teaching and assessment of clinical psychomotor skills. In order to provide safe care, there is an expectation that technical nursing procedures are performed competently and effectively. Due to limited opportunities to practice clinical skills there is a challenge to advance and implement innovative teaching approaches. Technological advances provide us with alternative options, outside of the traditional teaching approaches, to teach these skills. The aim of this state-of-the-art review was to examine and provide an overview of the current use of educational technologies in nursing and midwifery education in teaching clinical psychomotor skills. A-state-of -the-art literature review was carried out, as this type of evidence synthesis design reveals the current knowledge on a topic and identifies gaps for future research. We used a focused search strategy with the expertise of a research librarian. Data extraction included research designs and educational theories guiding the included studies along with the type of technologies studied. A descriptive summary of each study's findings in relation to the educational outcomes was performed. Sixty studies were sourced which met this reviews' eligibility criteria. Technologies in which most research was carried out included; simulation, video and virtual reality. The most common research design noted included randomized or quasi-experimental studies. The vast majority of studies (n = 47) did not elaborate whether educational theories guided them, while of the remaining thirteen studies, eleven theoretical frameworks were reported. Technology use in nursing and midwifery educational research surrounding psychomotor skills education is present. The educational outcomes reported by the majority of studies on the use of educational technology in teaching and/or assessing clinical psychomotor skills are encouraging. Additionally, the majority of studies noted that students evaluated the technology positively and were satisfied with its use in their education. Future research may include evaluating the technologies in both undergraduate and postgraduate populations. Finally, opportunities exist to expand the evaluation of student learning or assessment of these skills using technologies from the educational environment to the clinical environment. Not registered.

A secondary mixed methods analysis examining midwives’ responses regarding patient sexual orientation and gender identity (SOGI) disclosure

ObjectiveRecent research suggests that midwives generally have positive attitudes towards sexual and gender minority (SGM) clients; however, little research has examined whether and how these attitudes translate into specific clinical practices. In this study, we performed a secondary mixed methods analysis to examine midwives’ beliefs and practices regarding the importance of asking and knowing their patients’ sexual orientation and gender identity (SOGI). MethodsA confidential, anonymous paper survey was mailed to all midwifery practice groups (n = 131) in Ontario, Canada. Participants were midwives who were members of the Association of Ontario Midwives who responded to the survey (n = 267). Sequential explanatory mixed methods analysis was employed: quantitative SOGI questions were analyzed first, followed by qualitative open response comments to explain and contextualize the quantitative findings. FindingsMidwives’ responses indicated that it was not important to know or ask about clients’ SOGI because (1) it is not necessary to be able to provide the best care to everyone, and (2) the onus is on the client to disclose SOGI. Midwives indicated that they would like more training and knowledge to be able to confidently care for SGM. Key Conclusions and Implications for PracticeMidwives’ hesitancy to ask or know SOGI demonstrates that positive attitudes do not necessarily translate into current best practices for obtaining SOGI data in the context of SGM care provision. Midwifery education and training programs should address this gap.

Can peers improve student retention? Exploring the roles peers play in midwifery education programmes in Canada

ProblemPeer support is understudied as a factor that can impact midwifery student retention. BackgroundRetention of midwifery students is essential for creating a sustainable maternity care workforce. Research shows that peer support positively influences students’ experiences, but it needs more focus on the role peers play in student retention. AimWe aimed to examine how peer support can facilitate midwifery students’ retention by exploring the role peers play in students’ experiences and identifying the types of support students offer each other. MethodsWe conducted 31 semi-structured interviews with students attending Midwifery Education Programmes across Canada. Data were analysed inductively, following the constructivist grounded theory method. FindingsWhile motivated and engaged peers improved students’ learning experiences and desire to remain in their program, peers who created an overly competitive academic environment hindered learning. Students also noted that a lack of diversity, particularly of Black and Indigenous peers, limited their ability to learn about culturally safe care. Most students felt a sense of community and relied on one another for emotional, academic, and instrumental support. DiscussionPeer support has mostly positive effects on student learning and should be formalized by midwifery educators to improve retention. Reducing pressure to succeed, targeting recruitment of students who are Black, Indigenous, and People of Colour, and establishing formal mentorship programmes could enhance the role peers play in student retention. ConclusionWhile retention of students is a complex issue, positive interactions with peers can create a stimulating learning environment and increase students’ desire to stay in their programme.

Gambaran Tingkat Pengetahuan dan Tingkat Kecemasan Mahasiswa Tingkat Tiga Prodi DIII Kebidanan Poltekkes Karya Husada dalam Menghadapi Ujian Kompetensi Exit Exam sesuai Permendikbud No 2 Tahun 2020

Anxiety is an emotional state with the onset of discomfort in third-grade students of midwifery, and is a vague experience accompanied by feelings of helplessness and uncertainty caused by something that is not yet clear, because students will face the exit exam competency test for the first time. The purpose of the study in general is to find out the level of knowledge and anxiety levels of students facing the exit exam competency test. This type of research is descriptive analytics with a cross sectional approach, the population is a third-level student midwifery program, numbering 21 respondents, using primary data. Research time from June to December 2021. The results showed that the majority of students aged 21 years as many as 47.6% or 10 students. The majority of knowledge about the exit exam competency test has knowledge of either 80.95% or 17 students, and who have sufficient knowledge as much as 19.05% or 4 students, the majority of student anxiety levels are not anxious 80.95% or 17 students, mild anxiety levels 4.76% or 1 student, and severe anxiety levels 9.52% or 2 students, and very severe anxiety levels 4.76% or 1 student. Anxiety should be handled properly immediately otherwise it will have an impact on the student that is unable to concentrate properly so that it will not get maximum grades.

A Sierra Leone 2021 Midwifery Clinical Training Needs Assessment: A Call to Action to Augment Clinical Precepting.

Sierra Leone has one of the highest maternal mortality and infant mortality rates globally. We share findings from a Midwifery Clinical Training Needs Assessment, conducted in 2021 as a collaboration between the Government of Sierra Leone and Seed Global Health. The assessment identified existing needs and gaps in midwifery clinical training at health facilities in Sierra Leone from various stakeholders' perspectives. The descriptive needs assessment utilized mixed methods, including surveys, focus group discussions (FGDs), interviews, and reviews of maternal medical records. The following showed needs and gaps in labor and delivery management; record keeping; triage processes; clinical education for students, recent graduates, and preceptors; and lack of infrastructure and resources. The knowledge gained from this needs assessment can further the development of midwifery clinical training programs in Sierra Leone and other low-income countries facing similar challenges. We discuss the implication of our findings.

A Framework for teaching Cultural Competence in an Undergraduate Midwifery Programme

Culturally-appropriate maternity services are critical to safe and equitable care for birthing people and families, yet inequalities and discrimination impact individuals accessing and working in maternity services daily. Engaging in solutions, academics must embed opportunities to gain knowledge and understanding of race, ethnicity and diversity within undergraduate midwifery curricula – specifically designing learning to promote meaningful student introspection. The aim is to influence future midwives to provide care which sensitively meets the social, cultural and spiritual needs of the person. This article explores pedagogy and the use of a structured flipped classroom in cultural competence within the midwifery programme.

The influence of route of entry on a Pre-Registration Midwifery education programme.

Entry to midwifery education in the United Kingdom (UK) typically requires three A-Levels. However, the commitment to widening access to university has led to a growing number of students accessing midwifery education with ‘non-traditional’ qualifications. It is not known if widening access to include such entry qualifications has an impact on degree attainment or retention of students in midwifery education. This retrospective cohort observation study looked at entry route and outcomes, in a single higher education midwifery programme. Findings identify that route of entry does not have an impact on retention of students or final degree classification awarded.

PENYUSUNAN DAN UJI COBA PROGRAM INTERPROFESSIONAL EDUCATION (IPE) DARING PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS X: SEBUAH STUDI DENGAN METODE CAMPURAN

InterProfessional education (IPE) is a strategy used to prepare interprofessional collaboration teams in the future. However, with the various restrictions on social interaction during the COVID-19 pandemic, it encourages innovation in learning methods. Therefore, this study aims to design an online interprofessional learning module at the Faculty of Medicine of X University (FK X) as a strategy to prepare collaboration teams in the future. This study uses a mixed-method approach to obtain the data needed. A qualitative approach is used to obtain an overview of stakeholders' needs for online IPE learning design. The respondents consisted of study program leaders, lecturers and students of several study programs at the Faculty of Medicine, University X (FK X). Data collection was carried out with structured interviews and focus group discussions (FGDs). The data is recorded and made verbatim, then coding is carried out and arranged into themes and sub-themes. Evaluation of the online IPE teaching design was carried out by measuring students' perceptions of interprofessional education before and after taking the module using the IEPS (Interdisciplinary Education Perception Scale) questionnaire. The first stage of qualitative research (structured interviews and FGDs) on the leadership element, 2 lecturers, and 5 students of each study program resulted in as many as 14 themes and 47 sub-themes which were described into module learning outcomes, study topics, learning activities, and characteristics of online IPE module students. The module evaluation was carried out by testing the differences in perceptions of 252 students towards pre- and post-module interprofessional education. Wilcoxon's bivariate test results showed a significant difference in perception scores for post-module inteprofessional education compared to premodule( p=0.00). There is a positive difference, namely the number of post-module scores that are greater than the pre-module score of 141 people. The increase in perception scores can also be seen from the results of the bivariate analysis of the Medicine, Nursing, Midwifery, and Psychology Study Programs. This research shows that the implementation of the FK X online IPE module has succeeded in increasing students' perceptions of competence and autonomy, the perceived need to cooperate, and perceptions of interprofessional cooperation. This breakthrough is an alternative solution that can be considered for interprofessional learning during a pandemic

Obstetric ultrasound training programmes for midwives: A scoping review.

Antenatal care is essential for all expectant mothers and assists in reducing maternal mortality rates thus addressing the Sustainable Development Goal 3. Obstetric ultrasound complements antenatal care and is used in pregnancy to identify and monitor high-risk pregnancies. However, disparities exist and in low- and middle-income countries, ultrasound services are not readily available. This contributes to maternal and neonatal morbidity and mortality within these populations. Short ultrasound training programmes for midwives can be beneficial in alleviating some of the challenges experienced. The aim of this scoping review was to identify global ultrasound education programmes for midwives. Articles containing suitable keywords were retrieved from databases suitable to nursing, education and ultrasound. Themes were developed based on the articles included in the review. A total of 238 articles were identified, and after the duplicates and irrelevant studies were removed, 22 articles were included. Articles were analysed and discussed under the identified themes and categories. It is essential that sufficient training is provided to medical professionals performing obstetric ultrasound so that adequate and safe care is offered to expectant mothers. With the introduction of ultrasound in low-resource settings, the knowledge of safety and competencies required to operate the equipment necessitate adequate training. Developed programmes have been found to meet the demands of the ever-changing workforce and allow for midwives to perform focused obstetric ultrasound examinations. This scoping review highlighted ultrasound training programmes for midwives and provided guidance on the development of future midwifery ultrasound training programmes.

Taking up the challenge of trans and non-binary inclusion in midwifery education: Reflections from educators in Aotearoa and Ontario Canada

Perinatal services are being challenged to acknowledge that not all pregnant and birthing people are women and to ensure the design and delivery of services that are inclusive of, and deliver equitable outcomes for, trans, non-binary, and other gender diverse people. This is posing unique challenges for midwifery with its women-centred philosophy and professional frameworks. This paper presents the critical reflections of midwifery educators located in two midwifery programmes in Aotearoa11Aotearoa is the Māori language name for New Zealand. In recognition of Aotearoa as the Indigenous land of tangata Māori (the Māori people) the title Aotearoa will be used throughout the article. and Ontario Canada, who are engaged in taking up the challenge of trans and non-binary inclusion in their local contexts. The need to progress trans and non-binary inclusion in midwifery education to secure the human rights of gender diverse people to safe midwifery care and equitable perinatal outcomes is affirmed. We respond to an existing lack of research or guidance on how to progress trans and non-binary inclusion in midwifery education. We offer our insights and reflections organised as four themes located within the frameworks of cultural humility and safety. These themes address midwifery leadership for inclusion, inclusive language, a broader holistic approach, and the importance of positioning this work intersectionally. We conclude by affirming the critical role of midwifery education/educators in taking up the challenge of trans and non-binary inclusion to ensure a future midwifery workforce skilled and supported in the provision of care to the growing gender diverse population.

Women’s experiences of continuity of care from student midwives – A qualitative study from Norway

ObjectiveThe study aimed to gain a deeper understanding of women's experience of continuity of care by student midwives during the childbearing process. MethodA qualitative approach was the design used in this study. In-depth interviews were conducted with nine women who had received continuity of care during their childbearing process by student midwives. The interviews were analysed with the help of systematic text condensation. The study was approved by the Norwegian Centre for Research Data (ref. 905085) and the Regional Research Ethics Committee (ref. 2019/608). FindingsContinuity of care enabled a deep relationship between the woman and the student midwife and made the care provided more individualised, giving the woman emotional support and preparing her for birth. The presence of a student midwife during labour and birth who knew the woman’s story made the woman able to focus on the birth process. Even when unexpected events occurred, the woman had a positive birth experience due to the relationship between her and the student midwife. Continuity of care made the women feel safe and taken care of and was the preferred model of care. ConclusionContinuity of care contributes to individualised and personalised care, enabling all aspects of the woman's needs to be considered throughout the childbearing process. Due to the positive impact on the women in the present study, it is appropriate to implement a continuity of care model in midwifery education programmes. Further research should be conducted to examine how doing so would influence both student midwives and women.

Improving Speaking Skills through Tiktok Application: An Endevour of Utilizing Social Media in Higher Education

TikTok is one of the popular applications that contain short-video sharing. Every year, the number of users grows up in every country. They use TikTok not only as the media for entertainment and business but also as the media for learning. The aim of this research is to describe the effect of the TikTok application to improve students’ speaking skills. This research belongs to quasi-experimental research with group pre-post-test design involving 32 students in Diploma of Midwifery Program Universitas Muhammadiyah Kudus as the population. The sampling technique is total sampling with the experimental group (16 students) and control group (16 students). To know the students’ speaking skills, there are four components that must be measured, such as vocabulary, fluency, pronunciation, and comprehension. Moreover, the students’ score has been classified into five categories, they are very good, good, medium, low, and failed. After treatment, the score of speaking ability is improved for the experimental group. The vocabulary increases 45,6%, fluency increases 40,6%, pronunciation increases 31,6%, and comprehension increases 32,8% from the pre-test score. TikTok is a useful application that not only improves speaking ability but also improves the students’ creativity, motivation, and vocabulary.If the students have wrong in speaking, they not only get the academic punishment but also digital punishment.

The views and experiences of midwifery academics regarding LGBTQ+ health education in pre-registration programmes in the United Kingdom and Ireland: Qualitative findings from a mixed-methods study

AimThe purpose of this study was to identify the current LGBTQ+ health content within midwifery pre-registration programmes and identity education best practice and innovation. BackgroundThere have been significant developments in some countries in protecting the rights of LGBTQ+ people. LGBTQ+ people are and do become parents and require access to maternity services. Yet some report heteronormative assumptions, negative and discriminatory attitudes from midwives that results in barriers to service access and feelings of exclusion. DesignThis mixed-methods study involved a quantitative and qualitative design. The qualitative findings are reported here. MethodsAll 135 Schools of Nursing and Midwifery across the United Kingdom and Ireland were invited to participate in an online survey and qualitative interview. Thematic analysis of the qualitative data from 29 survey responses and seven midwifery follow-up interviews were conducted. ResultsThree themes identified following data analysis: (i) preparing midwifery students for practice; (ii) the diverse family unit; and (iii) safety, privacy and respect. ConclusionsThe findings provide insights into the challenges of meeting the education needs of midwifery students, with an opportunity to develop and implement a curriculum that is reflective of the needs and concerns of LGBTQ+ people within pre-registration midwifery programmes.

The Inclusion of LGBTQ+ Health across the Lifespan in Pre-Registration Nursing Programmes: Qualitative Findings from a Mixed-Methods Study.

Poor physical and mental ill-health is experienced by many LGBTQ+ people, compounded by a reluctance to access healthcare services. This reluctance is attributed to experiences of heteronormative assumptions and negative attitudes encountered. Despite increasing recognition of the need to include LGBTQ+ health in undergraduate healthcare programmes, inconsistencies and gaps in content, skills development, and assessment are still apparent. The aim of the study was to identify LGBTQ+ health content within nursing and midwifery pre-registration programmes and identify education best practice and innovation. A mixed-methods study involving a quantitative and qualitative design was undertaken. The qualitative findings from a nursing perspective were extracted from the dataset for further detailed analysis and are reported in this paper. Information about the study and an online survey were distributed to 135 Schools of Nursing and Midwifery in the UK and Ireland. Individual semi-structured online interviews took place with academics. Qualitative data from 29 survey responses and 12 follow-up interviews were thematically analysed. Eight of the 12 follow-up interviews were held with nursing academics and following data analysis three themes emerged: (i) LGBTQ+ health across the lifespan; (ii) taking the initiative for LGBTQ+ health inclusion; and (iii) identifying and overcoming challenges. The findings highlight the endeavours by nursing academics to integrate LGBTQ+ health within pre-registration programmes to meet the education needs of students and the opportunity to develop curriculum content to address the needs and concerns of LGBTQ+ people across the lifespan.

The Results of Evaluation Online Learning Using Hypnoteaching Method and Self-hypnosis

Hypnoteaching is a method that is attractive, provides comfort, and makes students feel happy when participating in the online learning process. This study aimed to determine the effect of online learning using hypnoteaching and self-hypnosis on the results of student learning evaluation. This type of research is quasi-experimental with a comparison group (post-test only with control group design) for 2 months. The research sample was all students in the Diploma III midwifery program, totaling 87 people. Data analysis was a significant difference in the mean value of learning evaluation results in the treatment group and the control group, it was concluded that the hypnoteaching and self-hypnosis methods were effective in improving student learning evaluation results. It is advisable to conduct research with learning motivation variables and measurement of brain waves.

An audit review of midwifery qualifications and distribution in Zambia

Background In Zambia, the last decade has seen the development of multiple midwifery qualification, including direct-entry midwifery, an advanced diploma in nursing and midwifery, or a Bachelor of Science, Master of Science or Doctor of Philosophy in midwifery programme. Despite advancements in midwifery training, there is no research on different categories of midwifery qualifications in Zambia and their competencies. Therefore, there is a need to review midwifery qualifications and the distribution of midwives in Zambia. The aim of this audit review was to evaluate qualification categories of midwives currently registered with the General Nursing and Midwifery Council of Zambia and the distribution of midwives across Zambia. Methods An audit review of midwifery qualifications and their distribution across Zambia was undertaken using the General Nursing and Midwifery Council of Zambia's register of nurses and midwives 2020. Data were extracted from the report and presented as frequencies. Results A total of 6112 midwives were registered by the General Nursing and Midwifery Council of Zambia at the time of data collection, of which the majority (87.6%) were women and registered nurse midwives (52.7%). The most common place of practice was a hospital (41.5%) and the greatest proportion of midwives worked in Lusaka (24.6%). Conclusions This audit review provides insights into midwifery qualification categories in Zambia and their distribution, and indicates that levels of practice should be clearly defined in terms of their competencies. With advancements in midwifery training, the authors believe there will be an increase in midwives' autonomy and their involvement in decision making at all levels of care.

Temeljni principi u izradi programa za obrazovanje medicinskih sestara i babica

Introduction: The this paper the authors describe the development of the education program for nurses in public health in the European Union (EU). Methods: This paper will present information from relevant professional/scientific data sources about the basic principles in the development of nursing and midwifery education programs, which will contribute to the development of new competencies of nurses in the field of health care and public health. The paper provides an overview of the Munich Declaration, followed by an overview of the educational systems for nurses and midwives in several countries of Western Europe and the Balkans. Topic: The authenticity of health care evaluation ensures the conditions for strengthening nurses' awareness of the value of their own profession and the independence of acquired competencies and skills from inappropriate external interference. Recognizing the profession or authenticity of nursing requires more education. All questions and reflections are focused on the identity and authenticity of the profession, emphasizing the value of nursing care, as well as the aspiration that the development of the nursing profession remains within the framework of the fundamental value. Conclusion: Today, nurses make a significant contribution to the health care system of a country at all levels of health care. In order to achieve the professionalization of nursing, it is necessary to transform nurses, which implies a high level of quality knowledge and skills, as well as an awareness of moral and ethical responsibility towards patients, colleagues and oneself.

Recruitment and selection: Establishing representation of LGBTQIA+ and inclusivity standards at the very onset of entering the midwifery profession

This article is a follow up to Samantha Meegan’s “Finding the Future Midwife: How the revised Standards of Proficiencies for Midwives Support Pre-registration Midwifery Programme Admissions Processes”, published in the November 2022 issue of The Practising Midwife.

Women's Perspectives on Cultural Sensitivity of Midwives During Intrapartum Care at a Maternity Ward in a National Referral Hospital in Zimbabwe.

Midwives attend intrapartum women of diverse ethnic backgrounds who each bring their cultural beliefs into the labor and delivery rooms. The International Confederation of Midwives has recommended providing culturally appropriate maternity care in its quest to increase skilled birth attendance and subsequently improve maternal and newborn health. This study aimed to examine midwives' cultural sensitivity during intrapartum care from women's perspectives, and how this relates to women's satisfaction with maternity care services. A qualitative phenomenological design was employed. Two focus group discussions were conducted with 16 women who had delivered in the labor ward of the selected national referral maternity unit. An interpretive phenomenological approach was used to analyze the data. This study revealed ineffective midwife-woman collaboration that excludes the incorporation of women's cultural beliefs in the design of maternity care plans. Emotional, physical, and informational support in the care provided to women during labor and childbirth was found to be incompetent. This suggests that midwives are not sensitive to cultural norms and do not provide woman-centered intrapartum care. Various factors implying midwives' lack of cultural sensitivity in their provision of intrapartum care were identified. Resultantly, women's expectations of labor are not met and this could negatively affect future maternity care-seeking behaviors. This study's findings provide policy makers, midwifery program managers and implementers with better insights for developing targeted interventions to improve cultural sensitivity for the delivery of respectful maternity care. Identifying factors that affect the implementation of culture-sensitive care by midwives could guide the adjustments required in midwifery education and practice.