Reflective education for professional practice: discovering knowledge from experience

To continually develop as a discipline, a profession needs to generate a knowledge base that can evolve from education and practice. Midwifery reflective practitioners have the potential to develop clinical expertise directed towards achieving desirable, safe and effective practice. Midwives are 'with woman', providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Midwife educators and practitioners can assist students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. This paper explores journal writing as a learning strategy for the development of reflective skills within midwifery and explores its value for midwifery education. It also examines, through the use of critical social theory and adult learning principles, how midwives can assist and thus enhance students learning through the development of professional and reflective skills for midwifery practice.     

Using online roleplay in undergraduate midwifery education: A case-study

Online roleplay i.e. role play which occurs using an online asynchronous discussion board, can be effectively utilised to teach a variety of skills to midwifery students. This paper will discuss the design and implementation of an online roleplay for a small (n = 19) class of final year undergraduate Midwifery students. It briefly describes the design of the online roleplay and outlines the expected learning outcomes of the activity. It then outlines evaluative survey results for student evaluation of the online role play. Results focus on student opinion of communication and collaboration skills developed through participation in the roleplay. Students considered that the online roleplay provided them with a means to allow communication skills to be developed and practiced. They also believed that the roleplay enable them to practice collaboration in an authentic real world setting. Finally implications for use of this method of teaching in nurse/midwife education are discussed.     

The application of reusable learning objects (RLOs) in preparation for a simulation laboratory in medication management: An evaluative study

To enhance the preparedness of undergraduate nursing and midwifery students to participate in the safe provision of medication administration on their clinical placements, an innovative blended learning strategy was designed and developed by the authors. The blended learning strategy included a suite of online reusable learning objects specific to medication management theoretical knowledge and psychomotor skills to prepare students for a 90-minute practical face to face simulation laboratory session. Students identified that the reusable learning objects had prepared them for the simulation laboratory session and was rated as a productive learning experience. The blended learning strategy implemented to teaching and learning medication management to undergraduate nursing and midwifery students can positively influence students’ acquisition of knowledge and psychomotor skills to safely administer medications prior to their practice placements in a clinical setting.     

Using a simulated environment to support students learning clinical skills

Within intellectual disability nursing students are prepared within a biopsychosocialeducational model and curriculum address these challenges. Using a simulated learning environment has great potential for promoting competence and in-depth knowledge of substantive topics relevant to practice. This article presents an assignment designed to more closely resemble real–world activities to allow students develop and exercise skills that translate to practice activities and incorporates a student's reflective comments on the process. The assignment was designed to foster intellectual disability student nurses ability to facilitate family/client education. The aim of the assignment was fulfilled through the students designing a clinical skill teaching session that could be used with families/clients. The sessions were recorded and the student reviewed their recording to reflect on their performance and to self assess. To facilitate student learning the modules academic lecturer also reviewed the recording and both lecturer and student meet to discuss the reflection and self assessment.     

Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.     

助产专业本科助产技能综合实训课程的设置与实践

目的探讨助产专业本科层次助产技能综合实训课程的效果评价。方法以临床工作过程为主线,设计助产技能综合实训课程(44学时)。采用课堂讲授、视频教学、小组讨论、实操演练等多种形式,对2016级大学三年级30名助产专业学生进行教学。课后采用多站式客观结构化临床考试评价学生的综合实践能力,并收集学生和教师对实训课程教学的评价。结果学生操作考核成绩为(92.21±2.01)分。学生及教师对课程的内容设置、教学方法等均比较满意,认为课程可以提高助产技能的综合应用能力。结论助产技能综合实训课程有助于提高学生助产技能综合应用能力、言语表达和沟通能力、分析和解决问题的能力、合作意识,缩短实验教学与临床实践的差距。     

床边教学法在助产学教学中的应用

目的 探讨床边教学法在助产学教学中的应用效果.方法 便利选取浙江中医药大学2017级助产专业学生(62名)为研究对象,采用床边教学法,将助产学中的理论及实验课内容融入到临床实际当中进行教学.教学结束后了解学生的参与程度,应用教学效果问卷评价床边教学的效果,并将2017级学生案例分析成绩与2016级进行比较.结果 学生课...     

The 'follow-through' experience in three-year Bachelor of Midwifery programs in Australia: a survey of students

IntroductionThe follow-through experience in Australian midwifery education is a strategy that requires midwifery students to ‘follow’ a number of women through pregnancy, labour and birth and into the parenting period.BackgroundThe experience was introduced by the Australian College of Midwives as part of national standards for the three-year Bachelor of Midwifery programs. Anecdotally, the introduction caused considerable debate. A criticism was that these experiences were incorporated with little evidence of their value.MethodsAn online survey was undertaken to explore the follow-through experience from the perspectives of current and former students. There were 101 respondents, 93 current students with eight recent graduates.ResultsParticipants were positive about developing relationships with women. They also identified aspects of the follow-through experience that were challenging. Support to assist with the experience was often lacking and the documentation required varied. Despite these difficulties, 75% felt it should be mandatory as it facilitated positive learning experiences.DiscussionThe follow-through experience ensured that students were exposed to midwifery continuity of care. The development of relationships with women was an important aspect of learning.ConclusionDespite these challenges, there were significant learning opportunities. Future work and research needs to ensure than an integrated approach is taken to enhance learning.     

Teaching evidence based practice and research through blended learning to undergraduate midwifery students from a practice based perspective

The international world of higher education is changing with universities now offering students flexible delivery options that allow them to study away from campus and at a time convenient to them. Some students prefer on line learning while others prefer face to face contact offered through a traditional lecture and tutorial delivery modes. The response by many universities is to offer a blend of both. While online and blended mode of delivery may be suitable for some subjects there is little knowledge of the efficacy of blended learning models to teach evidence based practice and research (EBPR) to undergraduate midwifery students. EBPR is a challenging, threshold level subject upon which deeper knowledge and skills are built. This paper describes the design, delivery, and evaluation of an undergraduate EBPR course delivered in blended mode to first year midwifery students. Components of the blended learning innovation included: novel teaching strategies, engaging practical activities, role play, and e-learning strategies to maintain engagement. University-based course evaluation outcomes revealed very positive scores and the course was rated within the top ten percent of all courses offered within the Health Group at the host University.     

Building midwifery educator capacity using international partnerships: Findings from a qualitative study

Midwifery educators play a critical role in strengthening the midwifery workforce globally, including in low and lower-middle income countries (LMIC) to ensure that midwives are adequately prepared to deliver quality midwifery care. The most effective approach to building midwifery educator capacity is not always clear. The aim of this study was to determine how one capacity building approach in Papua New Guinea (PNG) used international partnerships to improve teaching and learning. A qualitative exploratory case study design was used to explore the perspectives of 26 midwifery educators working in midwifery education institutions in PNG. Seven themes were identified which provide insights into the factors that enable and constrain midwifery educator capacity building. The study provides insights into strategies which may aid institutions and individuals better plan and implement international midwifery partnerships to strengthen context-specific knowledge and skills in teaching. Further research is necessary to assess how these findings can be transferred to other contexts.     

The perceptions of undergraduate student nurses of high-fidelity simulation-based learning: a case report from the University of Tasmania

This paper reports a qualitatively informed curriculum research project in the three-year Bachelor of Nursing (BN) at the School of Nursing and Midwifery (SNM) at the University of Tasmania. The project investigated the perceptions of second year undergraduate nurses and their academic teachers of their experiences of high-fidelity simulation using the Laerdal Vital Sim Nursing Kelly and Nursing Anne technology(2) as part of their preparation for clinical practice. An associated curriculum benchmarking audit was also undertaken. A voluntary purposeful sample of students enrolled in a clinically-based practise unit(3) participated in the research, along with a small cohort of academic teachers. The results indicated that undergraduate nursing students value the opportunity to practice nursing activities in a safe environment prior to clinical placement. Students believed that simulation is an innovative strategy that promotes active learning and has great potential for developing clinical competence and increasing confidence prior to practise. The academic staff reported a similar belief about the potential of high-fidelity simulation in a case-based curriculum. The associated curriculum benchmarking audit provided evidence to support further integration of high-fidelity simulation in the undergraduate nursing program.     

Midwifery participatory curriculum development: Transformation through active partnership

Evolving knowledge and professional practice combined with advances in pedagogy and learning technology create challenges for accredited professional programs. Internationally a sparsity of literature exists around curriculum development for professional programs responsive to regulatory and societal drivers. This paper evaluates a participatory curriculum development framework, adapted from the community development sector, to determine its applicability to promote engagement and ownership during the development of a Bachelor of Midwifery curriculum at an Australian University. The structures, processes and resulting curriculum development framework are described. A representative sample of key curriculum development team members were interviewed in relation to their participation. Qualitative analysis of transcribed interviews occurred through inductive, essentialist thematic analysis. Two main themes emerged: (1) ‘it is a transformative journey’ and (2) focused ‘partnership in action’. Results confirmed the participatory curriculum development process provides symbiotic benefits to participants leading to individual and organisational growth and the perception of a shared curriculum. A final operational model using a participatory curriculum development process to guide the development of accredited health programs emerged. The model provides an appropriate structure to create meaningful collaboration with multiple stakeholders to produce a curriculum that is contemporary, underpinned by evidence and reflective of ‘real world’ practice.     

An innovative strategy in evaluation: using a student engagement framework to evaluate a role-based simulation

Online role-play has the potential to actively engage students in authentic learning experiences and help develop their clinical reasoning skills. However, evaluation of student learning for this kind of simulation focuses mainly on the content and outcome of learning, rather than on the process of learning through student engagement. This article reports on the use of a student engagement framework to evaluate an online role-play offered as part of a course in Bachelor of Nursing and Bachelor of Midwifery programs. Instruments that measure student engagement to date have targeted large numbers of students at program and institutional levels, rather than at the level of a specific learning activity. Although the framework produced some useful findings for evaluation purposes, further refinement of the questions is required to be certain that deep learning results from the engagement that occurs with course-level learning initiatives.     

Using problem-based learning in web-based components of nurse education

Problem-based learning (PBL) is a student-centred method of teaching, and is initiated by introducing a clinical problem through which learning is fostered by active inquisition (Tavakol and Reicherter, 2003). Using this teaching and learning strategy for web-based environments is examined from the literature for potential implementation in a Bachelor of Nursing program. In view of the evidence, students accessing online nursing subjects would seem to benefit from web-based PBL as it provides flexibility, opportunities for discussion and co-participation, encourages student autonomy, and allows construction of meaning as the problems mirror the real world. PBL also promotes critical thinking and transfer of theory to practice. It is recommended that some components of practice-based subjects such as Clinical Practice or Community Health Nursing, could be implemented online using a PBL format, which should also include a discussion forum to enable group work for problem-solving activities, and tutor facilitation.     

Double degree destinations: Nursing or midwifery

BackgroundDouble degrees in nursing and midwifery have evolved in Australia as a proposed solution to possible impending shortages of qualified midwives in the healthcare workforce. The double degree is seen as a more acceptable option in non-metropolitan areas in particular. Concern has been expressed however, about dilution of midwifery philosophy and graduates’ opportunities in respect of future clinical practice.AimThis study aimed to provide a better understanding of motivations and intentions of students who undertake the Bachelor of Nursing Science/Bachelor of Midwifery double degree.MethodsA cross-sectional survey design was employed at four universities that offered double degrees in nursing and midwifery in three states of Australia. Students enrolled in first and fourth year of a double degree and graduates of a double degree were invited to complete an online survey comprised of Likert scales and items requiring free text responses. Quantitative data was analysed using SPSS and thematic analysis was used to analyse the qualitative data.FindingsParticipants indicated a clear preference for midwifery as a career with this preference increasing for each cohort at each stage of study.DiscussionPrimary reasons for selecting a double degree were perceived increased opportunity for employment and use of nursing skills to enhance midwifery practice in a population with growing co-morbidities. A strong identification with midwifery philosophy and identity was also demonstrated.ConclusionAn understanding of motivations and career intentions of students undertaking double degree studies can inform future program development and workforce planning.     

Assessment of learning needs and the development of an educational programme for registered nurses in advanced midwifery and neonatology

A key step in the development of any educational programme is learning needs assessment. This is however often neglected. The purpose of this research was to identify learning needs of potential students in order to develop a relevant educational programme for registered nurses in advanced midwifery and neonatology. A survey design was used, and the population of the study was the registered nurses in the Free State. Two thousand questionnaires were mailed to respondents, selected by means of simple random sampling. Advanced educational programmes emphasize the teaching of advanced knowledge and skills and accept that the students entering these programmes already have specific knowledge and skills included in the curricula for basic programmes. This is contrary to the findings of this study. The results underline the importance of learning needs assessment in the development of relevant educational programmes.     

An evaluation of the appropriateness and effectiveness of structured reflection for midwifery students in Ireland

Midwifery students undertaking the undergraduate midwifery education programme in Ireland participate in facilitated reflective sessions that aim to develop their skills of reflecting on and in clinical practice. This paper presents a qualitative evaluation of the appropriateness and effectiveness of the facilitated reflection sessions for pre and post-registration midwifery students in two large Dublin maternity teaching hospitals. The aim was to evaluate structured reflective practice sessions which sought to assist midwifery students to become competent reflective practitioners. Group reflection sessions were conducted weekly in a clinical practice area at the same time each week over one academic year. After the series of structured reflective sessions, midwifery students and facilitating staff were invited to evaluate the reflective process. This evaluation consisted of a self-completion survey to identify the factors that facilitated and impeded student participation in the sessions. Respondents answered a series of questions about the reflective practice sessions and were also invited to enter qualitative data regarding their subjective experiences of the process in free text boxes. The data were then collated into themes by an independent reviewer. The results of the evaluation clearly indicate that midwifery students and facilitators welcomed the opportunity to engage in group reflection sessions as a form of peer support and as a catalyst for learning from clinical practice. Findings suggest that reflective practice can contribute to the development of skilled, self-aware and engaged practitioners.