Factors that enhance midwifery students' learning and development of self-efficacy in clinical placement: A systematic qualitative review

Expanding the practice placement capacity in pre-registration midwifery education: A scoping review

BACKGROUND

Practice placements are an essential component of midwifery education, enabling students to apply their theoretical knowledge in a real-world midwifery setting. Exposure and immersion to practice is a core focus of midwifery education internationally. These placements are crucial for students to develop the skills and expertise needed to become safe, competent, and compassionate midwife practitioners. However, access to appropriate placements has become a significant challenge, compounded by increasing student numbers. This review aims to synthesise knowledge on practice placements used in midwifery education and identify strategies to increase placement capacity.

METHODS

A scoping review framework was utilised to present a broad understanding and knowledge synthesis of the available literature to identify the types of practice placements currently used within pre-registration midwifery education and identify opportunities to increase capacity for the future. Arksey and O'Malley's five-step framework was utilised and this review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews (PRISMA-ScR).

FINDINGS

The review identified eleven papers from five different countries. These papers highlight different practice placements utilised to develop competencies and potentially increase practice placement capacity for midwifery students. Community-based placements helped students understand practitioners' roles, while continuity of care models facilitated skill development and positive practice outcomes. Innovative settings such as student-led clinics and rural placements improved students' competence and learning experiences and are seen as successful strategies to develop competency and increase capacity. However, challenges like work-life balance issues and unclear role delineation were observed in some placements, which had a negative impact on student experiences.

CONCLUSION

This review emphasises the importance of developing and establishing new practice placement locations to develop competencies and increase the practice placement capacity in pre-registration midwifery education, ultimately leading to more qualified midwives. To achieve this objective, it is essential to explore opportunities in various settings, including midwifery group practices in the community, caseload midwifery practice, birth centres, private midwifery practice, rural placements, student-led activities, and primary care settings such as community health clinics. These findings can guide educational institutions and policymakers in developing diverse, sustainable placement opportunities to meet the growing demand for skilled midwives.

How the master's level is implemented in internships within master's programmes - exploring the views of students, clinicians, and educators in midwifery and public health nursing

In the course of worldwide attempts at the academisation of professional education and the Bologna process, nursing education has become both bachelor's and master's programmes at colleges, polytechnics, and universities.We investigated how a master's level in internships is conceptionalised by the involved parties. Our focus was on Norwegian master's education programmes in two different health professions, midwifery and public health nursing.The study also aimed at providing a better understanding of barriers and facilitators of realising the master's level in internships.Using the Theory of Planned Behaviour as a theoretical and methodological framework, we conducted individual in depth interviews with representatives of all involved parties (supervisors, students, university teachers, and clinic managers). After content analysing the interview data, we held focus group meetings aiming to confirm the findings from the first part of the study.The findings reveal a controversial debate over the necessity of a master's level education and the challenges participants reported from their attempts to implement the master's level into student internships. The main result is the lack of consensus on the role of internships within a master's programme and on how students, practise supervisors, and educational institutions should collaborate on this issue. Various assumptions about the roles, accountability, and professional functions of a master's student during an internship have been distilled into five distinct models. Instead of comparing and ranking these models, their mere coexistence is discussed as an obstacle to implementing advanced nursing practise. Recommendations are provided to help resolve this confusion.

Clinical internship environment and caring behaviours among nursing students: A moderated mediation model

BACKGROUND

Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students' caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy.

RESEARCH OBJECTIVE

This study aimed to examine the mediating effect of moral sensitivity and the moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours.

RESEARCH DESIGN

A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro.

PARTICIPANTS AND RESEARCH CONTEXT

This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China.

ETHICAL CONSIDERATIONS

This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students.

RESULTS

The clinical internship environment (B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity (B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students' caring behaviours via moral sensitivity (B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours (B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity (B = 0.006, 95% CI = [0.003, 0.010]).

CONCLUSION

Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students.

Developing effective communication skills in audiology using anonymous patient feedback

OBJECTIVE

To explore the value of anonymous patient feedback for audiology students, examining alignment between student and patient judgments on communication skills and assessing how students utilise the feedback.

DESIGN

This study utilised a mixed methods design, employing a Likert survey to collect patient and student ratings on professionalism, compassion, and listening and talking skills in clinical encounters. Semi-structured interviews investigated the student perspective of receiving patient feedback.

STUDY SAMPLE

13 Audiology students and 31 patients who were placed at, or received care at an Audiology teaching clinic.

RESULTS

Patients' ratings across all measures were higher on average when compared to students' self-ratings, only correlating significantly for the measure concerning students' talking skills. Five themes and one subtheme were identified: Emotional impacts, A worthwhile experience, Contrasting priorities, Patients retake centre stage, and Self-reflective learners (subtheme Self-doubt).

CONCLUSIONS

This study reveals that patient feedback led student Audiologists to report heightened seriousness in their interactions and increased attention on skills vital for patient-centred care. The process boosted students' confidence and reinforced awareness of the patient's perspective. Further research is needed to gauge the extent of these effects and explore the feasibility of implementing a large-scale patient feedback program in audiology training settings.

Midwives views about preceptorship and peer-learning in a birth unit: A cross-sectional study

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.

A qualitative evaluation of a student midwife placement teaching English to speakers of other languages (ESOL)

INTRODUCTION

A shortage of UK midwives has put pressure on clinical placements and supervision of student midwives. Alternative placement solutions are needed to provide students with meaningful learning experiences. One such learning experience was a placement undertaken by student midwives who attended a program teaching English to speakers of other languages (ESOL). This study evaluated the impact of the placement on student midwife learning and experiences of the ESOL participants.

METHODS

The 2022 study employed a qualitative design using Kolb's model of experiential learning as a framework. Ten student midwives placed with the ESOL program and three women enrolled in the program participated. Data were collected via online focus groups with the student midwives and a face-to-face focus group with the women. Data were analyzed using thematic analysis and Kolb's model of experiential learning.

RESULTS

Four themes were constructed: 'Putting the scripts aside: expectations versus the reality of being an educator', 'Adapting and personalizing teaching', 'We are learning too: an environment for mutual learning', and 'Taking our learning forwards'. Students faced barriers during their placement and had to adapt their teaching accordingly. They gained crucial knowledge of the challenges faced by women who speak other languages. The women valued the students' input and together they forged a reciprocal learning environment.

CONCLUSIONS

This study demonstrates how placing student midwives in a unique non-maternity setting has benefits for student learning which are transferrable to future practice. Importantly, it confirms that quality of learning during a novel placement is not compromised for students or participants.

Feelings and thoughts of midwifery students during their first birth suite placement: A qualitative study

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.

Deciphering the influence: academic stress and its role in shaping learning approaches among nursing students: a cross-sectional study

BACKGROUND

Nursing education presents unique challenges, including high levels of academic stress and varied learning approaches among students. Understanding the relationship between academic stress and learning approaches is crucial for enhancing nursing education effectiveness and student well-being.

AIM

This study aimed to investigate the prevalence of academic stress and its correlation with learning approaches among nursing students.

DESIGN AND METHOD

A cross-sectional descriptive correlation research design was employed. A convenient sample of 1010 nursing students participated, completing socio-demographic data, the Perceived Stress Scale (PSS), and the Revised Study Process Questionnaire (R-SPQ-2 F).

RESULTS

Most nursing students experienced moderate academic stress (56.3%) and exhibited moderate levels of deep learning approaches (55.0%). Stress from a lack of professional knowledge and skills negatively correlates with deep learning approaches (r = -0.392) and positively correlates with surface learning approaches (r = 0.365). Female students showed higher deep learning approach scores, while male students exhibited higher surface learning approach scores. Age, gender, educational level, and academic stress significantly influenced learning approaches.

CONCLUSION

Academic stress significantly impacts learning approaches among nursing students. Strategies addressing stressors and promoting healthy learning approaches are essential for enhancing nursing education and student well-being.

NURSING IMPLICATION

Understanding academic stress's impact on nursing students' learning approaches enables tailored interventions. Recognizing stressors informs strategies for promoting adaptive coping, fostering deep learning, and creating supportive environments. Integrating stress management, mentorship, and counseling enhances student well-being and nursing education quality.