Fundamentals of Midwifery: A Textbook for Students (7 page)

Further reading activityRead: Lisa McTavish’s article about her experiences as a student midwife and think about whatlessons you can learn from her story and write your own story.McTavish, L. (2010) ‘A student midwives’ experience in the 21st century’
British Journal of Midwifery
18 (1), pp. 43–47.Student midwives often face challenging times on their demanding midwifery programmes. This is good preparation for post-registration practice: some ‘mental resilience’ is needed for students and midwives alike. This is currently more challenging due to the latest changes to the NHS structure which are underway and the financial situation within the NHS. This means thatstudents and midwives need to develop coping strategies in order to manage the working
10 environment, whilst still giving good quality care.
Further reading activityFor more information on the latest changes in the NHS, read: The New NHS 2013.[Available online] http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspxAs midwifery education is very intimate in its delivery and practice, ‘people’ skills are para- mount. This is where, arguably, the emotionally intelligent element plays a significant role in course progression. Generally, mentor/student relationships are acknowledged as compatible or not; adjustments can easily be made if required. The important thing is to recognise if there is a problem and address it. This requires a confident, self-compassionate and resilient individual and highlights that appropriate student recruitment is vital.There is undisputed evidence to suggest that healthcare practitioners cope better than others with the challenge of the demands placed upon them, and there are also those who actively flourish and thrive. Resilience has been defined as:
. . . The inner strength, competence, optimism, flexibility and the ability to cope effectively when faced with adversity...
(Wagnild 2009, p. 105)Control is crudely, a cognitive ability, which requires knowledge and skill. It is seen as impor- tant when coping within the workplace and cited as a major cause of burnout if lost. Resilience has a core philosophy, which makes individuals take responsibility for their own success or failure, and it is a measure of self-worth (self-compassion). It focuses on emotional flexibility, responsiveness, strengths and resilience. Compassion has been defined as:
. . . Being open to and moved by the suffering of others, so that one desires to ease their suf- fering. It also involves offering others’ patience, kindness and non-judgmental understand- ing, recognising that all humans are imperfect and make mistakes...
(Neff 2003, p. 224)Buddhist belief regards the self and others as interdependent; therefore to be compassionate to others is not possible without compassion for the self (Baer 2010).University students must be adult learners who must develop and enhance their own learn- ing skills. Student midwives therefore should identify their needs; self-assess and be able to seek help and support proactively. Seeking help retrospectively, following poor performance in assessments, indicates earlier missed opportunities. There are many people within the univer- sity and the clinical practice areas who can help and support students; it is the student’s role to seek them out when necessary.
The programme
The midwifery degree is a degree of two awards: first, the professional award, Midwifery, whichis regulated by the NMC, and must adhere to all the NMC documentation, standards and guid- ance. The second award is the academic award of a degree, which is regulated and monitored by the university where it is being studied.
With the professional recognition of becoming a midwife, having evidenced all the require- ments and competences to be admitted to the professional register and achieve the University’s
₁₁
academic standard to be awarded a degree, comes an increase in workload and commitment.Despite being forewarned of this, this creates a major struggle for some student midwives.There are two lengths of programme. One is 156 weeks in length, or 3 years (NMC 2009); the other is where the student is already registered with the NMC as a nurse level 1 (adult). The length of this programme is not less than 78 weeks full time. Both student groups are
pre- registration
midwifery students, who will be competent to practise, at the point of registration. The theoretical content is driven by the Standards (NMC 2009); the clinical practice is driven by local provision and the EU Directive. The university processes generate the structure, assess- ment, teaching style and resources. All universities that provide pre-registration midwifery must appoint a Lead Midwife for Education (LME).
. . . The lead midwife for education is an expert in midwifery education and has the knowledge andskills todeveloppolicy, aswellastoadviseothersonallmattersrelatingtomidwiferyeduca- tion. She should liaise directly with commissioning and purchasing agencies for midwifery edu- cation, as well as being involved in any decisions regarding midwifery education...
(NMC 2009, p. 8)Midwifery lecturers are practising midwives who hold a recognised teaching qualification. Universities who run pre-registration midwifery programmes employ them. Midwifery pro- grammes usually exist within University Faculties or Departments encompassing Health, Social Care, or Medicine and Allied Health. The number of midwifery lecturers within each university was traditionally determined by student numbers and worked on a ratio of 1:10; however this is variable across the country and does impact on the quality of the teaching resource. Mid- wifery lecturers are all practising midwives; they must maintain their competence and confi- dence as a midwife, notify their intention to practise annually and remain up-to-date with mandatory training and education. Midwifery lecturers, in addition to teacher training, should hold or be working towards a higher degree or doctorate. In meeting these requirements, mid- wifery lecturers are able to apply contemporary practice to the classroom. This is to address the theory/practice divide which can occur if practice taught away from the clinical area is not consistent with practice that is taught/observed within the clinical area.The students’ theory elements are assessed generally in the university by the midwifery lec- turers employed by that university. Midwives in the clinical areas who are employed by the local Trusts assess midwifery practice. Assessment of practice must be graded and must contribute to the award of the degree as per the Standards (NMC 2009). Therefore, as it is the university who awards the degree, it is exceptional if university staff are not solely responsible for the assessment of that award. This has and does cause difficulties when seeking university approval, which must be granted by the university to offer and support pre-registration midwifery pro- grammes. To address this anomaly, the university seeks reassurance that equity and parity of all assessments are assured.Midwives who assess student midwives must be sign-off mentors. The role of the sign-off mentor is to make judgments about whether a student has achieved the required standards of proficiency for safe and effective practice for entry to the NMC register. The LME confirms to the approved education institution assessment board that both the theoretical and practice elements have been achieved on completion of the programme (NMC 2008b).The midwife with whom the student will be working mainly provides placement support. The NMC stipulate that a minimum of 40% of the time is spent working with a sign-off midwiferymentor, who is an experienced midwife and has undergone additional training to be able to
12 assess the students’ practice. Additional support is available by a Supervisor of Midwives who is available 24 hours every day, and a Practice Learning Facilitator (PLF). A PLF is a person whois generally jointly employed by the Trust and the university where students undertake their programme. The PLFs are visible within the clinical areas, and are a point of contact should issues arise; they work alongside a link lecturer. The link lecturer is usually a member of the midwifery teaching team at the university; along with the PLFs they provide ongoing education and training to clinical staff on curriculum issues and student assessment.A minimum of 50% of the programme must be spent in the clinical area: clinical systems of care will vary between Trusts and some students find that they prefer one system to another. The advantage of the team approach is consistency of mentor and continuity of carer for those accessing that service. The advantage of the non-integrated approach is working with different mentors and adjusting to different placement areas. All midwives, despite the same common goal and mission as depicted in the Midwives Rules and Standards (NMC 2012) work slightly differently. This is the autonomous element of the midwives’ role. All students have different learning styles and all educators and mentors have different teaching styles. Therefore some students and mentors/teachers work better together than others. However experiences can be unpredictable and there are times of stress in all systems.Different students have different learning styles whether in academic or clinical learning; therefore some teaching methods will appeal to some and not others. All curricula should evi- dence different styles in an attempt to meet the needs of all. All learners can be helped by knowing their own learning styles.
Activity 1.4 Learning styles The websites below will assist you in identifying your learning style and also examine thelearning situations which suite you best. If you have done one of these assessments before, it can still be worth doing this again as these can change over time.[Available online] http://www.brainboxx.co.uk/A2_LEARNSTYLES/pages/learningstyles.htm and http://www.vark-learn.com/english/page.asp?p=questionnaire