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Factors that enhance midwifery students' learning and development of self-efficacy in clinical placement: A systematic qualitative review. Nurse Educ Pract 2023; 66:103510. [PMID: 36462273 DOI: 10.1016/j.nepr.2022.103510] [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: 06/17/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
AIM To conduct a systematic review and synthesis of qualitative studies to explore the significant factors that enhance midwifery students' learning experiences and development of self-efficacy in clinical placement. BACKGROUND Midwifery education programs leading to registration as a midwife require students to achieve academic, clinical, and professional competence. Clinical placement comprises a significant part of the program as students work and are assessed under the direct supervision of the Registered Midwife or preceptor. This learning and teaching partnership aims to enable the transfer of knowledge, skills, and behavior, i.e., competence, while providing the opportunity for students to become socialized into the midwifery practice culture. Against this background, characterized by the shortage of midwives, declining fertility rates, and a stressful environment, students learn to become a midwife and develop self-efficacy. Self-efficacy is the belief in one's ability to master challenges, which is described as a component in learning theories. There seems to be a need to identify factors that contribute to this development. DESIGN A qualitative systematic literature review. METHOD A systematic database search was conducted to identify primary peer reviewed qualitative literature published between 2000 and 2021 that has explored what enhances midwifery students' learning during their clinical placement. The databases searched included CINAHL (EBSCO), Medline (Ovid), Embase (Ovid), PsycINFO (Ovid), JBI Joanna Briggs Institute (Ovid), SveMed+ , and Web of Science. The search yielded a total of 354 results, of which 22 met the inclusion criteria. The relevant findings from the 22 studies were thematically analyzed and presented in the results. RESULTS The analysis revealed two descriptive themes - 'A nurturing relationship' and 'Predictability in the learning process, contextual factors. In addition, one analytic theme emerged - 'Gaining access to and belonging in an enabling educational and working culture'. CONCLUSION The relationship with the preceptor is a prerequisite for midwife students learning process and achievement of self-efficacy. A learning culture appears to be the fertile ground in which midwife students thrive and where they develop the self-efficacy needed to meet the demands of clinical placement.
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Arundell F, Sheehan A, Peters K. Developing and conducting appreciative inquiry interviews. Nurse Res 2021; 29:36-43. [PMID: 34704427 DOI: 10.7748/nr.2021.e1811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The appreciative inquiry (AI) interview follows a specific format and needs to be planned and developed before implementation. AI questions are designed to draw on the interviewee's experiences, commencing with general questioning and progressing to more focused questioning. AIM To explain how to plan and undertake AI interviews, and to discuss issues that nurse researchers might encounter. DISCUSSION This article is based on the first author's experience of undertaking an AI doctoral study. The primary method of collecting data for the study was AI interviews. The more focused questioning related to participants' experiences of positive actions or behaviours. Although questioning was positive in nature and participant-centric, conducting the interviews was more problematic than the first author anticipated. Some participants struggled to recall positive memories to share. CONCLUSION The unexpected response to the interview questions required the first author to examine her practices, as well as beliefs and judgements relating to AI. This reflexivity assisted in implementing changes to the study's process, resulting in a more positive experience for her and the participants. IMPLICATIONS FOR PRACTICE Researchers using the AI interview require the capacity to be self-critical and change the process if necessary to enrich the outcome.
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Affiliation(s)
- Fiona Arundell
- School of Nursing and Midwifery, Western Sydney University - Parramatta South Campus, Penrith NSW, Australia
| | - Athena Sheehan
- Western Sydney University - Parramatta South Campus, Penrith NSW, Australia
| | - Kath Peters
- Western Sydney University - Parramatta South Campus, Penrith NSW, Australia
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Ball KL, Peacock AS, Winters-Chang P. A literature review to determine midwifery students' perceived essential qualities of preceptors to increase confidence and competence in the clinical environment. Women Birth 2021; 35:e211-e220. [PMID: 34226153 DOI: 10.1016/j.wombi.2021.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Midwifery students' experiences with preceptors in the clinical environment plays an integral role in developing the confidence and competence of students. As up to 50% of the midwifery program is taught in the clinical environment, an analysis of the preceptorship role in the context of midwifery student confidence and competence may be important to inform future practice and policy. AIM To discover, whilst on clinical placement, what is required by preceptors to suitably equip midwifery students to develop confidence and competence in the clinical environment. METHODS A search of the literature was undertaken using health and midwifery related electronic databases of PubMed, CINAHL, Intermid, SCOPUS and Web of Science. Grey literature, and reference lists from studies were also part of the thorough search process. FINDINGS After critical reading of the 15 included studies, there were a number of themes identified as the preceptor qualities that contributed to student confidence and competence. Those themes include 'belongingness', 'hands on experience/skill development', 'students' development of professional identity' and 'preceptor characteristics that impact student learning'. DISCUSSION Student confidence and competence can be dependent on the preceptor who supports them. There are preceptors who enable students to flourish in their confidence and competence, and there also appears to be preceptors who do not possess these qualities, which requires further enquiry. CONCLUSION As the evidence appears to find that trained preceptors are optimal for student confidence and competence, further enquiry is warranted to inform policy and practice around the concept of preceptorship training for midwives.
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Affiliation(s)
- Kathy L Ball
- University of Queensland, School of Nursing, Midwifery and Social Work, Bachelor of Midwifery, St Lucia, Queensland, 4067, Australia.
| | - Ann S Peacock
- The University of Queensland, School of Nursing, Midwifery and Social Work, St Lucia, Queensland, 4067, Australia
| | - Peta Winters-Chang
- The University of Queensland, School of Nursing, Midwifery and Social Work, St Lucia, Queensland, 4067, Australia
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Nagle C, McDonald S, Morrow J, Kruger G, Cramer R, Couch S, Hartney N, Bryce J, Birks M, Heartfield M. Informing the development midwifery standards for practice: A literature review for policy development. Midwifery 2019; 76:8-20. [PMID: 31150936 DOI: 10.1016/j.midw.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 11/16/2022]
Abstract
AIM To critically appraise and synthesise the literature regarding the role and scope of midwifery practice, specifically to inform the evidence based development of standards for practice for all midwives in Australia. DESIGN A structured scoping review of the literature DATA SOURCES: CINAHL Complete, MEDLINE Complete and Cochrane Libraries databases, online and grey literature databases REVIEW METHODS: Comprehensive searches of databases used key words and controlled vocabulary for each database to search for publications 2006-2016. Studies were not restricted by research method. FINDINGS There is no substantive body of literature on midwifery competency standards or standards for practice. From 1648 papers screened, twenty-eight papers were identified to inform this review. Eight studies including systematic reviews were annotated with three research papers further assessed as having direct application to this review. To inform the development of Midwife standards for practice, the comprehensive role of the midwife across multiple settings was seen to include: woman centred and primary health care; safe supportive and collaborative practice; clinical knowledge and skills with interpersonal and cultural competence. KEY CONCLUSIONS Midwifery practice is not restricted to the provision of direct clinical care and extends to any role where the midwife uses midwifery skills and knowledge. This practice includes working in clinical and non-clinical relationships with the woman and other clients as well as working in management, administration, education, research, advisory, regulatory, and policy development roles. IMPLICATIONS FOR PRACTICE This review articulates the definition, role and scope of midwifery practice to inform the development of contemporary standards for practice for the Australian midwife.
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Affiliation(s)
- Cate Nagle
- James Cook University, Centre for Nursing and Midwifery Research, 1 James Cook Drive, Townsville, Queensland 4814 Australia; Townsville Hospital and Health Service, 100 Angus Smith Drive, Douglas QLD 4814 Australia.
| | - Susan McDonald
- La Trobe University, School of Nursing and Midwifery, Kingsbury Dr Bundoora, Victoria 3086, Australia; Mercy Health, Studley Rd, Heidelberg, Victoria 3084, Australia
| | - Jane Morrow
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine, 115 Victoria Parade, Fitzroy, 3065 Victoria, Australia
| | - Gina Kruger
- St Alban's Campus, Victoria University, PO Box 14228, Melbourne 8001, Australia
| | - Rhian Cramer
- Federation University, School of Nursing Midwifery and Healthcare, Mt Helen Campus, Ballarat, Victoria 3353 Australia
| | - Sara Couch
- Australian Nursing and Midwifery Accreditation Council, Level 1, 15 Lancaster Place, Majura Park, Canberra Airport, 2609 ACT, Australia
| | - Nicole Hartney
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St, Geelong 3220, Victoria, Australia
| | - Julianne Bryce
- Australian Nursing and Midwifery Federation, Level 1, 365 Queen Street Melbourne 3000, Victoria, Australia
| | - Melanie Birks
- James Cook University, Centre for Nursing and Midwifery Research, 1 James Cook Drive, Townsville, Queensland 4814 Australia
| | - Marie Heartfield
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St, Geelong 3220, Victoria, Australia
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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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Lakhani A, Jan R, Baig M, Mubeen K, Ali SA, Shahid S, Kaufman K. Experiences of the graduates of the first baccalaureate midwifery programme in Pakistan: A descriptive exploratory study. Midwifery 2018; 59:94-99. [PMID: 29421644 DOI: 10.1016/j.midw.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/28/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND in 2012 the Aga Khan University in Karachi, Pakistan opened the country's first bachelor's degree program in midwifery for women who held diplomas in nursing and midwifery. The principal aims were to prepare midwives who would be competent to provide full-scope practice. For quality assurance, the programme was continuously monitored and assessed. As part of this ongoing evaluation process we sought in-depth feedback from the first graduates about their student experiences. OBJECTIVE this study aimed to explore the experiences of the first graduates of a Bachelor of Science in Midwifery (BScM) program to deepen our understanding of their views of the program's strengths and difficulties and to obtain their suggestions for change. DESIGN AND METHODS This qualitative descriptive exploratory study used universal sampling to collect data from all 21 of the first graduates of the BScM Program. Data collection involved focus group discussions using a semi structured interview guide and content analysis. The study was approved by Institutional Ethics Review Committee. FINDINGS three main themes emerged from the data: (1) Competence acquisition, (2) Attitude transformation, and (3) Strengths and limitations of the program. CONCLUSIONS the study findings highlighted that the degree program in midwifery had a positive impact on graduates' perceptions of their knowledge, skills, attitudes and ability to implement evidence-based midwifery practice. The graduates regarded the university's environment, teaching-learning strategies, preceptorship model, self-directed learning and exposure to diverse clinical settings as major facilitators in achieving competence.
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Affiliation(s)
- Arusa Lakhani
- The Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Stadium Road, Karachi 74800, Pakistan.
| | - Rafat Jan
- National University of Medical Sciences (NUMS), Islamabad, Pakistan.
| | - Marina Baig
- The Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Stadium Road, Karachi 74800, Pakistan.
| | - Kiran Mubeen
- The Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Stadium Road, Karachi 74800, Pakistan.
| | - Sadia Abbas Ali
- The Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Stadium Road, Karachi 74800, Pakistan.
| | - Shahnaz Shahid
- The Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Stadium Road, Karachi 74800, Pakistan.
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Arundell F, Mannix J, Sheehan A, Peters K. Workplace culture and the practice experience of midwifery students: A meta-synthesis. J Nurs Manag 2017; 26:302-313. [PMID: 29076580 DOI: 10.1111/jonm.12548] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 11/27/2022]
Abstract
AIM To describe midwifery students' practice experience and to explore facilitators and barriers to positive clinical learning experiences. BACKGROUND Practice experience is a vital component of every midwifery course. Course dissatisfaction and attrition of midwifery students has been attributed to sub-optimal practice experiences. Events or actions experienced by midwifery students that trigger dissatisfaction and attrition need to be identified. EVALUATION A meta-synthesis was based on that developed by Noblit and Hare. KEY ISSUES Students perceive workplaces as poorly prepared for their arrival and subsequent support. Students' experience in the practice setting is influenced by the existing workplace culture. Workplace culture influences institutional functioning and individuals within the culture. Enculturation of students into the midwifery culture and subsequent learning is affected by the support received. CONCLUSIONS The practice experience of midwifery students was profoundly influenced by workplace culture. Students tended to have polarized accounts of their experience that were predominantly negative. IMPLICATIONS FOR NURSING (MIDWIFERY) MANAGEMENT To provide an optimal environment for midwifery students; midwifery managers and individual midwives need to be aware of the facilitators and barriers to midwifery student development in the practice setting.
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Affiliation(s)
- Fiona Arundell
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Judy Mannix
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Athena Sheehan
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
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Vuso Z, James S. Effects of limited midwifery clinical education and practice standardisation of student preparedness. NURSE EDUCATION TODAY 2017; 55:134-139. [PMID: 28595070 DOI: 10.1016/j.nedt.2017.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/24/2017] [Accepted: 05/11/2017] [Indexed: 06/07/2023]
Abstract
AIM To explore the perceptions of midwifery educators regarding effects of limited standardisation of midwifery clinical education and practice on clinical preparedness of midwifery students. BACKGROUND Investigation of levels of clinical competency of students is a critical need in the current era. Such competency levels are especially important in midwifery practice in South Africa as there is a significant increase of maternal deaths and litigations in the country. Most of the deaths are in the primary healthcare level maternity units where the newly qualified midwives practise. These areas are mainly run by midwives only. The current article seeks to report the findings of the study that was conducted to investigate how midwifery educators prepare students adequately for clinical readiness. SETTINGS The study was conducted amongst midwifery nurse educators on three campuses of the Nursing College in the Eastern Cape. DESIGN A qualitative, explorative, descriptive and contextual research design was used for the study. DATA SOURCES AND METHODS Seventeen purposively selected midwifery educators, with the researcher using set criteria, from a Nursing college in the Eastern Cape, were the participants in the study. Data was collected using focus-group interviews that were captured by means of an audio-voice recorder. Tesch's data-analysis method was used to develop themes and sub-themes. Trustworthiness of the study was ensured using the criteria of credibility, transferability, dependability and confirmability. RESULTS Inconsistent clinical practice amongst midwifery educators in their clinical teaching and assessment were found to be the major factors resulting from limited standardisation. The inconsistent clinical practice and assessments of midwifery educators was found to lead to loss of the necessary skills required by the students which led them to perform poorly in their final clinical assessments. CONCLUSION There are some barriers in the current clinical teaching and education strategy used in this college that prohibit the production of confident, independent, and safe practitioners as planned. Midwifery educators need to be assisted in reviewing the current teaching strategy. Furthermore management should be involved if not the initiators of that reviewing and should put in-place new measures to support the teaching of the clinical module.
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Affiliation(s)
- Zanyiwe Vuso
- Department of Nursing and Midwifery Health Sciences, Nelson Mandela Metropolitan University, North Campus, Port Elizabeth, South Africa.
| | - Sindiwe James
- Department of Nursing Science and Midwifery, Nelson Mandela Metropolitan University, North Campus, Port Elizabeth, South Africa.
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McAra-Couper J, Gilkison A, Fielder A, Donald H. A mixed-method evaluation of a New Zealand based midwifery education development unit. Nurse Educ Pract 2017; 25:57-63. [DOI: 10.1016/j.nepr.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 04/21/2017] [Accepted: 05/07/2017] [Indexed: 11/26/2022]
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