Pre-registration Midwifery Programmes Research Articles

Mapping factors that may influence attrition and retention of midwives: a scoping review protocol

IntroductionAn appropriately staffed midwifery workforce is essential for the provision of safe and high-quality maternity care. However, there is a global and national shortage of midwives. Understaffed maternity services are...

Pre-registration midwifery

Emma Davies and Davie Morgan from Health Education and Improvement Wales discuss the successful recommissioning of Bangor University's pre-registration midwifery programme

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.

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.

‘We are the (simulation) champions – evaluating the role of simulation champions to enrich the diversity of simulation practice placements within higher education institutions undergraduate healthcare programmes’

Due to the COVID-19 pandemic, there has been a significant impact on undergraduate healthcare practice placement education [1]. In response, the Scottish Government, committed to ensuring Adult and Mental Health Nursing, Midwifery, and Paramedic Science students have adequate provision to student placements, awarded Higher Education Institutions (HEIs) funding to develop simulation placements. Within our HEI a Clinical Skills and Simulation Team (CSST) has been created comprising 3 Lecturers, a Simulation Technician, and a Digital Technologist. The team then built a Simulation Champions group (n=30) through fostering working relationships, to help promote simulation-based education (SBE) pedagogy across the HEI. The purpose of this study is to explore whether creating a simulation champions group has any impact on the delivery of simulated practice placements within undergraduate healthcare programmes. The Simulation Champions are a diverse group comprised of internal academic faculty and external National Health Service (NHS) partners (such as practice education facilitators) who are passionate educators in SBE. Each external partner has a contact within the HEI, aligned to their area of clinical expertise. Through an agreed Terms of Reference, their aim is to enhance, resource, and assist the delivery of high-quality, high-fidelity simulation placements to students by working collaboratively in line with the relevant professional body standards and proficiencies [2]. The CSST oversee the Simulation Champions, providing strategic direction, leadership, following the HEI strategy [3], and support the delivery of Simulation Placements. The group meets every quarter to discuss simulation practices, explore Continuous Professional Development (CPD) opportunities, and share knowledge and learning. The impact of this team will be measured through staff and student reflection using a framework to objectively analyse scenario diversity, achievement of learning outcomes, and alignment to professional body proficiencies. Following ethical approval, a group of Year 1 Adult Nursing students (n=60) will have completed a 40-hour Simulated Practice Placement designed and delivered by Simulation Champions (n=10). This study will then evaluate and conclude whether there is a need to create and develop a diverse, multi-professional Simulation Champions Group before successful Simulated Practice Placements can be achieved. It will also help determine if securing strong working relationships ensures a smooth transfer of knowledge and skills from clinical practice to the simulation setting within a HEI, and if all of this enhances the student experience. 1. Caplan J, Clements R, Chadwick C, Kadirgamar J, Morgan J, Rao A. Medical education in 2020: developing COVID secure undergraduate hospital placements. Medical Science Educator. 2020;30(4):1677–83. 2. NMC 2018a, 2018b, 2018c, 2018d: Nursing and Midwifery Council. The Code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council. Realising professionalism: Standards for education and training. Part 3: Standards for pre-registration midwifery programmes. Nursing and Midwifery Council. Realising professionalism: Standards for education and training. Part 3: Standards for pre-registration nursing programmes. 3. University of the West of Scotland. Strategy 2025. 2020. uws-strategy-2025.pdf. [Accessed on 25/01/2022]

Finding the Future Midwife: How the revised Standards of Proficiencies for Midwives support pre-registration midwifery programme admissions processes

Pre-registration midwifery education programmes are quietly undergoing a revolution. In 2019, the Nursing and Midwifery Council (NMC) published an ambitious set of proficiencies for the future midwife, defining a framework of skills, knowledge and behaviours that midwives are required to demonstrate at the point of qualification and subsequent entry to the register.1 The revised Proficiencies for Midwives were required to reflect the demands of contemporary maternity services and were based on the framework produced by Renfrew et al. within the Lancet midwifery series.

A guide to caesarean wound healing

A guide to caesarean wound healing

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

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

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

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

New academic year, new challenges: Tips for student midwives to maintain momentum and motivation

At the start of the academic year, the physical signs of progression from one year to the next for student midwives include an additional stripe on an epaulette, a different coloured badge or perhaps a change of uniform. But what about emotional progression? If we think of learning as a continuum, a lifelong process of developing skills and knowledge, then the transition from one year to the next should be seamless. However, in the context of the pre-registration midwifery programme, each academic year places more complex demands on students in both theory and practice as they progress from concentrating on normality in year one, to altered health in year two, to leadership, consolidation of practice and preparation for qualification in year three. The Nursing and Midwifery Council (NMC) Code requires midwives to be ‘lifelong learners’, basing their practice on the best available evidence—an ethos that should be embedded from day one of midwifery training. After a summer break, returning to studies and the physical and emotional demands of the pre-registration midwifery programme can be daunting; this article will provide tips for students to maintain momentum and motivation as they progress to the next year of their studies.

Supporting failing students: How collaboration is key

Nursing and Midwifery Council (NMC) standards state that the balance between clinical practice and theory in pre-registration midwifery programmes must be no less than 50% practice and no less than 40% theory, with students being supported by ‘midwife teachers’ and ‘midwife mentors’ ( NMC, 2009:18 ). Midwife teachers are expected to be involved in learning and assessment in both academic and practice learning environments by engaging in activities such as link tutoring; facilitating mentor development and updates; having a part-time clinical role or being involved with practice development, midwives' continuing professional development (CPD) or practice-based research activities. Clinical practice is supervised and graded by sign-off mentors, ‘gatekeepers to the profession’ who confirm that students are clinically competent, commensurate with their level of training, and are fit for entry to the midwives' part of the register at the end of their 3-year programme of study. This article will consider the importance of a collaborative approach between universities and clinical placement providers, particularly in relation to supporting failing students as, while ‘there has to be the recognition that some students need to fail’, sometimes students just require more focused support and planning to achieve the required skills, competencies and confidence in practice.

'Living the rural experience-preparation for practice': The future proofing of sustainable rural midwifery practice through midwifery education.

Rural practice presents unique challenges and skill requirements for midwives. New Zealand and Scotland face similar challenges in sustaining a rural midwifery workforce. This paper draws from an international multi-centre study exploring rural midwifery to focus on the education needs of student midwives within pre-registration midwifery programmes in order to determine appropriate preparation for rural practice. The mixed-methods study was conducted with 222 midwives working in rural areas in New Zealand (n = 145) and Scotland (n = 77). Midwives' views were gathered through an anonymous online survey and online discussion forums. Descriptive analysis was used for quantitative data and thematic analysis was conducted with qualitative data. 'Future proofing rural midwifery practice' using education was identified as the overarching central theme in ensuring the sustainability of rural midwives, with two associated principle themes emerging (i) 'preparation for rural practice' and (ii) 'living the experience and seeing the reality'. The majority of participants agreed that pre-registration midwifery programmes should include a rural placement for students and rural-specific education with educational input from rural midwives. This study provides insight into how best to prepare midwives for rural practice within pre-registration midwifery education, in order to meet the needs of midwives and families in the rural context.

Life after death: The bereavement midwife's role in later pregnancies

The ‘Clinicians in the Classroom’ series of articles explored the value of expert clinicians sharing their expertise in the classroom setting ( Power, 2016 ). One of the articles featured Tracy Rea (bereavement midwife), a regular contributor to the pre-registration midwifery programme at the University of Northampton, who invited Chris and Kate to a session to share their experiences of the loss of their son Stanley, and their subsequent pregnancy ( Power and Rea, 2016 ). This article will follow Tracy back into the clinical area to look at her role in supporting bereaved families through subsequent pregnancies, and will include the reflections of a second-year student midwife (Sharon) who spent time with Tracy in her specialist antenatal clinic and peer support group, ‘The Butterfly Group’.

Courage, commitment and resilience: Traits of student midwives who fail and retake modules

In the context of staff retention in maternity services in the UK, the concept of resilience has a high profile. The ever more complex demands of contemporary midwifery practice in the UK lead some midwives to make the difficult decision to leave the profession, with the top five reasons being: dissatisfaction with staffing levels; dissatisfaction with the quality of care they were able to give; excessive workload; lack of managerial support; and poor working conditions. It is estimated that around 20% of students who commence the pre-registration midwifery programme will not qualify to become a midwife; reasons for non-completion of studies include deciding it is the wrong career choice, financial difficulties and family circumstances. Academic failure, however, is not cited as a key reason for leaving the course. This article shares the stories of three students who failed and then retook a theory module during their pre-registration midwifery programme. The students show courage in their willingness to publicly discuss their experiences; commitment to their chosen profession by retaking the module; and resilience by persevering despite the additional emotional and financial demands of their situation. A fourth student offers advice for others who might find themselves in the same situation.

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.

Experiences and expectations of student midwives entering the final year of their programme of study

Although theoretical assessment is linear throughout the pre-registration midwifery programme, anecdotal evidence suggests there is a disproportionate increase in student midwives' expectations as they enter their third year of study, knowing they are closer to qualification and the associated responsibilities of autonomous practice. The Nursing and Midwifery Council states that pre-registration midwifery programmes must be at least 3 years or the equivalent to 156 weeks full-time, but there is anecdotal evidence of a culture of expectation that students should be proficient from the start of their third year. This article explores the experiences and expectations of student midwives who have just commenced their final year of training and—in the context of a rising birth rate, increasing workloads and staff shortages—consider how they can be best supported by education and placement providers to successfully complete their studies and ultimately be admitted to the register.

Lessons from a placement in Peru

At the end of her pre-registration midwifery programme, Heidi Stone undertook a voluntary observational placement in Peru, to learn about birth in a developing country.

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.

An exploration of the value of the role of the mentor and mentoring in midwifery

This research project aimed to examine the perceived value sign-off mentors (SOMs) in midwifery have for their role. Using a phenomenological approach, the results were drawn from in-depth interviews. The project included a literature review, methodology, results and discussion. The results indicate that mentors enjoy their role and they see themselves as essentials to the delivery of pre-registration midwifery programmes and for the supervision and assessment of student midwives. Mentors are not sure if student midwives value their sign-off mentor, or whether senior management is aware of the sign-off role and its value. This project also confirms previous findings from other studies, particularly the problem of finding time to complete student assessment paper work, support students in clinical practice and whether there are enough SOMs within clinical practice. The study does not conclude that the issues raised are distinctive to midwifery, potentially all of the points raised translate to the various forms of nursing practice.