The experience of student midwives being taught newborn infant physical examination (NIPE) as an extracurricular activity at a university in the UK: A descriptive survey study

Missed or delayed diagnosis of anorectal malformations: a review of the literature, current training and practice in the UK in relation to detection via the NIPE programme

Anorectal malformations (ARMs) are a spectrum of congenital anomalies where there is abnormal development of the anus and rectum. With an incidence of 1:5000 live births and affecting both males and females, these anomalies vary in their appearance and presentation, lack features enabling antenatal detection and should be detected at birth by the examining midwife or within 72 hours through the newborn and infant physical examination (NIPE) screening programme. However, it is recognised that the diagnosis of ARMs can be missed or delayed leading to morbidity and mortality. In the UK, despite the existence of the NIPE screening programme and NICE guidelines, published literature shows that nearly a quarter of ARMs are not diagnosed at birth. This review takes a critical look at the frequency of missed/delayed diagnosis of ARMs at birth, the implications of delayed diagnosis, and the possible reasons for this related to education and training of healthcare professionals involved in newborn examination, focusing on the UK national screening programme for NIPE. We propose a strategy for enhancing detection of ARMs in a timely manner through the existing framework of the NIPE screening programme.

A study to evaluate the introduction of the Newborn Infant Physical Examination knowledge and skills into an undergraduate pre-registration midwifery education programme

Newborn Infant Physical Examination is recommended between six to 72 h from birth and the midwife is ideally placed to undertake this screening examination. In the United Kingdom only a small percentage of midwives are competent to undertake this screening, and is usually taught once qualified. The aim of this qualitative study was to explore the experiences of student midwives in relation to the impact and effectiveness of introducing the theory of Newborn Infant Physical Examination into an undergraduate midwifery curriculum and the opportunity to apply the skills in practice. Two focus groups with final year student midwives (n = 11) were undertaken. The transcribed interviews were reviewed by the researchers and thematically analysed. Three themes emerged: i) timing of the theoretical content, ii) applying theory to practice iii) holistic care. Recommendations include the importance of incorporating the theoretical elements into the programme even if students do not have the opportunity to become competent in the required skills. Most students favoured the theory elements to be threaded throughout the three year programme rather than having a single dedicated module. Students identified that when midwives completed the newborn examination, holistic care was improved.