Relationship between reflection ability and clinical performance: A cross-sectional and retrospective-longitudinal correlational cohort study in midwifery

Strategies used by midwives to enhance knowledge and skill development in midwifery students: an appreciative inquiry study

BACKGROUND

Midwifery practice experience for midwifery students is an important component of education to enhance knowledge and skill development. Practicing midwives provide student support in the clinical setting, there is minimal literature relating to strategies midwives use to support students.

OBJECTIVE

To explore midwifery student experiences of the strategies used by midwives to facilitate knowledge and skill development in the clinical practice setting.

METHODS

Qualitative approach based on Appreciative Inquiry. The setting is one University in Australia. Participants, thirteen Graduate Diploma in Midwifery students. Individual interviews followed by thematic analysis.

RESULTS

Data analysis identified six themes, Willingness to share knowledge and develop skills; The positive use of questioning; Moderating support; Teaching through the woman; Learning through problematisation and Providing constructive affirmation.

CONCLUSIONS

Midwives incorporated varied strategies to support student development in the clinical setting. For an equitable clinical experience, all midwives need support to develop skills and confidence in facilitating student learning.

Continuing Midwifery Education: Midwifery Encouragements of Continuing Professional Education in Profession Stage in Indonesia: A Qualitative Study

BACKGROUND: High maternal and child morbidity and problems related to maternal and child health requires increasing the professionalism of the midwife profession through continuing education. The main competencies of midwives as service providers, educators, community leaders, managers, and decision-makers are carried out to provide midwifery services. AIM: The purpose of this study was to determine the motivation of midwives in continuing education at the professional level. METHODS: This research is qualitative research with a theoretical basis. Collecting data through focus group discussion and followed by in-depth interviews with nine midwives who are continuing their professional education four midwives education and professional organization. Analysis of the data used using fixed comparison analysis. RESULTS: The results of the qualitative analysis produced two themes, namely: internal encouragement with the sub-themes of midwives’ understanding of the body of knowledge of professional education, academic progress, self-development, professional recognition; and external encouragement with the sub-themes of career paths, policies, workplace, and professional organization. CONCLUSION: There are internal and external incentives that affect midwives who have worked to continue their education to a higher level.

Student midwives' perception of peer learning during their clinical practice in an obstetric unit: A qualitative study

BACKGROUND

Evidence supports peer learning in clinical settings, but it has not been studied in obstetric units. In Sweden, obstetric units are a challenging learning area for student midwives because of the lack of attention to student needs and the stress of attaining the final number of 50 assisted births.

OBJECTIVES

To explore how student midwives experienced peer learning during clinical placement in an obstetric unit.

DESIGN

Qualitative approach.

SETTINGS

Three hospitals and obstetric units in Stockholm, Sweden.

PARTICIPANTS

Fifteen student midwives in a peer-learning model during clinical placement.

METHODS

Individual interviews followed by deductive content analysis using Boud's (2001) theoretical descriptions of peer learning.

RESULTS

The students shared skills, experience, and knowledge as equals and took responsibility for their peers' learning while supporting women in labor and childbirth. Students shared ideas, thoughts, and knowledge and gained perspective while learning as peers on an equal level. Students used each other to work independently without much involvement from the preceptor. Feedback was welcomed as encouragement.

CONCLUSIONS

Peer learning had positive consequences as an educational model in the clinical context in obstetric units.

Measurable reflection in simulation: A pilot study

PURPOSE

Debriefing is considered a cornerstone in the success of simulated learning practices. For debriefing to be productive and meaningful, reflection of the learners is essential. Measuring reflection during debriefing has proven to be difficult. This study aimed to validate a reflection rubric based on Kolb's Theory of Experiential Learning and integrate the assessment tool into simulation debriefing practice.

METHODS

This research was a non-experimental mixed-methods, sequential explanatory design. Validation for the rubric was accomplished by expert content review and an observation process. Students participated in a standardized patient simulation (SPS) portraying a patient with bipolar disorder. The SPS debriefings were recorded and thematically coded to determine the quality and level of reflection of the students according to the following rubric criteria based on Kolb's theory: (1) Concrete Experience, (2) Reflective Observation, (3) Abstract Conceptualism, and (4) Active Experimentation. A descriptive statistical analysis of student responses was applied.

RESULTS

The Debriefing Reflection Rubric was successful in determining the level of reflection in the dental hygiene students; further descriptive results were evaluated by a thematic analysis of student responses (N = 173). Student responses demonstrated reflective observations and concrete experiences (n = 112); however, dental hygiene students demonstrated limited responses (n = 61) to abstract conceptualism and connecting their experience to future goals and experimentation.

CONCLUSION

The Debriefing Reflection Rubric, based on Kolb's Theory of Experiential Learning, was successful in measuring a learner's level and quality of reflection during a simulation debriefing.

Developing confidence during midwifery training: The experience of Swedish final year students

OBJECTIVES

Confidence is essential in performing midwifery care since the profession places great demands on the ability to work independently with a scientific approach and professional responsibility. Clinical training is extensive during midwifery education and is essential for the development of midwifery student's confidence and competence. The aim of the study was to describe the factors that increased and decreased confidence for midwifery students in clinical practice.

STUDY DESIGN

A qualitative design was used. Data was collected by a questionnaire that measured Swedish students' self-reported assessment of selected midwifery competencies. Two open questions gave the students the possibility to comment on what affected confidence during clinical practice. There were 401 comments analyzed by manifest content analysis.

RESULTS

Five categories described the experience of the students. Supervision during clinical training and the relationship with the midwives were most important factors for developing confidence. Further, to be theoretically and practically prepared before entering clinical practice. Regardless of activity the environment has to be learning and give time for reflection. Personal factors could affect professional confidence but above all it takes time to learn and practice midwifery. Factors that decreased confidence were stressed and uninterested supervisors. Patronizing attitudes towards students and the fear of doing something wrong also decreased confidence.

CONCLUSIONS

Several factors contributes to enhance confidence among midwifery students in clinical training. The most important factor was supervision and the role as supervisor must be emphasized and sufficient time must be allocated to supervising midwives for them to fulfil their commitment.

Exploring the needs and experiences of educators in facilitating use of the Bass Model of Holistic Reflection

Health professionals are required to reflect on practice to evaluate and improve care in rapidly changing health care environments. This study explored the professional development needs of educators facilitating development of reflective capacity in midwifery students using the Bass Model of Holistic Reflection. Thirteen midwifery academics at two Australian universities took part in the study conducted in three phases. Phase 1 identified the learning needs of educators described as 'understanding the building blocks of reflection'; 'practical application of the model, and 'assessment of reflective capacity'. Phase 2 involved an Intervention including development of a reflective practice tool kit and delivery of a two-day workshop. Phase 3 evaluated the experience of educators using the resources and four themes emerged: 1) 'Educators value a reflective practice toolkit'; 2) 'A toolkit builds confidence and trust in the model through promotion of deep personal reflection'; 3) 'Effective use of the model is key to achieving consistency in application by educators; and 4) 'Deeper understanding of the model promotes transformation of practice'. This paper confirms the importance of developing resources for educators, that support reflective pedagogy when implementing models of reflection into curricula.

Can a reflective rubric be applied consistently with raters globally? A study across three countries

INTRODUCTION

Reflection is a powerful tool for assisting students to develop the skills to make better informed decisions. As a pharmacy competency standard, reliable and fair assessment strategies are required to measure reflective skills and support students in developing their reflective capacity. The aim of this research was to explore whether we can extend the applicability of a previously tested rubric to a range of educational settings, to account for diversity of pharmacy educators and curricula internationally.

METHODS

Four raters from three countries applied a reflective rubric to assess a sample (n = 43) of reflective accounts, representing 41% of a cohort of 105 second-year undergraduate pharmacy students. The interrater reliability (IRR) was measured utilizing the intra-class correlation coefficient (ICC), using a two-way random effects model with absolute agreement, to determine the level of agreement between the raters' absolute scores. Generalizability Theory analysis was used to estimate generalizability of raters and stages.

RESULTS

Results indicated agreement of raters for (i) each of the seven stages of reflection and (ii) overall score for the reflective account, with moderate to substantial agreement (ICC = 0.55-0.69, p < 0.001); and high agreement for all raters for the overall score (ICC = 0.96, p < 0.001), respectively. The G-Study estimated a relative error coefficient of 0.78.

CONCLUSION

This additional analysis further confirms the reliability and applicability of the rubric to a range of rater academic backgrounds.

Midwifery students' experiences of learning through the use of written reflections - An interview study

In an effort to strengthen midwifery students' learning process, written reflections during the students' clinical practice at birth units have been applied. The aim of this study was to examine how students of midwifery experienced the writing of daily reflections on their practice at birthing units. An interview study was carried out using an inductive method with descriptive design. During 2013 (n = 12) and 2014 (n = 7), respondents were recruited from two cohorts of midwifery students (n = 19) at a university in southern Sweden. Narrative interviews were carried out. The interviews were analysed with thematic content analysis. One theme including four categories emerged from the analysis. The theme was "An educational strategy for the present and the future". The four categories were "Towards personal and professional development", "Reflection requires effort", "Supervisors' commitment" and "Clarification of the rationale". Daily written reflections are useful for students' personal and professional development during clinical practice/placement. In order for the reflections to be used optimally, students must be given clear instructions on the purpose of their use and be given enough time to write them. Furthermore, supervisors must provide constructive feedback on the students' written reflections.

[Evaluation of Maternal and Neonatal Health Services sein Guinea-Conakry and Togo.]

INTRODUCTION

The quality of mother and child healthcare remains a challenge for low and middle income countries. Quality interventions that allow a reduction of maternal and infantile mortality require the services of qualified personnel. The objective of this study is to present the results of analysis of the status of human healthcare resources and the quality of healthcare (technical, interpersonal, organisational) they provide to mothers and neonates in Guinea and Togo.

METHODS

Data were derived from Guinea and Togo case studies with embedded levels of analysis. Participants were: maternal and neonatal health care resources (MNCHR), health care beneficiaries, community members. Data collection methods comprised: observations of MNHCR clinical practice; interviews (beneficiaries, health care establishment and educational institution personnel); and focus groups (men, women, community leaders, students). Analysis consisted of qualitative analysis of the content of interviews and focus groups and quantitative analysis of quality scores.

RESULTS

The observations revealed a low level of health care quality for all criteria. Non-technical quality varied according to: the health establishment and level of experience, the MNHCR qualifications, specialisation and basic training. Geographic and financial accessibility, maternal and neonatal health care personnel capacities, continuity and extent of their services are unsatisfactory.

CONCLUSION

Recommendations target the establishment of public policies to reinforce MNHCR capacities, standard to define their practice, and organisation and work environment. Conclusions could be used as benchmarks for other countries from Sub-Saharan Africa.

Using Reflective Writing as a Predictor of Academic Success in Different Assessment Formats

Objectives. To investigate whether reflective-writing skills are associated with academic success. Methods. Two hundred sixty-four students enrolled in a pharmacy practice course completed reflective statements. Regression procedures were conducted to determine whether reflective-writing skills were associated with academic success in different assessment formats: written, oral, and video tasks. Results. Reflective-writing skills were found to be a predictor of academic performance in some formats of assessment: written examination; oral assessment task and overall score for the Unit of Study (UoS). Reflective writing skills were not found to predict academic success in the video assessment task. Conclusions. Possessing good reflective-writing skills was associated with improved academic performance. Further research is recommended investigating the impact of reflective skill development on academic performance measures in other health education.