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Shikuku DN, Bar-Zeev S, Ladur AN, Allott H, Mwaura C, Nandikove P, Uyara A, Tallam E, Ndirangu E, Waweru L, Nyaga L, Bashir I, Bedwell C, Ameh C. Experiences, barriers and perspectives of midwifery educators, mentors and students implementing the updated emergency obstetric and newborn care-enhanced pre-service midwifery curriculum in Kenya: a nested qualitative study. BMC MEDICAL EDUCATION 2024; 24:950. [PMID: 39217305 PMCID: PMC11365191 DOI: 10.1186/s12909-024-05872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION To achieve quality midwifery education, understanding the experiences of midwifery educators and students in implementing a competency-based pre-service curriculum is critical. This study explored the experiences of and barriers to implementing a pre-service curriculum updated with emergency obstetric and newborn care (EmONC) skills by midwifery educators, students and mentors in Kenya. METHODS This was a nested qualitative study within the cluster randomised controlled trial investigating the effectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in 20 colleges in Kenya. Following the pre-service midwifery curriculum EmONC update, capacity strengthening of educators through training (in both study arms) and additional mentoring of intervention-arm educators was undertaken. Focus group discussions were used to explore the experiences of and barriers to implementing the EmONC-enhanced curriculum by 20 educators and eight mentors. Debrief/feedback sessions with 6-9 students from each of the 20 colleges were conducted and field notes were taken. Data were analysed thematically using Braun and Clarke's six step criteria. RESULTS Themes identified related to experiences were: (i) relevancy of updated EmONC-enhanced curriculum to improve practice, (ii) training and mentoring valued as continuous professional development opportunities for midwifery educators, (iii) effective teaching and learning strategies acquired - peer teaching (teacher-teacher and student-student), simulation/scenario teaching and effective feedback techniques for effective learning and, (iv) effective collaborations between school/academic institution and hospital/clinical staff promoted effective training/learning. Barriers identified were (i) midwifery faculty shortage and heavy workload vs. high student population, (ii) infrastructure gaps in simulation teaching - inadequate space for simulation and lack of equipment inventory audits for replenishment (iii) inadequate clinical support for students due to inadequate clinical sites for experience, ineffective supervision and mentoring support, lack/shortage of clinical mentors and untrained hospital/clinical staff in EmONC and (iv) limited resources to support effective learning. CONCLUSION Findings reveal an overwhelmed midwifery faculty and an urgent demand for students support in clinical settings to acquire EmONC competencies for enhanced practice. For quality midwifery education, adequate resources and regulatory/policy directives are needed in midwifery faculty staffing and development. A continuous professional development specific for educators is needed for effective student teaching and learning of a competency-based pre-service curriculum.
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Affiliation(s)
- Duncan N Shikuku
- Liverpool School of Tropical Medicine (Kenya), P.O. Box 24672-00100, Nairobi, Kenya.
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK.
| | - Sarah Bar-Zeev
- Burnet Institute, 85 Commercial Road Prahran Victoria, Melbourne, Australia
| | | | - Helen Allott
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
| | - Catherine Mwaura
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Peter Nandikove
- Masinde Muliro University of Science and Technology, P.O. Box 190-50100, Kakamega, Kenya
| | - Alphonce Uyara
- Alphonce Uyara, Maseno University, P.O. Box 3275-40100, Kisumu, Kenya
| | - Edna Tallam
- Nursing Council of Kenya, P.O. Box 20056-00200, Nairobi, Kenya
| | - Eunice Ndirangu
- Aga Khan University of East Africa, P.O Box 39340-00623, Nairobi, Kenya
| | - Lucy Waweru
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Lucy Nyaga
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Issak Bashir
- Department of Family Health, Ministry of Health (Kenya), P.O. Box 30016-00100, Nairobi, Kenya
| | - Carol Bedwell
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
| | - Charles Ameh
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
- University of Nairobi, P. O. Box 19676-00100, Nairobi, Kenya
- Diponegoro University, JI. Prof Sudarto No 13, Temalang, Kec, Tembalang, P. O. Box 19676-00100, Kota, Semarang, Jawa Tengah, 50275, Indonesia
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Mann J, Brooks MB, Kella F, Euller L, Adelman S, Sonnie M, van de Water B. The impact of clinical placement site, community clinic versus tertiary hospital, on midwifery students' clinical learning experience in Sierra Leone: a cohort study. BMC MEDICAL EDUCATION 2023; 23:416. [PMID: 37287016 DOI: 10.1186/s12909-023-04413-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND In midwifery education, the clinical learning experience (CLE) is a critical component to gaining competency and should comprise greater than 50% of a student's education. Many studies have identified positive and negative factors affecting students' CLE. However, few studies have directly compared the difference in CLE based on placement at a community clinic versus a tertiary hospital. METHODS The aim of this study was to examine how clinical placement site, clinic or hospital, impacts students' CLE in Sierra Leone. A once 34-question survey was given to midwifery students attending one of four public midwifery schools in Sierra Leone. Median scores were compared for survey items by placement site using Wilcoxon tests. The relationship between clinical placement and student's experience were assessed using multilevel logistic regression. RESULTS Two-hundred students (hospitals students = 145 (72.5%); clinic students = 55 (27.5%) across Sierra Leone completed surveys. Most students (76%, n = 151) reported satisfaction with their clinical placement. Students placed at clinics were more satisfied with opportunities to practice/develop skills (p = 0.007) and more strongly agreed preceptors treated them with respect (p = 0.001), helped improve their skills (p = 0.001), provided a safe environment to ask questions (p = 0.002), and had stronger teaching/mentorship skills (p = 0.009) than hospital students. Students placed at hospitals had greater satisfaction in exposure to certain clinical opportunities including completing partographs (p < 0.001); perineal suturing (p < 0.001); drug calculations/administration (p < 0.001) and estimation of blood loss (p = 0.004) compared to clinic students. The odds of students spending more than 4 h per day in direct clinical care were 5.841 (95% CI: 2.187-15.602) times higher for clinic students versus hospital students. There was no difference between clinical placement sites in regards to number of births students attended (OR 0.903; 95% CI: 0.399, 2.047) or number of births students managed without a preceptor/clinician present (OR 0.729; 95% CI: 0.285, 1.867). CONCLUSION The clinical placement site, hospital or clinic, impacts midwifery students' CLE. Clinics offered students significantly greater attributes of a supportive learning environment and access to direct, hands-on opportunities for patient care. These findings may be helpful for schools when using limited resources to improve the quality of midwifery education.
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Affiliation(s)
- Julie Mann
- Seed Global Health, 20 Ashburton Place, 6th Floor, Boston, MA, 02108, US.
| | - Meredith B Brooks
- Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA, 02118, US
| | - Frederica Kella
- Seed Global Health Sierra Leone, 10B Murray Town Road, Congo Cross, Freetown, Sierra Leone
| | - Laura Euller
- Seed Global Health, 20 Ashburton Place, 6th Floor, Boston, MA, 02108, US
| | - Sara Adelman
- Seed Global Health, 20 Ashburton Place, 6th Floor, Boston, MA, 02108, US
| | - Mustapha Sonnie
- Seed Global Health Sierra Leone, 10B Murray Town Road, Congo Cross, Freetown, Sierra Leone
| | - Brittney van de Water
- Seed Global Health, 20 Ashburton Place, 6th Floor, Boston, MA, 02108, US
- Boston College, Connell School of Nursing, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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Li T, Zeng Y, Fan X, Yang J, Yang C, Xiong Q, Liu P. A Bibliometric Analysis of Research Articles on Midwifery Based on the Web of Science. J Multidiscip Healthc 2023; 16:677-692. [PMID: 36938484 PMCID: PMC10015947 DOI: 10.2147/jmdh.s398218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/17/2023] [Indexed: 03/13/2023] Open
Abstract
Objective This study aimed to bibliometrically analyse the main features of the 100 top-cited articles on the midwifery index on the Web of Science. Methods Academic articles on midwifery' research published from 1985 to 2020 were included. VOSviewer 1.6.15, SPSS 22.0 software and a homemade applet were used to identify, analyse and visualise the citation ranking, publication year, journal, country and organisation of origin, authorship, journal impact factor and keywords along with the total link strength of countries, organisations and keywords. Results Among the 100 top-cited articles, the highest number of citations of the retrieved articles was 484. The median number of citations per year was 5.16 (interquartile range: 3.74-8.38). Almost two-thirds of the included articles (n = 61) centred on nursing and obstetrics/gynaecology. The top-cited articles were published in 38 different journals, the highest number of which was published by Midwifery (15%). Australia was the most productive country (24%). According to the total link strength, the sequence ran from the United States (28) to England (28) to Australia (19). The University of Technology Sydney and La Trobe University in Australia topped the list with four papers each. Hunter B was the most productive author (n = 4), and the average citations were positively related to the number of authors (r = 0.336, p < 0.05). Conclusion This study identified the most influential articles on midwifery and documented the core journals and the most productive countries, organisations and authors along with future research hotspots for this field; the findings may be beneficial to researchers in their publication and scientific cooperation endeavours.
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Affiliation(s)
- Tingting Li
- Department of Science and Education, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Yilan Zeng
- Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xianrong Fan
- Department of Hospital Office, The Maternal and Child Health Hospital of Yongchuan, Chongqing, People’s Republic of China
| | - Jing Yang
- Department of Obstetrics and Gynecology, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Chengying Yang
- Department of Obstetrics and Gynecology, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Qingyun Xiong
- Department of Ultrasonography, Changsha Hospital of Traditional Chinese Medicine, Changsha, Hunan Province, People’s Republic of China
- Qingyun Xiong, Department of Ultrasonography, Changsha Hospital of Traditional Chinese Medicine, No. 22, Xingsha Avenue, Changsha County, Changsha City, Hunan Province, 410100, People’s Republic of China, Tel +86 731-85259000, Email
| | - Ping Liu
- Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
- Correspondence: Ping Liu, Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, 311 Yingpan Road, Kaifu District, Changsha, Hunan Province, 410005, People’s Republic of China, Tel +86 15973136512, Email
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Tallam EC, Kaura D, Mash R. Self-perceived competency of midwives in Kenya: A descriptive cross-sectional study. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 36546487 PMCID: PMC9772721 DOI: 10.4102/phcfm.v14i1.3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Midwifery competence is demonstrated in the context of midwifery education, regulation and practice to support the quality delivery of care to women. Midwives with appropriate competencies can deliver up to 80% of maternal health services. The pre-service education programmes in Kenya offers different midwifery competencies for the various programmes, influencing expected outcomes in practice. AIM This study aimed to assess midwives' perceived level of competence based on the International Confederation of Midwives (ICM) standards in Kenya. SETTING The study was conducted in selected public health facilities in Kenya. METHODS An observational cross-sectional design was used. A multi-stage sampling technique was used to select the counties and health facilities and random sampling to determine 576 midwives. Data were collected using a self-administered assessment tool adopted from the ICM competency domains. RESULTS A total of 495 (85.9%) midwife respondents participated in this study, of which 389 (78.6%) respondents in all training categories were highly competent in the four ICM domains. The midwives' qualifications and facility level were associated with their self-perceived competence during practice. Those trained in the direct-entry midwifery programme were more competent, p = 0.016 (Kruskal wallis H = 8.432). CONCLUSION Midwives' competence was influenced by the level of education and facility where they practice. All pre-service midwifery programme graduates must meet the essential ICM competencies and need to enhance continuous professional development (CPD) programmes and facility-based mentorship for the midwives.Contribution: To optimise midwifery-led practice in primary health care, midwifery competence should be enhanced in pre-service and in-service education for improved health outcomes.
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Affiliation(s)
- Edna C. Tallam
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,Nursing Council of Kenya, Nairobi, Kenya
| | - Doreen Kaura
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert Mash
- Department of Family and Emergency Medicine, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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Adnani QES, Gilkison A, McAra-Couper J. Strengthening midwifery education through clinical experience: Findings from a qualitative study in Indonesia. Women Birth 2021; 35:87-95. [PMID: 33745822 DOI: 10.1016/j.wombi.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND One of the Indonesian Government's strategies to reduce maternal mortality rates has been to place a midwife in every village to provide midwifery care and facilitate essential primary healthcare services. To increase the numbers of midwives, the Indonesian Government began opening midwifery schools. However, Indonesia's maternal mortality rates remained high. This raises the question of the quality of midwifery education in Indonesia and how this education could be strengthened so that midwifery plays a key role in reducing maternal mortality rates. AIM OF THE RESEARCH The aim of this study was to identify the barriers and enablers to strengthening midwifery education in Indonesia. METHODS A qualitative descriptive approach and in-depth interviews was the method used with 37 participants from 12 midwifery schools in eight cities situated in six provinces in Indonesia. Indonesian midwives, midwifery lecturers, midwifery students, newly graduated midwives, and obstetricians were interviewed in Bahasa Indonesia. Interviews were transcribed, translated, and thematically analysed following Braun and Clark (2006). FINDINGS This article focuses on findings on "midwifery clinical experience", a theme which contained four sub-themes: "effective hands-on clinical experience", "theory-practice gap", "role of the mentor in practice", and "the system in the clinical environment". CONCLUSION This study highlights barriers to preparing midwifery students for obtaining adequate midwifery knowledge and skills during clinical placement. Quality clinical experience would improve knowledge and skills for better preparedness for students to competently meet their role as midwives, contributing to the strengthening of midwifery education in Indonesia.
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Affiliation(s)
- Qorinah Estiningtyas Sakilah Adnani
- Department of Midwifery, Faculty of Health and Environmental Sciences, Auckland University of Technology, South Campus, Auckland 2104, New Zealand; Department of Midwifery, Karya Husada Institute of Health Science, Jl Soekarno Hatta P.O. Box 153, Kediri, East Java 64225, Indonesia.
| | - Andrea Gilkison
- Department of Midwifery, Faculty of Health and Environmental Sciences, Auckland University of Technology, North Campus, Auckland 0627, New Zealand
| | - Judith McAra-Couper
- Department of Midwifery, Faculty of Health and Environmental Sciences, Auckland University of Technology, South Campus, Auckland 2104, New Zealand
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McNeil KM, Silvey SR. Training the global midwifery workforce. Midwifery 2018; 65:87-88. [DOI: 10.1016/j.midw.2018.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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