Personal and professional values grading among midwifery students

The purpose of this study was to determine the professional and personal values among midwifery students in Turkey and to identify whether the years of study affected these values. A total of 192 participants were asked to prioritize 16 professional and 36 personal values. The relationship between the year of study and value ranking was analyzed by Kruskal-Wallis test. The first three of the professional values were justice, equality, and human dignity. Equality ranked sixth among the personal terminal values, and it increased with the years of study. Of personal instrumental values, responsibility and cleanliness ranked second and fifth, which are of central importance for the profession of midwifery. However, the other two important values, privacy and preventing unnecessary suffering, ranked lower when the years of study increased, in other words when the students confront clinics. Since these values are important for midwifery, ethics courses should be given throughout the midwifery education to prepare students for the challenges they face in the clinical environment.     

Infection control education for undergraduates

Healthcare-associated infection (HCAI) is recognised as a major and increasing problem to health (Scottish Executive 2002a). National strategies are being considered to address the problem. This article describes how one Scottish higher education institution collaborated to identify, adapt and implement the Cleanliness Champions programme--a national infection control educational initiative--in established undergraduate nursing and midwifery curricula. The result was that undergraduate nursing and midwifery students were included in the national campaign to tackle HCAI in Scotland.     

Review Article: Genetic competence of midwives in the UK and Japan

In the UK and Japan, midwives provide health services for women with concerns about a genetic condition or who are considering antenatal screening. In both countries, competences related to genetic health care have been devised but there is little evidence about midwifery competence in practice. A systematic literature review was undertaken to determine the extent to which midwives are achieving the genetic competences that are prescribed for their practice. English and Japanese literature from January 1999 to March 2009 was retrieved. Original studies or reviews, in which an aspect of midwifery practice was related to genetic competences, were eligible for inclusion. After a critical appraisal, six UK and five Japanese papers were eligible for inclusion. The findings indicated that midwives are not achieving the competences, nor are they confident about their genetics knowledge. Moreover, women are not being supported to make informed decisions regarding antenatal screening. We have confirmed that little research is being undertaken in both countries regarding competency achievement in practice. Changes to midwifery curricula and further continuing education are required to ensure that midwives are able to provide effective care regarding genetics.     

A review of evidence for the practice learning environment: enhancing the context for nursing and midwifery care in Scotland

This paper considers the issues which will ensure practice learning excellence in the future and in particular how these will impact on the delivery of high quality nursing and midwifery care in Scotland in the United Kingdom (UK). This will include the inter-dependency of learning in practice for undergraduate pre-registration students and qualified practitioners, in particular continuing professional development as a lifelong experience and its link to quality care provision. We contend that the practice learning environment is the whole of an organisation which values and supports the development of its workforce through education. Partnership working between education and service providers is central to ensuring an educated and professionally prepared workforce. Both nursing and midwifery are practice-based professions which are accountable for, and charged with assuring, effective public health and safety. The initial paper which established the key issues discussed here was initially written as one of the key background papers for a consensus conference to inform NHS Education for Scotland’s nursing and midwifery workforce development over the next five years (NES 2009).     

An evaluation of fitness for practice curricula: self-efficacy, support and self-reported competence in preregistration student nurses and midwives

Aims and objectives. This element of the larger Scottish evaluation aimed to explore differences between access routes, cohorts and higher education institutes (HEI) (universities and colleges) in levels of self‐efficacy, student support and self‐reported competence in a nationally representative sample of student nurses and midwives. Background. This paper reports findings from the National Review of Pre‐Registration Nursing and Midwifery Programmes in Scotland. Fitness for practice curricula have been the heart of many recent developments in nurse and midwifery education. Fitness for practice set out to map out the future direction of preregistration nursing and midwifery education with the aim of ensuring fitness for practice based on healthcare need. There have been no national evaluations of the effectiveness of this strategic objective. Previous major evaluations in the 1990s suggested that students may not have had the skills needed to be fit for practice. Design. The study design was a cross‐sectional survey of a stratified random sample of student nurses and midwives (n = 777). Data collected included demographic information, generalised perceived self‐efficacy, student support and self‐reported competency. Results. Students reported high levels of self‐reported competency. There were no significant differences between two cohorts or between students with different access routes. Students rated support from family and friends highest and support from HEI lowest. There was a significant difference in support levels between HEI. Self‐efficacy scores were similar to other population means and showed small‐moderate correlations with self‐report competence. Similarly, self‐reported competency appears to be at the higher end of the spectrum, although older students may have a more realistic perception of their competence. However, support from HEI was seen as less satisfactory and varied from one institution to another. Conclusions. This study portrays a relatively positive picture of preregistration fitness for practice curricula. Questions are raised about the relative value students place on support from educationalists and mentors and whether support from family and friends and from peers needs to feature more prominently in curricula. The study provides modest support for social cognitive theory. Relevance to clinical practice. The major drivers for changes in preregistration curricula stemmed from fears about the competence of students. This study did not provide support for this viewpoint, and students’ self‐reports suggest that curricula are, in this respect, meeting their objectives. Nevertheless support from mentors and from educational institutes may need to be improved.     

The pursuit of excellence and innovation in service user involvement in nurse education programmes: Report from a travel scholarship

The involvement of service users and carers in nurse education is increasing, with the new standards for pre-registration nurse education in the UK, which require nurse education providers to demonstrate how they are involving users and carers in the planning, delivery, teaching and evaluation of nursing curricula (Nursing and Midwifery Council, 2010). A travel scholarship provided the opportunity to explore best practice in this area, focussing on identifying support systems and processes that enable user involvement.The scholarship was undertaken in the UK and Ireland during a 4 week study tour between June and July 2011, during which I visited 15 universities, and met with nurse education staff, users and carers involved in nurse education programmes. Prerequisite processes, the spectrum and variety of involvement activities, quality assurance and evaluation; and sustainability of user involvement in nurse education are reported in this paper. Service users and carers are an under-utilised resource, and as experts by experience have much to offer students and staff by increased involvement in nurse education programmes. The importance of values, enthusiasm and relationships, the cornerstones that strengthen user involvement; often sustain such partnerships.     

Promoting patient safety using electronic medical records in nursing/midwifery undergraduate curricula: Discussion paper

This discussion paper highlights the importance of Australian nursing and midwifery students’ lack of exposure to electronic medical records during their undergraduate programs. There is pressure on universities offering nursing and midwifery programs to provide students with opportunities to learn to use patient electronic medical records. This will provide authentic rehearsal with the digital technology prior to clinical placements and increase graduate work readiness.Informed by contemporary literature, we describe the benefits of implementing electronic medical records (eMR) in health organisations and identify the challenges and barriers to implementing and integrating the education of electronic records into undergraduate nursing and midwifery programs. Undergraduate students who had not experienced eMR as part of on-campus learning felt unprepared and lacked confidence when commencing clinical practice. Some international nursing and midwifery programs have found that student’s skills improve in decision-making and documenting patient observations when eMR is integrated into their university education program. Successful integration of an eMR program should consider academic/teaching staff skills and confidence in technology use, initial and ongoing costs and technical support required to deliver the program.In conclusion, Australian universities need to embed eMR learning experiences into the nursing and midwifery undergraduate curricula to increase students work-readiness with a focus on patient safety.     

Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom

The prevalence and burden of pain has long been reported as problematic. Comprehensive pain education in undergraduate programmes is essential for developing knowledgeable, skilled and effective healthcare professionals. This cross-sectional survey describes the nature, content and learning strategies for pain curricula in undergraduate healthcare programmes in major universities in the United Kingdom (UK). Document analysis also highlighted gaps in pain-related standards from professional regulators and a higher education quality assurance body. The sample consisted of 19 higher education institutions delivering 108 programmes across dentistry, medicine, midwifery, nursing, occupational therapy, pharmacy, physiotherapy and veterinary science.Seventy-four (68.5%) questionnaires were returned averaging 12.0 h of pain content with physiotherapy and veterinary science students receiving the highest input. Pain education accounted for less than 1% of programme hours for some disciplines. Traditional teaching methods dominated (e.g. lectures 87.8%) and only two programmes had fully implemented the International Association for the Study of Pain’s (IASP) curricula. Minimal pain-related standards were found from professional regulators and the quality assurance documents.Pain education is variable across and within disciplines and interprofessional learning is minimal. Published curricula for pain education have been available for over 20 years but are rarely employed and pain is not a core part of regulatory and quality assurance standards for health professions. The hours of pain education is woefully inadequate given the prevalence and burden of pain. Recommendations include the introduction of pain-related educational standards across all professions, greater integration of pain content in undergraduate programmes and interprofessional approaches to the topic.     

The impact of pre-registration education on the motivation and preparation of midwifery students to work in continuity of midwifery care: An integrative review

Access to continuity of midwifery care (CoMC) models in Australia is increasing but the capacity of the emerging midwifery workforce to provide this care remains largely unknown. The aim of this integrative literature review is to discover how well pre-registration midwifery education prepares and motivates Australian midwifery students to work in CoMC models when they enter practice. Following title review of 432 papers, removal of duplicates and review against the inclusion and exclusion criteria, nine papers were included for review.The results show that access to CoMC is a crucial component of midwifery education, equipping students with knowledge, skills, confidence and motivation to work in this way upon graduation. Existing methods of program delivery and institutional structures often present students with challenges that detract from the value of their CoMC experiences. A focus on CoMC placement - particularly with a continuity of midwifery mentor – may motivate graduates to work in this model of care. This strategy is recommended to better align Australian midwifery education with maternity care reform.     

Heutagogy: A self-determined learning approach for Midwifery Continuity of Care experiences

AimThe aim of this discussion paper is to discuss learning theories in midwifery education, as related to the Midwifery Continuity of Care Experience and to propose an original conceptual framework based on Heutagogy.BackgroundMidwifery education curricula include a number of midwifery practice experiences. One of the requirements is for students to provide Midwifery Continuity of Care. To achieve these experiences, students in Australia are required to provide care to at least ten (10) women through pregnancy, be on call for the woman’s birth and provide at least two visits post-birth. Continuity of care experiences appear to have been incorporated without sufficient consideration of the educational purpose of the experience, or how the experiences contribute to the development of the profession. Although we do know midwifery practice embraces woman-centred care as its philosophical underpinning, a learning approach that is congruent with this philosophy needs to be clearly articulated.DesignA discussion paper that compared and contrasted learning theories to align with Midwifery Continuity of Care experiences.MethodsA review of the literature on learning theories was conducted before comparing and contrasting the theories to arrive at a conceptual framework focused on learning theory and its application to the Midwifery Continuity of Care Experience.ResultsHeutagogy provides a potentially congruent educational learning approach to underpin the continuity of care experiences, in comparison to traditional learning theories of pedagogy and andragogy. With a paucity of research in the application of heutagogy to midwifery education, it’s conceptual underpinnings and the possible application to the Continuity of Care Experience, this paper explores the possible theoretical applications of heutagogy to midwifery education.ConclusionAs a learning theory, heutagogy is well - aligned with woman-centred care. Heutagogy provides a theoretical framework suitable to underpin strategies, including the conceptual framework proposed, that may assist in empowering students to participate in their own education by giving them the ability to be self-determined in both their approach to learning and to evaluate their own learning needs.     

Ethics education in advanced practice nursing: respect for human dignity

Ethics education is an essential component of academic programs that prepare nurses for advanced practice; the concept of respect for human dignity is integral to this education. Sixty-three graduate students enrolled in their first course of a nurse practitioner program completed a researcher-developed Ethics Questionnaire that was designed to elicit their baseline ethics-related knowledge, including their understanding of the concept "respect for human dignity". Qualitative analysis of data yielded findings that validate the importance of using the American Nurses Association Code of Ethics for Nurses with Interpretive Statements as an essential foundation for ethics content and as a framework for understanding the meaning of human dignity in advanced practice nursing. Assessment and learning strategies are recommended.     

The midwifery miniCEX – A valuable clinical assessment tool for midwifery education

BackgroundMidwifery students, clinicians and educators in Australia identified the need for improved feedback for midwifery students whilst they are on clinical placement; in particular formative assessment. The miniCEX or mini-clinical evaluation exercise is one approach to assessment that has been proven valid and reliable in medical education. The aim of this research was to develop, implement and evaluate a miniCEX tool for midwifery education.MethodsUsing an action research approach, this project engaged midwifery clinicians and midwifery students to adapt and implement the miniCEX in a postnatal ward environment. Focus groups were held to establish the clinical expectations and develop performance guidelines of students across the domains of midwifery practice, as well as evaluate their use in practice.FindingsEvaluation of the midwifery miniCEX, including its applicability from the perspective of staff and students was positive. The miniCEX was found to be easy to use, time efficient and valuable for learning.DiscussionThe miniCEX is an innovative approach to assessment and feedback in midwifery education, and there is currently no identified evidence of its use in midwifery education despite broad use globally in medical education.ConclusionThe implementation of the midwifery miniCEX offers broad benefit to both midwifery students and midwifery clinicians and educators globally.     

An international exploration of blended learning use in pre-registration nursing and midwifery education

AimTo explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.BackgroundThe global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.DesignCross-sectional, sequential, mixed methods studyParticipants/settingsNursing/nurse education leaders from across International Council of Nurses regionsMethodsExploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants’ knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.ResultsParticipants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.ConclusionsBlended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.Tweetable abstractBlended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.     

A dignified approach to improving the patient experience: promoting privacy, dignity and respect through collaborative training

Globally there is a plethora of literature surrounding patients' privacy, dignity and respect, consequently highlighting the need for healthcare professionals to ensure such basic human rights are upheld when delivering care. For qualified practitioners this is further emphasised through the professional bodies and their varying codes of practice. To ensure privacy, dignity and respect move from rhetoric to reality in professional practice many pre-registration programmes promote service user involvement. Evidence suggests that involving service users in the delivery of educational programmes by directly telling their own stories enhances patient centred care. However given a number of recent patient surveys and/or audits reporting the lack of privacy, dignity and respect in health and social care settings there seems to be a growing need to reaffirm practitioners' knowledge, skills and values once qualified and practising in healthcare organisations. This paper reports on a project in a UK NHS Mental health Trust where service users, in collaboration with Trust staff, planned and delivered a series of privacy and dignity workshops to healthcare practitioners with the aim of improving the patient experience. Although the project took place within a Mental Health Trust the issues of privacy, dignity and respect apply to all healthcare sectors.     

A cross-sectional study of domestic violence instruction in nursing and midwifery programs: Out of step with community and student expectations

BackgroundDomestic violence is a global health concern. Nurses and midwives must respond to those who experience domestic violence, although many are not prepared to do this. The World Health Organization recommend that domestic violence content be included in all pre-registration training as a matter of urgency.ObjectivesTo examine self-reported undergraduate student perceptions of domestic violence content in their programs of study and student attitudes and beliefs about domestic violence.DesignA cross-sectional research design with online survey was employed from June to October 2017.MethodsUsing convenience sampling, 1076 students were recruited to the study from a total population sample of just over 6000 undergraduate nursing and midwifery students; a response rate of 17.9%. Survey data reported the nature and frequency of teaching and learning along with student attitudes and beliefs about domestic violence. Open ended responses were examined via thematic analysis.SettingsNine Australian universities offering undergraduate nursing and midwifery degrees.ParticipantsUndergraduate university nursing and midwifery students.ResultsOver half of students surveyed (53.7%, n = 578) reported that domestic violence was not addressed in their program of study. A direct correlation was found between students' perceived preparedness to assess and respond to domestic violence, and the amount of taught content in their program of study.ConclusionThis major gap in curricula has significant implications for professional practice preparedness. Further research should focus on examining the reasons why quality domestic violence content is lacking in undergraduate nursing and midwifery programs and how prioritisation of domestic violence content can be improved.     

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.     

Developing awareness of sustainability in nursing and midwifery using a scenario-based approach: Evidence from a pre and post educational intervention study

BackgroundThe delivery of healthcare has an impact on the environment and contributes to climate change. As a consequence, the way in which nurses and midwives use and dispose of natural resources in clinical practice, and the subsequent impact on the environment, should be integral component of nursing and midwifery education. Opportunities need to be found to embed such issues into nursing curricula; thus bringing sustainability issues ‘closer to home’ and making them more relevant for clinical practice.ObjectivesThe study was designed to measure the impact of a sustainability-focussed, scenario-based learning educational intervention on the attitudes and knowledge of student nurses and midwives.DesignPre test/Post test intervention study using scenario-based learning as the educational intervention. The Sustainability Attitudes in Nursing Survey (SANS_2) was used as the outcome measure.SettingsClinical skills session in a UK University School of Nursing and Midwifery.Participants676 second year undergraduate nursing and midwifery students.MethodsThe 7-point scale SANS survey was completed before and after the teaching session; standard non-parametric analysis compared pre and post intervention scores.ResultsChanges were observed in attitude towards climate change and sustainability and to the inclusion of these topics within the nursing curricula (p = 0.000). Participants demonstrated greater knowledge of natural resource use and the cost of waste disposal following the session (p = 0.000). Participants also reported that sessions were realistic, and levels of agreement with statements supporting the value of the session and the interactive nature of delivery were higher following the session.ConclusionsUsing a scenario-based learning approach with nursing and midwifery students can change attitudes and knowledge towards sustainability and climate change. Embedding this approach in the context of clinical skills provides a novel and engaging approach that is both educationally sound and clinically relevant.     

Assertiveness training for undergraduate midwifery students

Assertiveness can be defined as an interpersonal behaviour that promotes the fact all people in a relationship are equally important. All health professionals including midwives must work with and care for people. At times this will include facilitating interactions that require skilful negotiation and assertiveness. Yet embedding assertiveness education into undergraduate midwifery curricula has not been widely adopted.This paper explores one method of delivering assertiveness training in an undergraduate midwifery course and provides comment on the effectiveness of this strategy in developing assertiveness skills in a cohort of undergraduate midwifery students.We used an assertiveness survey which was administered immediately before and 3–4 months after an assertiveness training workshop.All students (n = 55) attending the training day were invited to participate. Of these 41 (77% response) chose to participate in the pre intervention survey and 32 participated (9 students lost to follow-up) in the follow up survey.There was an overall improvement in self-perceived assertiveness scores following the assertiveness training workshop.These findings provide encouraging evidence that educational institutions that offer specific and targeted assertiveness education will be rewarded with more assertive graduates.