Evaluation of a student-led midwifery group practice: A woman's perspective
Introduction
The introduction of student-led midwifery group practice is a timely initiative to the midwifery profession, directing us towards the vision of the profession. This vision extends from a large body of evidence that shows that midwives as primary carers are an essential element in reducing high maternal and neonatal mortality rates in all settings in all countries (UNFPA, ICM, WHO, 2014) and that quality midwifery education was a key aspect in reaching this vision (Luyben et al., 2017). This CoCE initiative encompasses the forming of a unique and nuanced relationship between the woman and the midwifery student to enhance better outcomes for both the woman, her baby and significant others including her family and community members. There is limited evidence exploring women's experiences of student-led midwifery group practices. Preparation of midwifery students to enter the profession as safe and competent practitioners is an essential requirement of the profession (Nursing and Midwifery Board of Australia, 2018) and midwifery group practice is one way of developing the skills necessary to build a relationship with the woman.
At one NSW tertiary hospital, the Women's and Children's Health Network (services department) has a high quota of midwifery students and it became increasingly difficult to place all students at a given time into the antenatal clinic, making it difficult to achieve the university mandatory clinical requirements of CoCE's due to the overburdening of the number of midwifery students to each midwife's capacity to support the student. The student-led midwifery group practice piloted their first antenatal clinic in 2015. This initiative was signed off by the Head of Department for Women's and Children's Health as a new model of care. The four Bachelor of Midwifery students study at two universities and are allocated to spend time in a caseload midwifery antenatal clinic that has evolved into a midwifery student-led midwifery group practice. The students follow through approximately 40 women throughout their final year, meeting the requirement of the 10 CoCE women for the Bachelor of Midwifery program. This alternative was posed to support midwifery students and also provides another opportunity to provide care for low risk women and their families. This study focused on data that were collected in 2018.
Section snippets
Literature review
The concept of woman-centred care is an integral component to this CoCE relationship as the midwife focuses on each woman's individual needs encompassing her physical, psychosocial, emotional, intellectual, spiritual and cultural needs. A component of the National Maternity Services Plan 2010 to 2015 (Australian Health Ministers Advisory Council, 2011) was to provide quality evidence-based care to women close to where they live. This plan included a five-year national initiative of continuity
Aim of the study
This study aimed to evaluate women's experiences of a student-led midwifery group practice.
Methods
This research was an exploratory mixed methods study that explored women's experiences and level of satisfaction about a student-led midwifery model of care. The four students in this model of care worked as a team, with two students working primarily as a pair. This enabled the students to work as primary and back-up caregivers for the women. However, the women could have met all of the midwifery students providing antenatal care. This study was approved by the local Health District Human
Participant characteristics
The participants who completed the surveys were aged between 20 and 40 with a mean of 30 (seeTable 3).
The majority of women's responses were positive about the student-led midwifery group practice clinic. The most positive responses (strongly agree, always and relaxed) were scored 1 as compared to the other end of responses (disagree, never and highly anxious) that were scored 4 to 5. The total number of women who responded to the survey and their responses are displayed in Table 4. Women
Discussion
This mixed methods study measured and explored women's satisfaction levels and experiences of all risk primiparous and multiparous women who completed their childbearing journey with a team of four Bachelor of Midwifery students from two different universities in their third year in a public hospital within a student-led midwifery group practice model that underpinned a CoCE model of care. Both the quantitative and qualitative findings resonate the benefits and satisfaction with the quality of
Limitations
The small sample size of the quantitative study component and the nature of the qualitative design of this mixed methodological design may not be generalizable to other populations. Women in this study were interviewed within 6 weeks of the postnatal period, reducing the risk of recall bias.
Conclusion
This study has measured and explored women's experiences of a student-led midwifery group practice model of care that underpins a CoCE philosophy. This study has offered more substantive findings about the importance and appropriate trajectory for students into midwifery group practice models of care. The data from this study highlight the importance of woman-centred care for women during their childbearing journey.
Contributor
Sandra Lyness Clinical Midwifery Educator - Nepean Blue Mountains Local Health District
Ethical approval
Obtained from the Nepean Blue Mountains Local Health District HREC on 17 Dec, 2017 – HREC/17/Nepean/134 and Reciprocal Approval from Western Sydney University HREC on 19 Dec, 2017 – RH125.
Funding sources
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
CRediT authorship contribution statement
Virginia Stulz: Conceptualization, Formal analysis, Investigation, Methodology, Validation, Writing - original draft, Writing - review & editing. Dr Rakime Elmir: Writing - review & editing. Heather Reilly: Formal analysis, Writing - review & editing.
Declaration of Competing Interest
None declared.
Acknowledgement
We would like to acknowledge Sandra Lyness, the Clinical Midwifery Educator - Nepean Blue Mountains Local Health District in her assistance with recruitment of women.
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