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Spets M, Barimani M, Zwedberg S, Tingström P, Ulfsdottir H. Midwives views about preceptorship and peer-learning in a birth unit: A cross-sectional study. NURSE EDUCATION TODAY 2024; 139:106255. [PMID: 38788631 DOI: 10.1016/j.nedt.2024.106255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Practical training in a birthing unit is an important part of midwifery education. Previous research on the preceptor role predominantly consists of qualitative interview studies and have not explored pedagogical models like peer learning. OBJECTIVES The purpose of this study was to quantitatively describe midwives' experiences, conditions, and needs in their role as preceptors in a birthing unit, as well as their attitudes towards and experiences of peer-learning. DESIGN A cross-sectional study, using a web-survey. SETTINGS The survey was distributed to all midwives working in a birthing unit in Sweden. PARTICIPANTS A total of 573 valid responses were obtained. METHODS A questionnaire consisting of 22 questions, which included background questions, questions to be answered on a four-point Likert scale, and open-ended questions, was sent out from November 2022 to March 2023. The collected data were analysed using descriptive statistics, Chi-square, and Mann Whitney U test analyses. The open-ended responses were analysed using quantitative content analysis. RESULTS Midwives with ≤10 years of experience were more hesitant about taking on the preceptor role. They also described a lack of support and found it more challenging to integrate supervision into their working hours than midwives with >10 years of experience. Time for supervision and time for reflection with midwifery students were identified as areas that could improve the quality of supervision. Of the respondents, 42.8 % had experience of peer learning. "Students learn from each other" was identified as the most common advantage of peer learning. CONCLUSIONS Long-term experience as a midwife plays a crucial role in how midwives perceive their role as a preceptor and the conditions they experience. The midwives in this study had started supervising students earlier than they deemed advantageous. As the preceptor plays a critical role in the midwifery student's learning process, it is important to have experienced preceptors.
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Affiliation(s)
- M Spets
- Department of Health, Medical and Caring Sciences, Linköping University, Sweden.
| | - M Barimani
- Department of Health, Medical and Caring Sciences, Linköping University, Sweden; Academic Primary Care Centre, Region Stockholm, Sweden.
| | - S Zwedberg
- Department of Health, Medical and Caring Sciences, Linköping University, Sweden.
| | - P Tingström
- Department of Health, Medical and Caring Sciences, Linköping University, Sweden.
| | - H Ulfsdottir
- Department of Women's and children's health, Karolinska Institutet, Stockholm, Sweden.
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Rahimi M, Haghani F, Kohan S, Shirani M. A model for improving the learning environment in high-stress and emotion-bound clinical settings. MEDICAL TEACHER 2024; 46:1099-1107. [PMID: 38122811 DOI: 10.1080/0142159x.2023.2292977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION In clinical settings, it is necessary to create a clinical learning environment that provides the ground for the learners to acquire competencies especially in high-stress and emotion-bound clinical settings. METHODS In the present study, a model for improving the learning environment in high-stress and emotion-bound clinical settings was designed by conducting a multi-method study in the form of three sub-studies. RESULTS This model was designed with 3 pivotal concepts; organizing learning opportunities around safe care, fair participation in learning opportunities and creating a positive emotional climate and 6 peripheral concepts; designing physical space and appropriate equipment for education and care, preparing learners to attend the clinical setting, preparing learners to participate in learning opportunities, balancing the learner role and the care provided by the learners, the presence of a competent educator and providing education to all learners, and acquiring the ability to manage emotions by learners, faculty and staff. CONCLUSIONS The implementation of the model obtained from this study provides the basis for solving the challenges of clinical learning environments, especially in high-stress and emotion-bound clinical settings, and improves clinical education and the realization of educational and care outcomes.
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Affiliation(s)
- Masoumeh Rahimi
- Education Development Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Haghani
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Shirani
- Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Balkan E, Genc Koyucu R. Feelings and thoughts of midwifery students during their first birth suite placement: A qualitative study. Nurs Health Sci 2024; 26:e13125. [PMID: 38742244 DOI: 10.1111/nhs.13125] [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: 08/28/2023] [Revised: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 05/16/2024]
Abstract
This descriptive qualitative study aimed to understand the feelings and thoughts experienced by 4th year midwifery students during the first birth they attended during clinical practice. Focus group interviews were conducted with 22 final year midwifery students in Istanbul, Türkiye December 2020. The transcribed data were analyzed by the descriptive qualitative analysis method. The students experienced not only negative feelings such as fear, torment, anxiety but also positive feelings such as hope, excitement, and curiosity during the first birth practice. The situations that caused negative feelings and thoughts were not only the feelings of the students but also the conditions that negatively affected the care provided to the patient in the clinic. The clinical practice environment affects the feelings and thoughts of midwifery students about the birth process. For this reason, improving the clinical practice environment and supporting students throughout the education process may contribute to the development of positive feelings and thoughts when attending as a student for their first birth suite placement.
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Affiliation(s)
- Elif Balkan
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Yalova University, Yalova, Turkey
| | - Refika Genc Koyucu
- Department of Midwifery, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
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Lloyd B, Bradshaw C, McCarthy J, Tighe SM, Noonan M, Atkinson S. Midwifery students' experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study. Midwifery 2023; 127:103861. [PMID: 37948792 DOI: 10.1016/j.midw.2023.103861] [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: 03/12/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme. DESIGN A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated. SETTING AND PARTICIPANTS To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study. FINDINGS Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.
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Affiliation(s)
- Barbara Lloyd
- Department of Nursing and Midwifery, University of Limerick, Ireland.
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, Ireland
| | - Jan McCarthy
- Department of Nursing and Midwifery, University of Limerick, Ireland
| | | | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Ireland
| | - Sandra Atkinson
- Department of Nursing and Midwifery, University of Limerick, Ireland
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Abraha TA, W/tensay KT, Gebre MB, Abrha BA, Haile GB. Opportunities and challenges in clinical learning of midwifery students in public Universities of Tigray Region, Ethiopia, 2020: a qualitative study. BMC MEDICAL EDUCATION 2023; 23:801. [PMID: 37884955 PMCID: PMC10601281 DOI: 10.1186/s12909-023-04765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Clinical learning focuses on real problems in the context of professional practice in which learners are motivated by its relevance and active participation. Studies showed that midwifery students were challenged by the absence of a variety of cases in non-teaching hospitals, overcrowded teaching hospitals, absence of objective-based evaluation methods, and lack of supervision from clinical instructors. If the theory learned in class was applied in practice, it is helpful to produce skillful and competent midwifery professionals. The aim of this study was exploring opportunities and challenges for midwifery students in the clinical learning environment. METHODS the study was conducted in public Universities of Tigray, Ethiopia. Phenomenology study design and purposive sampling technique were employed; four focused group discussions and five key informant interviews were conducted. Data were collected using an open-ended guide, transcribed verbatim, entered into ATLAS ti7 software, and translated. Then codes and themes were derived from the transcribed data, and finally analyzed thematically. RESULTS a total of 33 participants in which 28 in four focused group discussions and five key informant interviews participated in this study. Based on the result, midwifery students were getting opportunities to practice when they were assigned to non-teaching hospitals, working with close supervision, having smooth relationships with staff, receiving constructive feedback, and evaluated based on their skills. Whereas, they were challenged by aggressive staff, poor follow up, overcrowded teaching hospitals, low usage of skills lab, and short time for clinical practice. CONCLUSION Midwifery students have positive attitude, and were getting opportunities to practice while they were assigned to a very conducive clinical learning environment with supportive and skillful clinical instructors/ preceptors. However, they have negative attitude, and were challenged to work due to the poor attention given to midwifery students' clinical learning. It is recommended that midwifery students have to practice well in skills lab before they assigned for clinical practice so that the skills lab have to be strengthen with all necessary materials for clinical practice and clinical instructors have to be integrated to teaching hospitals so as to educate students while their hands-on.
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Affiliation(s)
- Tomas Amare Abraha
- College of health science Midwifery department, Mekelle University, Mekelle, Ethiopia
| | | | - Merhawi Birhane Gebre
- College of health science Midwifery department, Mekelle University, Mekelle, Ethiopia
| | - Birhanu Abadi Abrha
- College of health science Midwifery department, Bule Hora University, Bule Hora, Ethiopia
| | - Gebrhud Berihu Haile
- College of health Science School of nursing, Mekelle University, Mekelle, Ethiopia
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Anderson R, Williams A, Emdadul Hoque DM, Jess N, Shahjahan F, Hossain A, Bogren M. Implementing midwifery services in public tertiary medical college hospitals in Bangladesh: A longitudinal study. Women Birth 2022; 36:299-304. [PMID: 36154792 DOI: 10.1016/j.wombi.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND A necessary precursor for quality maternity care provision is high quality education. The quality of care that students are exposed to during clinical education on maternity wards shapes their competencies and professional identities. In this study, we look at the introduction of midwives educated to international standards - with facility mentorship - deployed in tertiary level teaching hospitals in Bangladesh with the intention of improving the use of World Health Organization (WHO)-recommended birth practices. AIM To examine the outcomes of introducing midwifery services into tertiary level care facilities in Bangladesh, on the use of WHO-recommended birth practices. METHODS A retrospective review of patient register data was carried out to understand level of changes in use of WHO-recommended birth practices after the introduction of a midwifery service. Multivariate linear regression was applied using an interrupted time series analysis, with and without a delayed effect, to assess both level and trend change following the introduction of the midwifery service. FINDINGS A significant increase (p < 0.001) in use of WHO-recommended birth practices was found, both immediately following the midwives' introduction and after one year. Quality improvement was observed not only in births attended by midwives, but also in those attended by doctors and nurses. CONCLUSION By introducing quality maternity care provision through midwives in clinical sites, especially in tertiary-level care hospitals with large numbers of students, international standard midwives can improve the quality of clinical education in maternity wards, a critical priority for maternal health worldwide.
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Affiliation(s)
| | | | - Dewan Md Emdadul Hoque
- United Nations Population Fund, Dhaka, Bangladesh; Data, Design + Writing, Oregon City, USA; Michigan State University, USA; Obstetric and Gynaecological Society of Bangladesh, Dhaka, Bangladesh; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
| | | | - Fatima Shahjahan
- Obstetric and Gynaecological Society of Bangladesh, Dhaka, Bangladesh
| | | | - Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden.
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Exploring Midwifery Students’ Experiences of Professional Identity Development During Clinical Placement: A Qualitative Study. Nurse Educ Pract 2022; 63:103377. [DOI: 10.1016/j.nepr.2022.103377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/08/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
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Zwedberg S, Barimani M, Jonas W. Exploring the internship experiences of Swedish final term student midwives: A cross-sectional survey. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 26:100543. [PMID: 32771942 DOI: 10.1016/j.srhc.2020.100543] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/04/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
Today, student midwives in Sweden spend half of their midwifery education at various internships. Practice reality demonstrates that there is an insufficient number of preceptors for the students, and the workload is demanding. Therefore, the present study aimed to explore the experiences of final term Swedish students during their midwifery internship and whether other paedagogical learning experiences beyond the apprenticeship model were included. A cross-sectional survey was distributed to 288 final year midwifery students at all universities offering the midwifery programme in Sweden. This paper focuses on open-ended questions, which were answered by 108 students, and analysed inductively via thematic analysis. Students described an intensive period with pressure during their internship. They expressed a desire for fewer parallel tasks and a better-structured internship. Students revealed that it was both a challenge and stressful to be under constant high performance while practising clinically. Furthermore, students described feelings of competition towards fellow peers in regard to attaining the final number of 50 assisted births. As to the paedagogical methods, the classical preceptorship model with a one-to-one student-preceptor relationship was predominately used. Preceptors were perceived as crucial role models. However, this learning experience was considered suboptimal for learning in the event where preceptors were not engaged or felt insecure regarding their knowledge, or if the preceptor was changed. For the students, the most optimal setting would be if preceptors were selected, trained, and supported in their role to supervise students, instead of being assigned any available preceptor, who was, at times, not a midwife.
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Affiliation(s)
- Sofia Zwedberg
- Sophiahemmet University, Department for Health Promotion Science, Lindtstedtsvägen 8, 114 86 Stockholm, Sweden; Karolinska University Hospital, Solna, Childreńs & Womeńs Health Theme, PA Pregnancy Care and Delivery, Karolinska Universitetsjukhuset Solna, Karolinska vägen, 171 76 Solna, Sweden.
| | - Mia Barimani
- Department of Learning, Informatics, Management and Ethics (LIME), C7 Karolinska Institutet, Tomtebodavägen 18A, 3rd Floor, SE- 171 77 Stockholm, Sweden.
| | - Wibke Jonas
- Department of Women's and Children's Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, Level 8, 171 77 Stockholm, Sweden.
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