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Power T, Catling C, Rossiter C, Manton D. Indigenous students' experiences of being taught indigenous health. NURSE EDUCATION TODAY 2024; 143:106364. [PMID: 39178810 DOI: 10.1016/j.nedt.2024.106364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 08/01/2024] [Accepted: 08/16/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Increasing the numbers of Indigenous health professionals is an international priority to enhance health outcomes for Indigenous communities. It is also incumbent on academics to ensure all graduates are culturally safe to work with Indigenous Peoples, and that accredited health degrees contain appropriate Indigenous content, improving the cultural competence of the registered health workforce. However, little current research investigates Indigenous tertiary students' experiences of learning about Indigenous health. AIM To explore Indigenous students' experiences of being taught Indigenous health. DESIGN This study employed an online survey (16 % response rate) developed to evaluate student's beliefs, attitudes and learning experiences following operationalisation of a university Indigenous Graduate Attribute. An Aboriginal researcher also conducted Yarning Circles with Indigenous students as a culturally appropriate means to deepen insight into their experiences of studying Indigenous health topics alongside non-Indigenous peers. SETTING A large urban Australian university. PARTICIPANTS Twelve Indigenous students from four health disciplines completed the anonymous survey. Five Indigenous midwifery students participated in a Yarning Circle. METHODS Survey data were analysed descriptively using SPSS version 27. Qualitative data from Yarning Circle transcripts were analysed thematically from an inductive Indigenous standpoint. RESULTS Results from the survey demonstrated unanimous agreement that all health students should learn about Indigenous Peoples' health and cultures. However, most participants agreed that there needed to be more content on Indigenous knowledges, derived from Indigenous authors, researchers, and community presenters. The Yarning Circle yielded rich discussion of students' experiences, explored across three key themes and associated sub-themes. Themes were: When your culture is content; Being an Indigenous student; and Sources of strength and support as Indigenous students. CONCLUSIONS Findings indicate the importance of framing Indigenous content, incorporating Indigenous knowledge into curricula, ensuring Cultural Safety in classrooms with both Indigenous and non-Indigenous students, and supporting Indigenous students to excel.
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Affiliation(s)
- Tamara Power
- Faculty of Medicine and Health, University of Sydney, D18 Western Ave, Camperdown, NSW 2006, Australia.
| | - Christine Catling
- Faculty of Health, University of Technology Sydney, 235 Jones St, Broadway, NSW 2007, Australia.
| | - Chris Rossiter
- Faculty of Health, University of Technology Sydney, 235 Jones St, Broadway, NSW 2007, Australia.
| | - Danielle Manton
- Faculty of Health, University of Technology Sydney, 235 Jones St, Broadway, NSW 2007, Australia.
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Donnelly E, Lee J, Donnellan-Fernandez R. Understanding attrition of early career midwives in Australia. Women Birth 2024; 37:101636. [PMID: 38917646 DOI: 10.1016/j.wombi.2024.101636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
PROBLEM There is a lack of understanding of the experiences of early career midwives which lead to workforce attrition. BACKGROUND In the Australian midwifery setting, workforce attrition in conjunction with the ageing profile of the workforce is of increasing concern. Midwives in the earliest stages of their career are most vulnerable to career attrition, however limited research specifically engages with this cohort. AIM To understand the professional and social circumstances that led early career midwives to leave clinical practice, how their midwifery background influenced career trajectories, and what would compel them to return to clinical practice. METHODS Semi-structured interviews were conducted with 11 early career midwives who had left the profession within 5 years of qualification. Transcripts underwent thematic analysis. FINDINGS Three themes described early career midwives' experiences: transition to professional practice, an untenable workplace culture, mental health impacts of early clinical midwifery practice. Two further themes emerged about experiences post-midwifery careers: influence of midwifery on subsequent career, and conditions for re-entry. DISCUSSION Challenges with transitioning to professional midwifery practice in conjunction with untenable workplace culture led to such deterioration in wellbeing that remaining within the profession became unfeasible for early career midwives. Desire to remain within health care was apparent, however re-entry to the profession was deemed by most to be out of the question. CONCLUSION Early workforce retention strategies should be the focus of future workforce planning and policy. Larger scale inquiry foregrounding early career midwives is necessary to inform strategies for midwifery workforce retention in Australia.
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Affiliation(s)
- Eleanor Donnelly
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia.
| | - Jessica Lee
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Kranz A, Schulz AA, Weinert K, Abele H, Wirtz MA. A narrative review of Master's programs in midwifery across selected OECD countries: Organizational aspects, competence goals and learning outcomes. Eur J Midwifery 2024; 8:EJM-8-30. [PMID: 38873232 PMCID: PMC11171422 DOI: 10.18332/ejm/188195] [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: 01/15/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master's programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master's programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs' aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master's programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems.
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Affiliation(s)
- Angela Kranz
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
| | - Anja A. Schulz
- Research Methods in the Health Sciences, University of Education Freiburg, Freiburg, Germany
| | - Konstanze Weinert
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
| | - Harald Abele
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
- Department for Women’s Health, University Hospital Tübingen, Tübingen, Germany
| | - Markus Antonious Wirtz
- Research Methods in the Health Sciences, University of Education Freiburg, Freiburg, Germany
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Tierney O, Vasilevski V, Kinsman L, Sweet L. Development of the essential learning outcomes for the midwifery student continuity of care learning model: A Delphi study. Women Birth 2024; 37:101582. [PMID: 38278700 DOI: 10.1016/j.wombi.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/25/2023] [Accepted: 01/16/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND In Australia, midwifery students are required to undertake at least ten Continuity of Care Experiences (CoCE) during their education. The learning outcomes of this experience have never been explicit or standardised resulting in inconsistent assessment. AIM To develop and identify standardised learning outcomes for the CoCE. METHODS A modified Delphi survey was conducted with an expert panel. Intended learning outcome statements were developed, reflecting the learning objectives identified in a previous study. Bloom's taxonomy levels of thinking complexities guided the wording of the outcomes. Participants were asked to rank and rate their level of agreement with each statement over two survey rounds. FINDINGS Round one was completed by 32 participants, with 92.5% of the 40 statements reaching consensus. The second round was completed by 23 participants, with 70.7% of the 33 statements reaching consensus. Content analysis of participant comments from each round identified duplicates that were removed and informed refining the wording of some statements. A final set of 15 learning outcomes were agreed upon. The outcomes were broadly grouped within the themes of accountability, advocacy, and autonomy. DISCUSSION This study has identified agreed learning outcomes for midwifery students undertaking CoCE. The consensus agreement of experts reinforced the learning model enables the development of woman-centred practice that is underpinned by accountability, advocacy, and autonomy. CONCLUSION Purposeful learning outcomes for the CoCE have been developed, informing how the model can be embedded in curricula, guide student learning and assessment to standardise the pedagogy of the model to prepare future midwives.
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Affiliation(s)
- Olivia Tierney
- School of Nursing and Midwifery, Deakin University, Victoria, Australia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
| | - Leigh Kinsman
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University Bendigo, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
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Hewitt L, Dadich A, Hartz DL, Dahlen HG. Midwifery group practice workforce in Australia: A cross-sectional survey of midwives and managers. Women Birth 2024; 37:206-214. [PMID: 37726186 DOI: 10.1016/j.wombi.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Despite robust evidence on the benefits of midwifery group practice (MGP), there remains difficulties with implementing and sustaining the model. However, contemporary data on the MGP workforce and how each model has been operationalised are limited. This constrains an understanding of the factors that help or hinder implementation and sustainability of MGP. AIM To describe the characteristics of Australian MGPs and the factors that help or hinder sustainability. METHODS A national cross-sectional survey was undertaken in Australia between March 2021 and July 2022, inclusive. Quantitative data were analysed using descriptive analysis while qualitative data were analysed using content analysis. FINDINGS Of 669 survey responses, 579 were midwives and 90 were managers. The mean years of experience for clinical midwives was eight years, and 47.8% (almost twice the national average) completed a Bachelor of Midwifery (BMid). Half (50.2%) the models provided care for women of all risk. Midwives resigned from MGP because of the MGP work conditions (30%) and how the service was managed or supported (12.7%). Managers resigned from MGP because of role changes, conflict with their manager, and limited support. Almost half (42.6%) of MGP managers also managed other areas, leading to heavy workloads, competing demands, and burnout. CONCLUSION The BMid appears to be a common educational pathway for MGP midwives, and many MGP services are providing care to women with complexities. Flexible practice agreements, organisational support and appropriate workloads are vital for recruitment, retention, and sustainability of MGP.
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Affiliation(s)
- Leonie Hewitt
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Ann Dadich
- School of Business Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Donna L Hartz
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Hannah G Dahlen
- School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Smith RM, Calvert B, Kata E, Hataogo S, Ioane TR, Tarabo M, Kiritome M, Abraham J, Lees T, Devi C, Ross L, Mafi LL, Tuitupou T, Blackburn K, Homer CS. Midwifery education in Pacific Island countries: A discussion paper. Women Birth 2023; 36:e605-e612. [PMID: 37263877 DOI: 10.1016/j.wombi.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The aim for 95% maternal health care coverage and zero-unmet need for family planning in Pacific Island countries by 2030 could be achieved by strengthening the midwifery workforce. To enable health services to provide accessible, locally acceptable, and high-quality care, the midwifery workforce must be regulated and educated to global standards and supported to practice in enabling environments. In 2019, around 64,000 live births occurred in Pacific Island countries, yet information regarding the state the midwifery workforce and midwifery education is limited. AIM Using data from recent reports and country case studies, this paper provides an overview of the current midwifery education situation in Pacific Island countries and discusses strategic directions for strengthening quality midwifery education and therefore quality midwifery care provision in Pacific Island countries. DISCUSSION Six Pacific Island countries have midwifery curricula, all post-nursing programs, although few offer midwifery education programs on a regular annual basis. Current programs do not meet ICM Global Standards for Midwifery Education. Critical areas for strengthening include making underpinning philosophical frameworks, the vision for midwifery education, and program intended learning outcomes explicit in curricula documents and ensuring integration of these in program implementation. Fortunately, five of six midwifery education programs are under processes of renewal and strengthening against global, regional, and national standards. CONCLUSION Strengthening the midwifery workforce in the Pacific to meet maternal and newborn health targets can be achieved through supporting the existing midwifery education programs to meet global standards. Strengthened midwifery education programs in Pacific Island countries offer an opportunity to meet each country's maternal and newborn health targets.
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Affiliation(s)
| | | | | | | | | | - Monica Tarabo
- School of Midwifery, Kiribati Institute of Technology, Kiribati
| | - Maile Kiritome
- School of Midwifery, Kiribati Institute of Technology, Kiribati
| | | | | | - Clara Devi
- Solomon Islands National University, Solomon Islands
| | - Leila Ross
- Solomon Islands National University, Solomon Islands
| | | | - Telesia Tuitupou
- Queen Salote Institute of Nursing and Allied Health, Kingdom of Tonga
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Tierney O, Vasilevski V, Kinsman L, Sweet L. Advocacy, accountability and autonomy; the learning intention of the midwifery student continuity of care experience. Nurse Educ Pract 2023; 72:103772. [PMID: 37634289 DOI: 10.1016/j.nepr.2023.103772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
PROBLEM The Continuity of Care Experience is a mandated inclusion in midwifery education programs leading to registration as a midwife in Australia. The practice-based learning experience has evolved over time, yet there remains no standardised learning intentions, objectives, or outcomes for the model. AIM To identify the key learning intentions of the Continuity of Care Experience by an expert panel to support the development of learning outcomes. METHODS A descriptive qualitative study with two focus groups were conducted with an expert panel (n = 15). Participants were midwifery education subject matter experts on the Continuity of Care Experience with backgrounds in academia, policy development, curriculum design, accreditation, or clinical education. The discussions were transcribed and thematically analysed. FINDINGS Three main themes and six sub-themes describe the learning intentions of the Continuity of Care Experience. The main themes were: (1) advocacy for women; (2) accountability of care; and (3) autonomy in practice. DISCUSSION The education model of continuity of care enables students to develop midwifery practice that involves advocating for women, being accountable for their care and being autonomous in practice. We have established that during the experience students practice in partnership with women and are exposed to the full scope of midwifery care. Importantly students learn holistic woman-centred practice. CONCLUSION The learning intentions of the Continuity of Care Experience reflects woman-centred practice. Having identified a common understanding of the learning intention, these can now be used to design learning, and assessment, through the development of measurable learning outcomes.
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Affiliation(s)
- Olivia Tierney
- School of Nursing and Midwifery, Deakin University, Victoria, Australia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
| | - Leigh Kinsman
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University Bendigo, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
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