Pre-registration Midwifery Education Research Articles

Midwifery education and technology enhanced learning: Evaluating online story telling in preregistration midwifery education

BackgroundA major issue regarding the implementation of blended learning for preregistration health programmes is the analysis of students' perceptions and attitudes towards their learning. It is the extent of the embedding of Technology Enhanced Learning (TEL) into the higher education curriculum that makes this analysis so vital. ObjectivesThis paper reports on the quantitative results of a UK based study that was set up to respond to the apparent disconnect between technology enhanced education provision and reliable student evaluation of this mode of learning. DesignEmploying a mixed methods research design, the research described here was carried to develop a reliable and valid evaluation tool to measure acceptability of and satisfaction with a blended learning approach, specifically designed for a preregistration midwifery module offered at level 4. MethodsFeasibility testing of 46 completed blended learning evaluation questionnaires - Student Midwife Evaluation of Online Learning Effectiveness (SMEOLE) - using descriptive statistics, reliability and internal consistency tests. ResultsStandard deviations and mean scores all followed predicted pattern. Results from the reliability and internal consistency testing confirm the feasibility of SMEOLE as an effective tool for measuring student satisfaction with a blended learning approach to preregistration learning. ConclusionsThe analysis presented in this paper suggests that we have been successful in our aim to produce an evaluation tool capable of assessing the quality of technology enhanced, University level learning in Midwifery. This work can provide future benchmarking against which midwifery, and other health, blended learning curriculum planning could be structured and evaluated.

Active blended learning for clinical skills acquisition: innovation to meet professional expectations

The standards for pre-registration midwifery education state that the practice-theory ratio of the programme should be no less than 50% practice and no less than 40% theory, adopting a variety of learning and teaching strategies, including simulation. Simulation for skills teaching has been found to bridge gaps between theory and practice, and to positively affect how prepared and confident the student midwife feels to apply knowledge and skills in the practice setting. With changes in regulation under consultation, and an ever more complex clinical environment, it is timely to revisit learning, teaching and assessment strategies in pre-registration education to ensure that they are fit for purpose. The University of Northampton's approach to learning and teaching, termed active blended learning, is a student-centred approach to support the development of subject knowledge and understanding, independent learning, and digital fluency. This involved the modification of a traditional, four-stage, step-by-step approach to teaching clinical skills, by introducing video-assisted technology to prepare students for a summative assessment using simulation. It is anticipated that this innovative approach to the teaching of clinical skills will enhance the ‘toolkit’ of learning, teaching, and assessment strategies appropriate to contemporary midwifery preregistration education.

The Newborn Infant Physical Examination: Incorporating the theory into midwifery education

Background The Newborn Infant Physical Examination (NIPE) can be performed by any qualified health professional, although changes to the roles of health professionals has led to an increase in midwives undertaking continuing professional development (CPD) modules, in order to embrace the NIPE role. Aim The curriculum planning team at the University of Manchester recognised the diverse structures of CPD modules throughout the UK and sought to incorporate the theoretical component of NIPE training into pre-registration midwifery education. Methods The team consulted with local and national stakeholders to assess the need for NIPE education, and the possible challenges. Findings Evaluations from the first cohort of students have been positive, especially in relation to increased employability. Conclusions Including the theory of the NIPE into pre-registration midwifery education has been successful, although support to develop the clinical elements of the NIPE is still needed.

How can universities ‘ASSIST’ student midwives with additional needs to achieve?

Previous articles have discussed how pre-registration midwifery education should prepare student midwives ‘to cope with the complex emotional and physical demands of their chosen profession’ ( Power, 2016:66 ); acknowledged the importance of a partnership approach to education through the ‘Clinicians in the Classroom’ series ( Power, 2016 ; Power and Briody, 2016 ; Power and Gupta, 2016 ; Power and Rea, 2016 ; Power and Rooth, 2016 ) and considered how best to support student midwives with appropriate learning and teaching strategies (Power and Farmer, 2017). What is yet to be considered is what extra support is available to students who have additional needs, disabilities or medical conditions that might impact on their studies. This article will take the University of Northampton as a case study and review the support services it has in place to support such students to meet their full potential. This service is called The Additional Student Support and Inclusion Services Team (ASSIST).

Innovation in preregistration midwifery education: Web based interactive storytelling learning

Backgroundthrough a critical description of the implementation of a web based interactive storytelling learning activity introduced into an undergraduate, preregistration midwifery education programme, this paper will explore how low-cost, low-fidelity online storytelling, designed using Moodle, can be used to enhance students’ understanding of compassion and empathy in practice. Samplecross sectional sample of first year undergraduate Midwifery students (n111) Methoddrawing from both research and audit data collected in an Higher Education Institution in London England, the paper presents the case for using web based technology to create a sustainable model for midwifery education. Findingsinitial results indicate that it is both the low cost and positive student evaluations of web based interactive storytelling, which make this approach to preregistration midwifery education which suggests that this approach has significant potential for learning and teaching in midwifery education in diverse settings around the world. Or how about: global relevance?.

Pre-registration midwifery education: Do learning styles limit or liberate students?

In 1995, all pre-registration health education moved into higher education, signalling a shift from the apprenticeship model to an academic one. Since 2008, the Nursing and Midwifery Council has required all pre-registration midwifery programmes to be offered at degree level only, with a required practice-to-theory ratio of no less than 50% practice and no less than 40% theory. Individual education institutions vary in how these requirements are met in terms of learning and teaching strategies. This article explores literature in relation to the ‘learning styles’ pedagogical approach, which advocates that all students have a particular preferred learning style and will learn best if they are allowed to learn in their preferred style. The key question is: What are the most appropriate learning and teaching strategies to support student midwives to develop the skill set required to meet the demands of contemporary practice?

Including the newborn physical examination in the pre-registration midwifery curriculum: National survey

Aims This study aimed to assess the scope of newborn infant physical examination (NIPE) education in programmes of pre-registration midwifery education. Methods An online questionnaire was sent to all lead midwives for education in the UK. Findings are reported in two parts: part A (the current paper) examines the education provision for the inclusion of NIPE in the midwifery curriculum. Part B (a subsequent paper) explores NIPE education as a post-registration module. Findings Of 58 education institutions, 40 (68.9%) completed the questionnaire. A quarter (25.0%) stated that NIPE training is included in their pre-registration midwifery programmes; 37.5% reported plans to implement it within the next 2–5 years and 30.0% had no plans to do so. Benefits for practice partners, commissioners, students and service users were identified. Challenges were noted, particularly in relation to resources and student support in practice. Conclusion Although barriers doubtless exist, the success of the few institutions that have incorporated NIPE into their curricula is evidence that this is not only possible, but has proven benefits.

Working together to implement a Pre-Qualifying Skills Passport in Wales: Report of a pilot project

Midwives are required to undertake a wide range of hands-on skills. Immediately upon qualification, they will be expected to use these skills safely and effectively as part of their practice. Therefore, student midwives must be supported to develop competence and confidence in such skills. Currently, many practical midwifery skills are not specifically identified in the Nursing and Midwifery Council (NMC, 2009 ) Standards for pre-registration midwifery education. Over time, it has become clear that some midwives were qualifying from universities in Wales and entering their new posts feeling unprepared to undertake a number of important midwifery skills, such as the administration of intramuscular vitamin K to babies. This article describes how heads of midwifery education and lead midwives for education worked together with heads of midwifery to develop and implement an All Wales Midwifery Pre-Qualifying Skills Passport, to address these shortcomings.

Clinicians in the classroom: The consultant anaesthetist

In 2013–14, 166 081 babies born in England—accounting for 26.2% of all births in the country—were born by caesarean section ( Health and Social Care Information Centre (HSCIC), 2015 ). Epidural or caudal anaesthesia was required in 16.4% of births, while spinal anaesthetics were used in 15.1% of births ( HSCIC, 2015 ). Support from obstetric anaesthesia services is also required in obstetric emergencies such as postpartum haemorrhage and eclampsia. Modern maternity services require a multi-professional approach to providing high-quality care, and it is therefore important that pre-registration midwifery education prepares student midwives to work in such an environment. This is the fourth in a series of articles exploring the value of expert clinicians' participation in teaching pre-registration midwifery students in the classroom setting. This article will consider sessions at the University of Northampton facilitated by Dr Kalpna Gupta, consultant anaesthetist at Northampton General Hospital NHS Trust.

Clinicians in the classroom: The consultant midwife

This is the third in a series of articles exploring expert clinicians' participation in teaching pre-registration midwifery students in the classroom setting. This article considers sessions facilitated by a consultant midwife. The role of consultant midwife was first introduced in the UK in 2000 as a senior position within maternity services to provide professional leadership and a senior level of clinical midwifery expertise. A key element of the role of the consultant midwife is education, training and development ( Department of Health, 1999 ). A consultant midwife from Milton Keynes University Hospital NHS Foundation Trust discusses her experience teaching pre-registration midwifery students. Feedback from students indicates that they value the input of expert clinicians into pre-registration midwifery education.

Clinicians in the classroom: The bereavement midwife

The aim of pre-registration midwifery education is to prepare the student for the demanding and complex role they aspire to, using a range of teaching, learning and assessment strategies both in theory and practice. This article is part of a series exploring the role of clinicians as facilitators of learning in the classroom environment. This article explores the role of the bereavement midwife and discusses a teaching session conducted by bereavement midwife Tracy Rea with second-year students on the 3-year pre-registration midwifery programme. The session included input from a couple who shared their experiences of the loss of their son and their subsequent pregnancy. The article concludes with student feedback on the session, demonstrating the deep and meaningful learning that took place and confirming the value of bringing the realities of practice into the classroom environment.

Pre-registration midwifery education: Clinicians in the classroom

According to the Nursing and Midwifery Council ( NMC, 2009 ), pre-registration midwifery programmes of study must be made up of no less than 50% practice and no less than 40% theory. The programme must also include a variety of teaching and learning strategies. Programmes of study are enhanced when midwifery teaching is complemented with input from other experts such as service users, midwives and other members of the multidisciplinary team. This is the first of a series of articles discussing teaching by a range of health professionals, each of which will include the featured professional's role and responsibilities, their motivations to teach, the topics they cover and, where appropriate, how this input is evaluated by student midwives.

The hospital birth environment: Impacts on midwifery practice during labour and birth

Nursing andMidwiferyAccreditationCouncil (ANMAC)having regulatory responsibility for the development and assessment of these standards under the course accreditation system. As a key influencer in the revision of these standards, the midwifery profession must now set a clear and consistent agenda about what we believe is essential for midwifery education in Australia. The professional practice requirements are often viewed as the most contentious issue, however the midwifery profession needs to also view the standards more holistically and also consider benchmarking to international standards. There is limited available literature on midwifery education standards. The current ANMAC standards (ANMC, 2009) are the definitive standards for Australianmidwifery curricula,whilst the InternationalConfederationofMidwives (ICM) (2010) provide Global Standards for Midwifery Education. Both these standards provide clear guidelines on requirements, however debate continues over the complex issue of numbers, hours and types of midwifery experiences that should be required for midwifery registration programs. The current Australian standards require students to complete a number of continuity of midwifery care experiences. These experiences were first established in the inaugural midwifery education standards (ACM, 2001) and were viewed as an opportunity for midwifery students to experience continuity of midwifery care. There are serious implications for the future of midwifery education in Australia if the professional experience requirements are reduced for pre-registration midwifery education programs. The future for midwifery education in Australia relies on considered discussion and leadership to ensure that these standards provide the best possible opportunity formidwifery students to meet competency standards.

Call the midwifery student: Facilitating continuity of care experience in education and practice

Pre-registration midwifery students in Australia undertake a minimum of ten continuity of care experiences with childbearing women. However, women are rarely asked to formally evaluate this care by students.To evaluate data from a routine, web-based survey of women about having a midwifery student provide a continuity of care experience.All women (n = 886) recruited by a midwifery student for a continuity of care experience during a 12 month period received an email inviting them to complete an online survey. The survey included personal details, experiences of care, and two scales on Respect and Satisfaction.A response rate of 57% (n = 501) was achieved. On average students attended six antenatal visits (mean = 5.83) and had six postnatal contacts with women. Most students attended labour and birth (92.6% n = 464). Most women rated overall satisfaction with care by their student as ‘better than they had hoped’. Positive correlations were found between number of antenatal visits and postnatal contact with students on both levels of satisfaction and respect felt by women. Women felt more satisfied when their midwifery student attended labour and birth.The online survey was feasible and provided valid and reliable feedback from women about their student during a continuity of care experience. Women valued having an ongoing relationship with a student during pregnancy, labour and birth, and postpartum. Pre-registration midwifery education programs should continue to privilege relationship-based care and national standards should support the effective integration of continuity of care experiences.

The M@NGO Trial: Does caseload midwifery reduce caesarean section operation rates?

Nursing andMidwiferyAccreditationCouncil (ANMAC)having regulatory responsibility for the development and assessment of these standards under the course accreditation system. As a key influencer in the revision of these standards, the midwifery profession must now set a clear and consistent agenda about what we believe is essential for midwifery education in Australia. The professional practice requirements are often viewed as the most contentious issue, however the midwifery profession needs to also view the standards more holistically and also consider benchmarking to international standards. There is limited available literature on midwifery education standards. The current ANMAC standards (ANMC, 2009) are the definitive standards for Australianmidwifery curricula,whilst the InternationalConfederationofMidwives (ICM) (2010) provide Global Standards for Midwifery Education. Both these standards provide clear guidelines on requirements, however debate continues over the complex issue of numbers, hours and types of midwifery experiences that should be required for midwifery registration programs. The current Australian standards require students to complete a number of continuity of midwifery care experiences. These experiences were first established in the inaugural midwifery education standards (ACM, 2001) and were viewed as an opportunity for midwifery students to experience continuity of midwifery care. There are serious implications for the future of midwifery education in Australia if the professional experience requirements are reduced for pre-registration midwifery education programs. The future for midwifery education in Australia relies on considered discussion and leadership to ensure that these standards provide the best possible opportunity formidwifery students to meet competency standards.

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

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

Exploring the value of the tripartite assessment of students in pre-registration midwifery education: A review of the evidence

Many universities use a tripartite assessment within the pre-registration midwifery curriculum to grade student practice; we consider what the purpose and value are from an educational, formal and social perspective. By utilising research, policy documents and reflections from our experiences we explore the principles which underpin this judgement of student performance. After deliberation, we consider the increased presence in practice to have many benefits, but have evidence that it is not required educationally, to assess student practice, or to formalise the assessment process, since sign-off mentors are now better prepared to undertake this role. Thus, to support our increased partnership with practice, afforded by tripartite assessments, we offer an alternative.

Newborn examination: The student’s role?

There has been some discourse with regard to student midwives undertaking examination of the newborn during their midwifery education as a compulsory skill, and practising this on qualification against midwives performing this procedure as an enhanced role. It is acknowledged that providing skills in examination of the newborn from the point of qualification will support the midwives' role around normality as well as promoting holistic care. Issues surrounding timing, experience and accountability have been explored to establish if examination of the newborn is appropriate to be undertaken as a compulsory skill within the pre-registration midwifery education programme and performed by newly qualified midwives. This article will discuss the issues regarding student midwives learning the role of examination of the newborn as a compulsory skill and performing this from the point of qualification against the current practice that only experienced midwives should perform this as an enhanced role.

The MINT project—An evaluation of the impact of midwife teachers on the outcomes of pre-registration midwifery education in the UK

Objectiveto explore the contribution of midwife teachers in preparing student midwives for competent practice. Designa three phase design using qualitative and quantitative approaches. Phase one involved UK wide on-line questionnaire surveys, phase two was a case study method in six UK approved education institutions and phase three was a diary study with newly qualified midwives. Participantsphase one included all UK Lead Midwives for Education (LMEs), midwife teachers and Local Supervising Authority Midwifery Officers; phase two participants were three year and shortened programme student midwives, midwife teachers, LMEs and programme leads from each of the four countries; and phase three included a sample of newly qualified midwives graduating from the case study sites and their preceptors and supervisors of midwives. Findingsmidwife teachers were valued for their unique and crucial role in supporting the application of knowledge to midwifery practice. Visibility and credibility were two key concepts that can explain the unique contribution of midwife teachers. These concepts included being able to support skills acquisition, understanding of contemporary midwifery practice, having a role in practice contexts and able to offer personal support. Visibility of teachers in practice was vital for students and mentors to assist students put their learning into practice and monitor learning and assessment decisions. Conclusions and implications for practicegiven the complexity of midwifery education a team approach is essential in ensuring the effectiveness of these programmes. This requires a sufficient differentiation of midwife teacher roles to deliver the pre-registration curriculum. A set of resource quality indicators is proposed to support midwife teacher teams achieving sufficient clinical and academic expertise to deliver effective education programmes.

Problem-solving and communication skills in clinical practice: A reflection

As part of pre-registration midwifery education, the Nursing and Midwifery Council stipulates that students need to progressively develop essential key skills including problem-solving and communication. It is insufficient for these skills to be understood on a purely academic level; they need to be applied in clinical practice. This reflective account illustrates how progression and attainment of these skills and the application thereof is an achievable standard. Additionally it demonstrates the requirement for students to build on these skills so that they learn to effect positive outcomes in challenging situations which occur frequently in the midwifery profession.