What do midwifery mentors need? Priorities and impact of experience and qualification

Mentoring in the clinical training of midwifery students - a focus study of the experiences and opinions of midwifery students at the Medical University of Warsaw participating in a mentoring program

BACKGROUND

The current system of clinical training for midwifery students in Poland is in need of considerable revision to adapt it to the global standards and the expectations of healthcare providers, healthcare users and student midwives themselves. Aim of this study was to report the experiences of midwifery students participating in a mentor-led clinical training program and their opinions of mentoring as a novel training method.

METHODS

A qualitative descriptive study that used a focus group was undertaken in the period from October 2017 to June 2019. The participants were 12 s- and third-year midwifery students at the Medical University of Warsaw who at various times during the study period had their clinical training in the Department of Obstetrics, Solec Hospital in Warsaw, Poland. All students had previous experience of clinical training other than clinical mentorship. At the end of the study, a focus group interview was conducted with all 12 participants. Five questions were selected to guide the focus group discussion: Did you get any valuable learning experience during your clinical training? How did this clinical training differ from your previous clinical training? What was your experience of one-on-one mentoring? Did the mentoring program meet your expectations? What do you think could be changed to make the proposed mentor-led clinical training more effective?

RESULTS

Four themes were identified. The study demonstrated that mentoring was perceived by the participants as an innovative and effective method of clinical training for midwifery students. All students positively evaluated the quality of the mentor-led clinical training which allowed improving their clinical skills and building new competencies. Students believed they could effectively use their clinical skills and make informed decisions in a safe and supportive clinical learning environment. They felt that their inclusion in the therapeutic team contributed to better patient care.

CONCLUSIONS

The use of innovative forms of clinical training at undergraduate level improves its effectiveness and in the future should be reflected in a high-quality maternity care. Mentoring has its advantages for both, mentor and mentee, but the main goal is to develop and improve professional competencies of the junior partner.

A mixed-methods study exploring sign-off mentorship practices in relation to the Nursing and Midwifery Council standards

AIMS AND OBJECTIVES

To investigate the current practice and experience of sign-off mentors in one NHS trust.

BACKGROUND

In the UK, sign-off mentors support nursing students in their last clinical placement and are accountable for the final assessment of fitness to practice as a registered nurse.

DESIGN

Mixed-methods study.

METHODS

The focus was on two key Nursing and Midwifery Council standards: the requirement for students to work at least 40% of their time on clinical placement with a sign-off mentor/mentor; the sign-off mentor had one-hour-per-week protected time to meet the final placement student. Data were collected through two audits of clinical and university documents and an experience survey administered to all sign-off mentors in one trust.

RESULTS

The audits showed that only 22/42 (52%) of students were supervised by their sign-off mentor/mentor at least 40% of the time, whilst 10/42 (24%) students never worked a shift with their sign-off mentor. Only one student met their sign-off mentor every week. Complete data were available in 31/64 (47%) sign-off mentors, of whom 21/30 (70%) rarely/never had reduced clinical commitment to mentor final placement students. Furthermore, 19/28 (68%) met their student after their shift had ended with 24/30 (80%) reporting not getting any protected time.

CONCLUSION

Sign-off mentors have inadequate time and resources to undertake their role, yet are accountable for confirming the student has the required knowledge and skills to practise safely. The current model needs urgent review to improve mentoring standards.

RELEVANCE TO CLINICAL PRACTICE

Understanding how the role of the sign-off mentor is working in practice is critical to ensuring that the Nursing and Midwifery Council standards are met, ensuring students are well supported and appropriately assessed in practice, and mentoring is given the high profile it deserves to guarantee high-quality care and protecting the public.

Factors defining the mentoring competencies of clinical midwives: An exploratory quantitative research study in Japan

BACKGROUND

Clinical education is an extremely important process in cultivating healthcare professionals, and the quality of educators has a major impact on the quality of future practitioners. Although practicing clinical midwives contribute to the education of pre-registered midwives and those qualified within the past year (new midwives), the factors defining the educational competencies of clinical midwives have not been clarified.

OBJECTIVES

The purpose of this study was to explore the factors that define the mentoring competencies of clinical midwives involved in educating new midwives.

DESIGN

An exploratory quantitative research study.

METHODS

Questionnaires were distributed to 694 midwives who had previously conducted educational activities with new midwives at the 63 facilities whose administrator or nurse manager in charge of all staff, including midwives, consented to participate. Of the 694 midwives, 464 (66.9%) returned the questionnaire and 451 (65.1%) valid responses were analyzed. Exploratory factor analyses were performed on the following three concepts: [competency as a professional], [competency as an educator], and [personal characteristics].

RESULTS

[Competency as a professional] consisted of two factors: <self-awareness and self-reflection for finding confidence> and <sharing their midwifery practice>; [competency as an educator] consisted of four factors: <supporting experimental study>, <thoughtfulness and empathy for new midwives>, <making effective use of new midwives' own experience> and <commitment to educational activities>; and [personal characteristics consisted of three factors: <exercising leadership> <approachability>, and <tendency to be a caring mentor>. These three concepts were defined by a total of nine sub-concepts (factors), and 41 items were extracted with a reliability coefficient (Cronbach's α) of 0.944 CONCLUSIONS: "Mentoring competencies of clinical midwives (MCCM)" are defined by three concepts and nine sub-concepts, which can be evaluated by 41 items regarding the behavior, thoughts, and characteristics that clinical midwives exhibit when they educate new midwives in clinical settings.

Using root cause analysis to promote critical thinking in final year Bachelor of Midwifery students

BACKGROUND

Midwives require well developed critical thinking to practice autonomously. However, multiple factors impinge on students' deep learning in the clinical context. Analysis of actual case scenarios using root cause analysis may foster students' critical thinking and application of 'best practice' principles in complex clinical situations.

OBJECTIVE

To examine the effectiveness of an innovative teaching strategy involving root cause analysis to develop students' perceptions of their critical thinking abilities.

METHODS

A descriptive, mixed methods design was used. Final 3rd year undergraduate midwifery students (n=22) worked in teams to complete and present an assessment item based on root cause analysis. The cases were adapted from coroners' reports. After graduation, 17 (77%) students evaluated the course using a standard university assessment tool. In addition 12 (54%) students provided specific feedback on the teaching strategy using a 16-item survey tool based on the domain concepts of Educational Acceptability, Educational Impact, and Preparation for Practice. Survey responses were on a 5-point Likert scale and analysed using descriptive statistics. Open-ended responses were analysed using content analysis.

RESULTS

The majority of students perceived the course and this teaching strategy positively. The domain mean scores were high for Educational Acceptability (mean=4.3, SD=.49) and Educational Impact (mean=4.19, SD=.75) but slightly lower for Preparation for Practice (mean=3.7, SD=.77). Overall student responses to each item were positive with no item mean less than 3.42. Students found the root cause analysis challenging and time consuming but reported development of critical thinking skills about the complexity of practice, clinical governance and risk management principles.

CONCLUSIONS

Analysing complex real life clinical cases to determine a root cause enhanced midwifery students' perceptions of their critical thinking. Teaching and assessment strategies to promote critical thinking need to be made explicit to students in order to foster ongoing development.

Exploring cognitive skill development in midwifery education

Changes in maternity services and the role of the midwife mean that the midwife must provide flexible, evidence-based, woman-centred care. As the lead professional, the midwife must use a high level of professional judgement, clinical reasoning and decision-making to enable choice while ensuring the safety and wellbeing of mother and infant. Delayed development of these cognitive skills is suggested by the continuing theory-practice gap, suboptimal practice and students requiring to conform to non-evidence-based practice. The purpose of this research was to explore midwifery students' understanding and experience of the development of cognitive skills. The research employed analysis of undergraduate midwifery programme documentation and a focus group discussion with student midwives from second and third year of the programme. Document analysis and thematic analysis of the interview data indicated a lack of emphasis on cognitive skill development and a sense that these skills improve naturally through exposure to clinical practice. The findings suggest a need to change our approach to learning in clinical practice and to conduct further research to improve understanding of mechanisms to support the development of cognitive skills.

What future for midwifery?

Safe, effective and high quality maternity care is crucial to the wellbeing of mother and baby and for society as a whole. The midwife is now recognized and recommended as the lead professional and co-ordinator of care for low risk women and plays a central role in ensuring a safe outcome for mother and newborn. A number of key policy documents, service audits and reviews highlight the essential role of the midwife and the skills and expertise required to provide expert care and make educated decisions about care management. Yet there has been considerable attention and debate in the media, from the public and from the profession itself because of the current shortage of midwives in England. This paper debates some of the implications of the lack of midwives and the need to ensure a commitment to the recruitment and education of midwives who are equipped to deal with the challenges of providing the highest quality woman-centred care which is safe, effective and meets the changing needs of society and the profession. Some of the questions centre around the importance of the availability of midwives to provide midwifery care and support the development of student midwives, as well as the need to ensure continued access to opportunities to maintain and update midwives' knowledge and skills.

Midwives' supervisory styles and leadership role as experienced by Norwegian mothers in the context of a fear of childbirth

AIM

The aim of the present study was to describe the midwives' supervisory style and leadership role as experienced by pregnant women and new mothers in the context of a fear of childbirth.

BACKGROUND

A service led by midwives can influence the quality of care.

METHODS

The sample consisted of 13 mothers. Data were interpreted by means of qualitative content analysis.

RESULTS

The findings revealed that the midwives' supervisory styles were related to their ability to create a trusting and caring relationship, demonstrate problem-solving capacity, and showing willingness, preparedness and courage to support the women. The midwives' leadership role was described as involving a crucial set of professional management skills and techniques.

CONCLUSION

The findings have strengthened the argument for the provision of continuity of care to women who are afraid of childbirth. Further studies should focus more specifically on the implementation of research in practice.

IMPLICATION FOR NURSING MANAGEMENT

It is necessary for midwives to demonstrate leadership in order to develop practice, predict challenges and changes, provide different care delivery models and acquire an evidence base for care. This also demands systematic supervision to improve care outcomes.

Core-competence skills in e-mentoring for medical educators: a conceptual exploration

BACKGROUND

E-mentoring had the potential to improve medical training, patient services, could be cost-effective, and support continued professional development. Research in terms of required core-competences for its effective utilisation in medical education seemed to be inconsistent, fragmented with significant variations in methodological rigor.

AIM

The primary aim was to review and synthesise existing evidence in educational science that addressed the question: "what are the required core-competences in e-mentoring for medical educators?"

METHODS

A systematic literature search covered 25 literature databases and employed 42 single search terms and concepts and their Boolean combinations. Coverage was improved by Internet searches, further focus on "Grey literature" and the manual searching of library journals and inspecting the bibliographies of the references obtained by these methods.

RESULTS

A total of 4344 citations from the literature search were identified. Altogether 44 items were finally selected for inclusion in the study. The extant quality of published research was generally weak. The weight of the best available evidence suggested that seven specific e-mentoring core-competence domains were seen as significant.

CONCLUSIONS

E-mentoring seemed educationally effective and complemented face-to-face mentoring for continuous professional development. Research in this field needs improvement in terms of rigor and quality.