Midwifery Program Research Articles

Design and implementation of an online admissions interview for selection to nursing and midwifery programmes: a partnership approach

BackgroundThe recent surge in applications to nursing in the United Kingdom together with the shift towards providing virtual interviews through the use of video platforms has provided an opportunity to review selection methodologies to meet a new set of challenges. However there remains the requirement to use selection methods which are evidence-based valid and reliable even under these new challenges.MethodThis paper reports an evaluation study of applicants to nursing and midwifery and reports on how to plan and use online interviews for in excess of 3000 applicants to two schools of nursing in Northern Ireland. Data is reported from Participants, Assessors and Administrators who were asked to complete an online evaluation using Microsoft Forms.ResultsA total of 1559 participants completed the questionnaire. The majority were aged 17–20. The findings provide evidence to support the validity and reliability of the online interview process. Importantly the paper reports on the design and implementation of a fully remote online interview process that involved a collaboration with two schools of nursing without compromising the rigour of the admissions process. The paper provides practical, quantitative, and qualitative reasons for concluding that the online remote selection process generated reliable data to support its use in the selection of candidates to nursing and midwifery.ConclusionThere are significant challenges in moving to online interviews and the paper discusses the challenges and reflects on some of the broader issues associated with selection to nursing and midwifery. The aim of the paper is to provide a platform for discussion amongst other nursing schools who might be considering major changes to their admissions processes.

Knowledge, Attitude and Self-efficacy towards Providing Sexual Counselling among Students Doing the Master of Counseling in Midwifery Program in Iran

Knowledge, Attitude and Self-efficacy towards Providing Sexual Counselling among Students Doing the Master of Counseling in Midwifery Program in Iran

Does the Stage of University Education Differentiate Midwifery Students in Terms of Their Behaviors in Certain Situations and Sense of Self-Efficacy?

Midwifery students’ behaviors in relevant spheres of their lives, as well as their sense of self-efficacy, can affect the process of training in the midwifery profession. The aim of the study was to determine the behaviors of students in Poland, assessed in a situational context, as well as their sense of self-efficacy in correlation with these behaviors at different levels of education in the midwifery profession. The study group included first- and third-year bachelor’s degree (BS) midwifery students, as well as master’s degree (MS) midwifery students. The survey was conducted on 1031 students. The ‘Inventory for Personality Assessment in Situations’ (IPS) and the General Self-Efficacy Scale (GSES) were used in the study. The largest group of students that were categorized as having problematic profiles was observed in the social-communicative domain, which indicates the necessity of introducing corrective and therapeutic actions concerning their interpersonal relations. The leading trait in the social-communicative domain among the BS students was sensitivity to frustration. The lowest self-confidence was observed among the third-year BS students. The average result of generalized self-efficacy among all the respondents was M = 28.36 (SD = 4.41), which indicates the average level of the obtained results. Students at different stages of midwifery programs demonstrate different behaviors when assessed in the situational context.

WHY WE HAVE TO REFORM MIDWIFERY EDUCATION?

Background: Learner, methods and contents are three important parts of the learning variables beside lecturer, academic environment and patients. Facts and new findings show that we need to reform these learning variables accordingly especially in Obstetrics and Midwifery domainGaps:maternal deaths is still high despite higher number of obstetricians, doctors and midwives; as well asthe government has encouraged an increase in the number of institutions providing midwifery study programs. On the other hand, new paradigm in education has been ordered by the Ministry of Education such as student-centred learning, Outcome-based education, and also other approaches suggested by expert in medical education such as holistic education, bedside teaching, feedback & reflection, and problem based learning. Thus modify educational content and method in obstetrics and midwivery inline with new facts and findings and appropriate methods is necessary.Recommendation: One alternative to modify educational content and methods in midwifery education that can be implemented in clinical learning is the continuity of care approach accompanied by continuous feedback. This approach is proven to be able to reduce maternal mortality and as an effort to synergize education in an effort to achieve government program targets. However, in reality, midwifery education institutions have not fully adopted this approach. So there is a need for leadership commitment to carry out learning reforms with a sustainable curriculum approach, continuous feedback, continuous assessment, continuous midwifery care and continuous supervision so that learning outcomes as outputs and reducing maternal mortality as an outcome can be as expected.

W3 - To-Get-There, Together: Creative Approaches to Mentoring Conversations

The workshop is designed to enable participants to experience some of the Appreciative Inquiry (AI) tools used within the NSW Health Mentoring in Midwifery (MiM) Program. The MiM Program aims to develop a reciprocal learning relationship that expands opportunities for connection, learning, growth and support for midwifery students and midwives working in NSW Health. The workshop will commence with an overview of the NSW Health MiM program as informed by relationship-centred practice and utilising an Appreciative Inquiry approach. Facilitators will work with participants in small groups to explore Appreciative Inquiry tools used within the MiM Program. In closing the workshop, participants will have an opportunity to reflect on the use of these tools and the variety of ways in which they can be integrated within practice. The workshop showcases the NSW Mentoring in Midwifery (MiM) Program and demonstrates how traditional hierarchical relationships can be opened up through the conversations that flow from the use of Appreciative Inquiry tools. Participants will gain insight into how these tools can facilitate conversations to quickly build relationships, uncover new learning, and support people to move forward, together. The Appreciative Inquiry tools practised at this workshop were included when developing a structured Mentoring in Midwifery Program in NSW to promote conversations about midwifery practice between the mentor and mentee. These tools are readily transferable and can be used in day-to-day practice to enhance conversations, engagement, reflection and learning in the moment with other staff, women, and their families.

O73 - Us, together- Co-creating a Mentoring in Midwifery Program in NSW

This presentation outlines the approach taken by NSW Health, Nursing and Midwifery Office to lead the co-creation and design of a new mentoring program for midwives. The NSW Health Mentoring in Midwifery Program (MiM) aims to develop a reciprocal learning relationship that expands opportunities for connection, learning, growth and support for midwifery students and midwives working in NSW Health. This presentation will outline how a co-creative process was used to collaborate with a range of midwifery leaders, midwives, and academics to envisage the MiM Program. The International Confederation of Midwives (ICM) Mentoring Guidelines and Principles of Appreciative Inquiry informed our approach. This presentation will describe the Senses Framework as the underpinning ingredient to promote learning in the workplace, and how this was enhanced using Appreciative Inquirer, Belinda Dewar’s Caring Conversations. The tools used to promote generative conversations about midwifery practice between the mentor and the mentee will be described. The NSW Health Midwifery Strategy aims to support midwifery leaders to respond to the needs of the profession now and into the future. MiM builds on previous work sponsored by the Nursing and Midwifery Office that revealed successful relationships between students and midwives was key to a sense of belonging and positive learning environments. Midwives valued the opportunity to provide a learning environment to students and recognised the importance of supporting our future workforce. A structured mentoring program was identified by midwives as an opportunity to strengthen the midwifery profession together. The intention of this work is to develop and implement an innovative and sustainable mentoring program that is transferable across all midwifery training and clinical facilities to become a normal part of midwifery culture in NSW. This program will support the midwifery profession, develop leadership at all levels and help in the retention of a strong, confident, and skilled midwifery workforce.

O29 - Accountability, Advocacy and Autonomy: the top intentions for midwifery student learning in the Continuity of Care Experience

Continuity of Care Experience (CoCE) is a practice-based learning experience for midwifery students in Australia. This mandated component of education leading to the registration as a midwife provides students the experience of providing continuity of care regardless of the setting the clinical practice takes place. Since implementation, no standardised learning intention or measure of learning outcome is evident. The aim of this research is to identify the common understanding of the purpose and learning objectives of the CoCE in midwifery programs from the perspective of midwifery professionals. This presentation discusses the themes identified from Australian midwifery professionals who hold expert opinion pertaining to how the CoCE is imbedded in curriculum. Two focus groups were conducted with a total of 17 midwifery professionals across Australia via virtual platform. Participants were midwifery academics, published authors on CoCE, researchers, policy makers and accreditation experts. The focus group discussions were facilitated using open-ended ‘prompt’ questions derived from themes identified from the integrative literature review. The discussion was recorded and transcribed verbatim. A thematic analysis of the qualitative data was undertaken. The analysis of the data identifying the common understanding and purpose of the CoCE exposed three themes. Three themes identified the learning objectives: accountability, autonomy, and advocacy. The CoCE afforded the midwifery student the opportunity to engage in learning underpinned by accountability of professional responsibility, advocacy for women, and autonomy in practice. The learning objectives accountability, autonomy, and advocacy are distinctive qualities the CoCE. As opposed to traditional clinical practice based model, the CoCE affords the midwifery student an engagement experience and exposure to develop a midwifery professional identity that enables woman centred care. This research identifies the intention of the CoCE learning and is an important step toward standardisation and strengthening this mandated component of curriculum.

O52 - Review of accreditation standards: A snapshot of the Midwife Accreditation Standards 2021

The purpose of this presentation is to highlight key aspects of the newly published Australian Nursing and Midwifery Accreditation Council’s Midwife Accreditation Standards 2021. The Australian Nursing and Midwifery Accreditation Council (ANMAC) uses the Midwife Accreditation Standards to accredit and assess entry to practice midwifery programs and the education providers who offer them. In developing the Midwife Accreditation Standards 2021, wide-ranging consultation was undertaken with key stakeholders in midwifery education. ANMAC received more than 250 submissions across three separate consultation periods. Stakeholders contributed feedback by way of online surveys, written submissions, and face-to-face consultation. Synthesis of stakeholder feedback is available on the ANMAC website. The consultation process identified several key areas for consideration including, governance arrangements, intraprofessional learning, digital literacy and midwife prescribing and diagnostics. These will be the focus of this presentation. Significant changes to the Midwifery Accreditation Standards 2021 include clarifying the requirements of the head of discipline role, as well as content related to intraprofessional learning and digital literacy. When developing these standards ANMAC consulted widely on the inclusion of prescribing in entry to practice midwifery programs though this was not ultimately included in the standards. Hence the inclusion of prescribing and diagnostic skills in future accreditation standards for undergraduate midwifery programs will also be explored. Additionally, some practical changes have been implemented by replacing the previous nine standards with five, and the inclusion of an Essential Evidence document to support the development of accreditation submissions

S2 - Taking Midwifery to the Top and Beyond: PNG Midwifery Rural Care Practicum Experience

Papua New Guinea (PNG) is Australia’ nearest neighbour, about 150 km from the top of the mainland and only a few kilometres from some of the Torres Strait Islands. Despite its proximity to Australia, PNG has one of the highest rates of Maternal Mortality. A woman in PNG is 80 times more likely to die in childbirth than a woman in Australia. There are multiple intersecting reasons for this, including lack of, or difficult access to midwifery services due to remoteness and geographical challenges. The midwifery education program at Pacific Adventist University (PAU) is addressing some of the access issues through taking midwifery to women in remote villages. The midwifery students in the PAU Bachelor of Midwifery program undertake a 280-hour, 8-week Rural Health Care Practicum experience towards the end of their studies. This year, the experience involved taking midwifery care up and over mountainous terrain and over open seas to deliver care to isolated women and families, or as the students describe – reaching out to the unreached. The midwifery students were accompanied by their Course Coordinator and Lecturer. The clinical practicum experience involves the students providing sexual, reproductive, maternal, and newborn care to remote communities and also undertaking community assessment projects like improving sanitation facilities, so their practicum has a lasting impact. The five-hour walk to the village up mountains and over rivers contributes to students’ understanding of the difficulties these communities face in accessing Universal Health Care and allows them to ‘walk a mile’ in others’ footsteps, thus developing empathy and understanding of the significant issues faced. This presentation provides a voice for the Bachelor of Midwifery students and staff to describe their experiences and discuss significant learning resulting from being together at the top (of the mountain) with women and communities in remote PNG.

O96 - How is cultural safety translated into midwifery practice? A review of the literature

Providing culturally safe maternity care for Aboriginal and/or Torres Strait Islander Australians is a key element of midwifery practice and in recent years this has been recognised in the professional codes and standards. The Australian Nursing and Midwifery Accreditation Council (ANMAC) Midwifery Education Standards (ANMAC, 2021), the International Confederation of Midwives (ICM) Code of Ethics (ICM, 2014) and the Nursing and Midwifery Board of Australia (NMBA) Code of Conduct for Midwives (NMBA 2018a) and the Midwife Standards for Practice (NMBA, 2018b) each identify that the provision of culturally safe care is integral to the midwifes role. Whilst research to date has explored midwifery academics awareness of cultural safety (Fleming et al., 2017), and how cultural safety is taught within midwifery education programs (Biles et al., 2021), it is important to understand how this knowledge, once registered, is understood, and translated into midwifery practice. To identify and map the literature that has explored midwives understanding of cultural safety and how this translates into practice. A scoping review of the literature was undertaken. Pre-determined electronic databases were searched, and the data extracted from the included articles was thematically analysed. The findings have identified that there is limited research about how midwives translate cultural safety into the care of Aboriginal and/or Torres Strait Islander women and their families.

O82 - Mandarin Caseload Midwifery Program-Using Non-English Language Concordance and continuity of midwifery care

This presentation will focus on the experiences of bilingual midwives providing care to Chinese born women. It will also discuss the results of a retrospective cohort study that evaluates birth outcomes of the Mandarin Caseload Midwifery Program (MCMP). Cultural variances become more pronounced during the perinatal period, and language difficulties can be more impactful for women from non-English speaking backgrounds affected by the heterogeneity of health determinants, needs, and vulnerabilities. Discordant language communication, when a woman and care provider don't share proficiency in the same language, creates an added disadvantage. Chinese-born women are the third-largest group of women giving birth in Australia, and more than 20% of them require an interpreter when receiving maternity care. However, migrants are not just recipients of care but are also increasingly represented amongst clinicians providing care. At Westmead Hospital, we used an opportunity to utilise bilingual midwives to provide caseload midwifery services for women who share their ethnic background and first language. MCMP was established within an existing low-risk entry, no exit model of caseload midwifery care. It started in August 2019 with two full-time Mandarin-speaking midwives, each caring for 36 women a year. By September 2021 MCMP looked after 142 Chinese born women and their babies. The Midwives providing the care develop strong relationships with women. They feel more confident delivering education in their first language and understand and support the cultural differences encountered when accessing the Australian healthcare system . Routine audits evaluated the outcomes of care, and the data in this retrospective cohort review demonstrates high levels of vaginal birth (87%), lower reliance on epidural analgesia (30%), and shorter hospital stays. Westmead hospital MCMP demonstrates the benefits of language concordant care for midwives using bilingual skills and maternity care outcomes.

O30 - "Learning to learn": Commencing midwifery students' experiences of self-determined learning in an undergraduate midwifery program

Self-determined learning aims to develop learners who can be creative, reflexive, think critically, be collaborative and build self-efficacy and capability using a non-linear approach to learning. Supporting deeper learning aligns with midwifery education as it develops critical thinking and reflective skills rather than simply acquiring skills and knowledge. A deeper understanding applies the midwifery student's learning to new situations and potentially challenging circumstances. Some learners find the transition to innovative and non-traditional learning activities and assessments challenging. Students can be de-motivated or reluctant to engage and embrace the opportunities available, potentially leading to disengagement, poor performance or attrition from the program. Investigating commencing midwifery students' conceptions and experiences of self-determined learning aimed to determine appropriate support to ease this transition. To explore commencing midwifery students' experiences and perceptions of self-determined learning. A qualitative descriptive design was used. In-depth online interviews involved ten midwifery student participants. Data was analysed using thematic analysis with an inductive approach. Making the transition described becoming familiar with the new way of learning, including beliefs about self-determined learning. Trusting the journey encompassed making adjustments and developing the confidence to be vulnerable in the learning process. Recognising the value incorporates the advantages and the importance of becoming a capable self-determined learner and how this aligns with becoming the midwife the student aspires to be. After a transition period, self-determined learning encourages midwifery students to take responsibility for their learning. Midwifery students valued a holistic, relationship-based support system that included accessible resources and a safe and respectful learning environment. Developing self-determined learning capacity and capability facilitates transformation in the student, supporting midwifery graduates who are confident, capable, and embrace the challenges of future professional midwifery practice.

O31 - Clinical outcomes for women participating in continuity of care experiences with pre-registration midwifery students

Midwifery students in Australia are required to care for a minimum of 10 women in a continuity of care experience (CoCE) as part of their pre-registration midwifery program. Clinical outcomes for women receiving care from midwifery students may be documented by students in portfolios or ePortfolios but are rarely reported. The extent to which students value add to women’s care is unknown. This novel study used a retrospective descriptive design to evaluate the routinely collected clinical outcomes of women who had participated in a CoCE with a midwifery student (n = 5972 during pregnancy and n = 3933 during labour and birth) in one Australian BMid program between 2015 and 2020. The clinical outcomes collected and reported by students were compared with the National Core Maternity Indicators. Clinical outcomes were analysed for (1) women in a CMC primary model and who had a CoCE; (2) women in fragmented primary model of care and who had a CoCE; and (3) a comparison of clinical outcomes for women according to their model of care. The analyses revealed that women who had a CoCE with a midwifery student experienced equal to, or better clinical outcomes than national outcomes. In particular, tobacco smoking after 20 weeks of pregnancy, fourth degree tears and episiotomy rates were reduced for women who had CoCE with a midwifery student. Greatest benefit of CoCE with midwifery students was achieved when care began earlier in pregnancy. It is recommended that midwifery students commence CoCE as early as possible in pregnancy and that pre-registration midwifery programs extend and develop CoCE to maximise benefits for students and women.

P21 - Mobile Midwives Transforming Midwifery Care

Despite abundant research demonstrating the benefits of ‘continuity of care, Australian women are still receiving fragmented care in a system that does little to reduce their anxiety. What can we do to make a difference to women’s satisfaction with their birth experience? How can we increase the number of women having joyful birth experience? It has been a hot topic for midwifery researchers for many years and yet progress has not been sustained. Continuity of Care models such as Midwifery Group Practice (MGP), Caseloads, and even Maternal Antenatal and Postnatal Care (MAPS provide a great deal of promise. Sometimes the ability for the teams to provide continuity is limited because of rostering, leave workloads and staff availability. There are some Community Midwifery Programs being run through the public system which provide continuity of care and choice of birthplace (home or hospital). These are ideal and can truly provide women with the same midwives throughout the pregnancy and at birth. It would be optimal if these systems could be replicated around the country. Services need to optimize their efforts and gain efficiencies. It is beneficial for hospitals to examine options. Satisfied midwives result in less downtime. My book Mobile Midwives Transforming Birth Options describes a way four midwives developed a business providing antenatal care, birthplace of choice and postnatal care with continuity of care from the same primary midwife with a known backup midwife. Midwives in each of your areas should look for opportunities to make change, keeping women central to your thoughts and design innovative programs that will help.

O100 - Feasibility of embedding feedback from women participating in continuity of care experiences with pre-registration midwifery students

Quality midwifery care is woman-centred in both philosophy and model of care (ICM, 2022). Assessment of midwifery student clinical learning has typically depended on preceptor/supervisor feedback, university academic feedback and self-reflection but has not routinely embedded women’s feedback to improve student learning and practice. One pre-registration midwifery program in south-east Queensland has begun to routinely seek feedback from women about their experiences with a midwifery student providing a continuity of care experience (CoCE). The aim of this study was to evaluate the feasibility of conducting a routine, online survey of women’s perceptions of satisfaction and respect during CoCE with a midwifery student. Data from the first 12 months (July 2019 – July 2020) of this online survey was analysed and reported. The online survey was found to be feasible, reliable and valid. Over half of the women invited to complete the survey did so (response rate of 57%, n = 501). Most women reported being more satisfied with their student than they had hoped; would have a midwifery student in future pregnancies; and would recommend a midwifery student to their friends and family. Students in this study cared for a larger number of women through CoCE than the prescribed minimum of 10 required by the national regulator (Nursing and Midwifery Board of Australia, 2022) (20 CoCE minimum in this BMid program). For each woman, the student provided more antenatal care, attendance at labour and birth and postnatal contacts than minimum program requirements. Women reported greater satisfaction and respect as the number of antenatal visits and postnatal contacts with their student increased. Similarly, women were more satisfied when their student attended their labour and birth. This presentation will discuss processes to routinely obtain women’s feedback (including ethical approval); survey content; approach to data analysis; findings and future directions.

O101 - Embedding critical thinking within a Bachelor of Midwifery curriculum

The application of critical thinking to midwifery practice is essential in the provision of evidence based, safe, high quality woman centred care. Yet, critical thinking in midwifery is rarely explicitly articulated, taught, or measured in undergraduate midwifery programs. To develop, test, embed, and scaffold resources and processes to promote critical thinking within an undergraduate midwifery program. The multi-method approach involved (1) development and testing of two tools that measure critical thinking in undergraduate midwifery students; (2) a systematic review of the literature to inform a conceptual model of critical thinking in midwifery practice to guide decision making in teaching and midwifery practice; (3) a Delphi study with 32 international midwifery experts to develop a consensus definition of critical thinking. The two tools measured critical thinking in midwifery practice through self-assessment and preceptor rating annually. The scales demonstrated good internal reliability and validity. Within the Delphi study 14 habits of mind and 12 skills that are at the core of critical thinking in midwifery practice were identified. The tools, consensus definition and conceptual model were then embedded within a Bachelor of Midwifery curriculum. A scaffolded approach was applied to the articulation, teaching, measurement and facilitation of the development of critical thinking in undergraduate midwifery students. The use of well-developed critical thinking skills to inform midwifery decision making is vital in the provision of midwifery care that is evidence based, woman centred and of high quality. The scaffolding of an evidence-based definition of critical thinking, sophisticated tools and models throughout a Bachelor of Midwifery curriculum will develop these skills and ensure graduates can navigate the complex decision making in midwifery practice.

Literature review: Ubi Jalar Ungu sebagai Bahan Makanan Tambahan Remaja Kurang Energi Kronis

The quality of the nation's next generation is largely determined by adolescent girls who act as future mothers. The physical and psychological maturity of adolescent girls greatly affects a woman's readiness to become a mother in a healthy family. Basic health research data (Riskesdas) in 2018 reported that west Nusa Tenggara (NTB) province had women aged >18 years thin based on BMI as much as 12%, and Mataram city had the second most thin >18 years old women (14.02%) after North Lombok district which was 15.99%. An initial survey conducted on 20 female students at STIKes Yarsi Mataram in February 2021 found that 30% of female students had Lila <23.5 cm. This situation shows that not all female students at STIKes Yarsi Mataram have a good nutritional status. This study aims to identify the nutritional status of STIKes Yarsi Mataram students as an early detection of chronic lack of energy events in the health college environment. This study used an observational descriptive design with a cross-sectional approach. The population of this study is students of the Nursing study program at the D3 level, the midwifery study program at the D3 level and the undergraduate program in semesters 1 and 3 at STIKes Yarsi Mataram. The sample was taken using purposive sampling techniques for 1st and 3rd semester students who used offline learning methods and were not practicing outside the campus with a total of 176 female students. The primary data taken are in the form of BB, TB, and Lila. This research was conducted in September 2021 - January 2022 at STIKes Yarsi Mataram. The results of this study found thata large number of STIKes Yarsi Mataram students had a normal BMI (18.5-25), although there were a small number of female students who had a thin BMI (<18.5) and a fat BMI (>25). Most of the students of STIKes Yarsi Mataram have a normal Lila (>23.5 cm), but the rest have a risk Lila of SEZ (<23.5 cm). It is hoped that there will be an intensive increase in the knowledge, attitudes and behaviors of female students about diet, nutrient intake and body image from lecturers in collaboration with nutritionists.

PEMBENTUKAN BIDAN ENTERPRENEUR SEBAGAI PELUANG USAHA BIDAN MELALUI PELATIHAN POSTNATAL TREATMENT

Postnatal treatment is a service provided to mothers after giving birth either normally or by cesarean. Postnatal treatment is one of the types of care that is mastered by the alumni of DIII Midwifery Program since it is included in the DIII Midwifery Curriculum at the Midwifery Study Program, Curup Ministry of Health Poltekkes, Bengkulu. Postnatal treatment that has been modified is to do breast care and oxytocin massage with the patient in a position to soak in warm water and be given aromatherapy along with relaxation music. This community service aims to increase the knowledge and skills of students and alumni for entrepreneurship. The solution offered by the implementing team is to increase the knowledge and skills of students and alumni through training on Postnatal Treatment. The entrepreneurial development method passes through three stages, namely entrepreneurial knowledge, entrepreneurial ability, and entrepreneurial mentality. Assistance to students and alumni during the process of implementing activities. Monitoring and evaluation is carried out by the Lecturer Team on students and alumni. This activity resulted in the formation of a new entrepreneurial group, as well as the availability of facilities and infrastructure to support activities such as modules, tools and materials for Postnatal treatment. After the training, there was an increase in the knowledge of alumni and students about Postnatal Treatment.

Nursing and Midwifery Students’ Perceptions and Experiences of Using Blended Learning in Rwanda: A Qualitative Study

BackgroundAlthough blended learning (BL) is being adopted in public and private higher learning institutions (HLIs) in Rwanda, little is known about students’ use of BL in their learning activities. This article describes a qualitative descriptive study of students’ perceptions and experiences of BL in Rwanda’s post-secondary nursing and midwifery programs in public and private HLIs.MethodsThirty-three nursing and midwifery students from all public and private HLIs in Rwanda exposed to BL were invited to participate in three online focus group discussions (FGDs) conducted using a developed FGD guide with open-ended questions. Inductive content analysis was used to analyze the transcripts.ResultsThree main themes emerged from the data analysis:(1) BL perceived as a new and effective teaching and learning approach, (2) Contextual challenges to the BL method, and (3) Recommendations to improve the BL method. From students’ experiences, the benefits included but were not limited to the flexibility of the approach, time, and cost-saving. However, several challenges were identified, including technological issues such as lack of ICT skills and poor internet connectivity.ConclusionThis study provides insights into the usefulness of BL in HLIs and offers recommendations on how BL teaching and learning can be improved to strengthen nursing and midwifery pre-service education quality.Rwanda J Med Health Sci 2022;5(2):203-215

“They hold your fate in their hands”: Exploring the power dynamic in the midwifery student-preceptor relationship

AimTo examine (1) what role preceptors play in students’ learning; (2) how student-preceptor relationships can impact students’ views of the profession and their decision to leave the program; and (3) what strategies can be used to improve the preceptor-student relationship to facilitate student retention. Research design and participantsWe used a qualitative methodological approach utilising semi-structure interviews with 31 midwifery students across Canada. Participants were recruited from all midwifery education programs and were in various stages of their educational journey. The interviews were conducted in English and French. Inductive analysis followed Charmaz's guidelines moving from line-by-line to focused coding and development of analytical categories. FindingsThe results show that positive relationships with preceptors boosted students’ confidence and contributed to the constructive learning experiences among trainees. Students pointed out that their best learning experiences were facilitated by preceptors who created a safe space to make mistakes and were knowledgeable and invested in students’ learning. Students also suggested that power imbalance is embedded in student-preceptor relationships and can negatively impact students’ learning experiences and their decision to stay in the program. Key conclusions and implications for practiceIt is important to consider how to mitigate the power imbalance embedded in preceptor-student relationship. Offering more training to preceptors, oversight of preceptors’ mentorship skills by midwifery educators, and creation of ombudsperson's position might mitigate some of the power differential and facilitate students’ ability to complete midwifery training.