Development of a Model of Holistic Reflection to facilitate transformative learning in student midwives

Background

Reflective practice is considered an essential aspect of personal and professional development, and critical reflection is considered the cornerstone of being an accountable and autonomous practitioner. Tertiary education should lay the foundations of lifelong learning by ensuring students develop into critically reflective and reflexive practitioners, who demonstrate self-awareness and an ability to reflect on personal values and beliefs and their impact on the wider healthcare system. This level of reflective practice is essential to effect change at both an individual and societal level. Reflection should therefore be embedded into education programs as a learning, teaching and assessment strategy.

The development of a rubric for peer assessment of individual teamwork skills in undergraduate midwifery students

BackgroundPoor teamwork is cited as one of the major root causes of adverse events in healthcare. Bullying, resulting in illness for staff, is an expression of poor teamwork skills. Despite this knowledge, poor teamwork persists in healthcare and teamwork skills are rarely the focus of teaching and assessment in undergraduate health courses.AimTo develop and implement an assessment tool for use in facilitating midwifery students’ learning of teamwork skills.MethodsThis paper describes how the TeamUP rubric tool was developed. A review of the literature found no research reports on how to teach and assess health students’ teamwork skills in standing teams. The literature, however, gives guidance about how university educators should evaluate individual students using peer assessment. The developmental processes of the rubric were grounded in the theoretical literature and feminist collaborative conversations. The rubric incorporates five domains of teamwork skills: Fostering a Team Climate; Project Planning; Facilitating Teams; Managing Conflict and Quality Individual Contribution. The process and outcomes of student and academic content validation are described.ConclusionThe TeamUP rubric is useful for articulating, teaching and assessing teamwork skills for health professional students. The TeamUP rubric is a robust, theoretically grounded model that defines and details effective teamwork skills and related behaviours. If these skills are mastered, we predict that graduates will be more effective in teams. Our assumption is that graduates, empowered by having these skills, are more likely to manage conflict effectively and less likely to engage in bullying behaviours.     

Schooling the public on boys: the ongoing salience in media representations of the “crisis” in boys’ education

This paper explores the salience of the “crisis” in boys’ education as it is articulated in Australian print media. We will consider the ways in which this crisis is expressed through a gendered language which simultaneously represents boys as “forgotten” by teaching practices thought to be prioritising girls’ learning, and as an equity (disadvantaged) grouping who require specialised teaching methods different from those currently offered within the Australian school system. Further, we will examine the extent to which feminist-inspired reforms in education are either implicitly or explicitly referenced as an explanation for boys’ apparently poor education attainment, and relatedly consider the work of “experts” supporting claims of a pro-feminine bias that adversely affects boys’ learning outcomes, particularly those experts offering neurological or psychological/cognitive findings which assert a biological basis for gender difference. In this context, we argue that rather than advancing gender equity in schools, popular public discourse, as presented in Australian print media, reinforces and perpetuates notions of gender difference and masculine entitlement.     

Acknowledging the primacy of continuity of care experiences in midwifery education

BackgroundContinuity of midwifery care is the best maternity care model for women at any risk level, and there is a global imperative to improve access to midwifery-led care. However, diverse perspectives about how best to prepare graduates for working in midwifery continuity of care models persist. The continuity of care experience standard in Australia was anticipated to address this.AimTo challenge the dearth of published information about the structures and processes in midwifery education programs by identifying: the educational value and pedagogical intent of the continuity of care experience; issues with the implementation, completion and assessment of learning associated with continuity of care experience; and discuss curriculum models that facilitate optimal learning outcomes associated with this experience. We discuss the primacy of continuity of care experience in midwifery education programs in Australia.DiscussionThe inclusion of continuity of care experience in midwifery programs in Australia became mandatory in 2010 requiring 20, however this number was reduced to 10 in 2014. Research has shown the beneficial outcomes of continuity of care experience to both students and women. Continuity of care experience builds mutual support and nurturing between women and students, fosters clinical confidence, resilience, and influences career goals. We require curriculum coherence with both structural and conceptual elements focusing on continuity of care experience.Implications and recommendationsEducation standards that preference continuity of care experience as the optimal clinical education model with measurable learning outcomes, and alignment to a whole of program philosophy and program learning outcomes is required.     

Optimising the continuity experiences of student midwives: an integrative review

BackgroundIn several countries, midwifery students undertake continuity of care experiences as part of their pre-registration education. This is thought to enable the development of a woman-centred approach, as well as providing students with the skills to work in continuity models. A comprehensive overview of factors that may promote optimal learning within continuity experiences is lacking.AimTo identify barriers and facilitators to optimal learning within continuity experiences, in order to provide a holistic overview of factors that may impact on, modify and determine learning within this educational model.MethodsAn integrative literature review was undertaken using a five-step framework which established the search strategy, screening and eligibility assessment, and data evaluation processes. Quality of included literature was critically appraised and extracted data were analysed thematically.FindingsThree key themes were identified. A central theme was relationships, which are instrumental in learning within continuity experiences. Conflict or coherence represents the different models of care in which the continuity experience is situated, which may conflict with or cohere to the intentions of this educational model. The final theme is setting the standards, which emerged from the lack of evidence and guidance to inform the implementation of student placements within continuity experiences.ConclusionThe learning from continuity experiences must be optimised to prepare students to be confident, competent and enthusiastic to work in continuity models, ultimately at the point of graduation. This will require an evidence-based approach to inform clear guidance around the intent, implementation, documentation and assessment of continuity experiences.     

Addressing the midwifery workforce crisis: evaluating an employment model for undergraduate midwifery students at a tertiary maternity hospital in Melbourne, Australia

Background and aims

In Victoria, maternity services are under significant strain due to increased numbers of women giving birth and critical workforce shortages. Hospitals have experienced challenges in adequately staffing maternity units, particularly on postnatal wards. In 2008, a tertiary maternity hospital in Melbourne introduced a model where undergraduate midwifery students were employed as Division 2 nurses (SMW_Div2) (enrolled nurses), to work in the postnatal area only. This study explored the pilot employment model from the perspective of the SMW_Div2 and hospital midwives.

Methods

A web-based survey was administered to hospital midwives and the SMW_Div2s in the employment model in January 2010. The survey explored the views of midwives and SMW_Div2s regarding the perceived impact of the model on workforce readiness, recruitment and retention, and clinical competence and confidence.

Findings

Forty-seven of 158 midwives (30%) and five of nine SMW_Div2s employed in the model responded to the survey. Both groups considered the model to have benefits for the organisation, including increased: student workforce readiness; clinical confidence and competence; and organisational loyalty. Both groups also considered that the model would facilitate: workforce recruitment; a teaching and learning culture within the organisation; and enhanced partnerships between students, hospitals and universities. Caution was expressed regarding workload and the need for ongoing support for SMW_Div2s working in the model.

Discussion and conclusion

SMW_Div2s and midwives were positive about the introduction of the paid employment model at the Women's. The findings are consistent with evaluations of similar programs in the nursing setting. The employment model has potential short and long term individual and organisational advantages, which is important in the context of increasing births and workforce shortages. Progression of such models will be contingent on the collaboration and cooperation of the various stakeholders involved in maternity workforce and education.     

Educating student midwives around dignity and respect

Focus

There is currently limited information available on how midwifery students learn to provide care that promotes dignity and respect.

Perinatal mental healthcare: Developing skills in midwifery students

Midwives have a pivotal role in screening for risk factors for mental illness and psychosocial vulnerabilities in women during the perinatal period. They also have a key responsibility to provide women with the appropriate resources to support their mental wellbeing. Midwives can lack confidence and/or feelings of competence regarding these skills.Care of women in the context of their perinatal mental health is a core midwifery skill that deserves practical learning during pre-registration education, just as the more ‘hands on’ skills such as abdominal palpation, labour and birth support or newborn examination. However, there is limited opportunity for students to gain clinical placement experiences that are specific to perinatal mental health (PMH).This discussion paper describes an innovative teaching and learning project that aimed to improve confidence in students’ ability to conduct screening, support, and referral of women experiencing mental ill health. The project involved the development of an Objective Structured Clinical Examination (OSCE) and audio visual resources to support learning and teaching and clinical placement. Feedback was collected to inform the refinement of the first OSCE, and to assist in the design of the audio visual resources that are now displayed publicly on the Australian College of Midwives website at https://www.midwives.org.au/Web/Web/Professional-Development/Resources.aspx?hkey=12c2360e-d8b9-4286-8d0a-50aeaeca9702.     

Continuity or team-teaching approach for midwifery education? An exploratory qualitative study of student and academic preferences

BackgroundThe content of midwifery courses is very similar across universities. The teaching approach is not, with universities adopting a variety of pedagogical methods.AimTo explore views of midwifery students, midwifery academics and senior academic managers comparing a continuity approach where one main academic provides the majority of midwifery content plus pastoral care compared with a team-teaching approach of midwifery education where lecturers change throughout the course.MethodsSemi-structured interviews and focus groups were used to discover thoughts, benefits and disadvantages of two teaching approaches. Data were analysed using thematic analysis.FindingsMidwifery students and academics valued relationship building, consistency of advice and assessment expectations of the continuity approach but also appreciated a variety of teaching styles and content found in the team-teaching approach. Senior academic managers favoured a team-teaching approach due to workload concerns.DiscussionContinuity and team-teaching pedagogical approaches offer different advantages. Continuity in midwifery education may provide students with a meaningful trusting relationship with their teacher and consistency of information, which could aid learning. A team-teaching approach provides students with diversity of teaching styles and midwifery ‘stories’. A combination of both pedagogies offering both a mix of teachers and a named ‘go-to’ mentor might help meet student requirements for both continuity and variety.ConclusionRelationship building, consistency and trust, were all evident in the continuity approach whereas the team-teaching approach was considered to be a more sustainable workload model.     

Are Theories About Social Capital Empirically Supported? Evidence from the Farming Sector

Social capital is the bond that links societies together and without which there is little opportunity for economic growth or individual well-being. Thus, this paper aims to contribute to the literature by providing an analytically reliable concept of social capital and a methodological tool for empirically testing a theoretical model of how social capital is built. Based upon a decomposition of the concept of social capital characterising three main dimensions (i.e., structural, relational and cognitive), for each specific group of individuals under study the structural equation model allows us: (1) to confirm the multidimensional construct of social capital; (2) to measure the interrelation between its different attributes and; (3) to set a solid basis for additional research on the effects of social capital. This approach has been empirically applied to Andalusian (southern Spain) farmers as case study. We believe this research to be a fundamental starting point for informing social capital policymakers and helping them implement the necessary tools to facilitate sustainable development processes at different moments in time as it takes into account the multidimensional, contextual and dynamic nature of the concept.     

Midwifery students’ satisfaction with perinatal simulation-based training

BackgroundSimulation-based training has proved to be an effective teaching and learning approach in healthcare. Nevertheless, any assessment of its effectiveness should also take the students’ perspective into account.AimTo validate the Satisfaction with Simulation Experience Scale (SSES) for use with midwifery students and evaluate midwifery students’ satisfaction with perinatal simulation-based training.MethodsSatisfaction with simulation was assessed using the SSES, a measurement tool translated from English to Dutch. Data was collected in four consecutive years (2016–19). A mixed methods design was used to capture both qualitative and quantitative data. Using the quantitative data, factor analysis was performed to assess the construct validity, while Cronbach’s alpha was used to assess internal consistency. Qualitative data was assessed using thematic content analysis.Findings367 SSES questionnaires were completed by 251 students. The exploratory factor analysis resulted in a three-factor model covering debriefing and reflection, clinical reasoning and clinical learning. Cronbach’s alpha showed good internal consistency. Students were very satisfied with perinatal simulation-based training for all three factors: 4.30 (SD = 0.47) for debriefing and reflection, 3.97 (SD = 0.55) for clinical reasoning and 4.10 (SD = 0.46) for clinical learning. Satisfaction scores remained high and stable over the years investigated. Thematic content analysis identified 6 categories: simulation-based training is valuable, the need for more simulation-based training, fidelity, students, negative feelings, and preparation is vital.ConclusionStudents were satisfied with the simulation-based training, experiencing it as providing added value to their education. Simulations gave them the opportunity to make and learn from mistakes in a safe learning environment.     

Mapping vulnerability to climate change-related hazards: children at risk in a US–Mexico border metropolis

There are significant human impacts associated with climate change. This paper introduces a model for identifying small area risks associated with children’s vulnerability to climate change-related hazard exposures, which is transferable to other regions and adaptable to varied population and exposure scenarios. The cross-national El Paso-Ciudad Juárez (US-Mexico) metropolis serves as the study area for model implementation, which involves mapping social vulnerability, hazard exposure, and cumulative climate change-related risks. This study addresses two limitations of extant fine-scale climate change vulnerability mapping studies. First, rather than focusing on one exposure variable, it assesses the combined risks of multiple exposures (extreme heat, peak ozone, and floods) and, thus, offers a model for mapping neighborhood-level cumulative climate change exposure risks. Second, it provides a model for small area spatial analyses of climate change vulnerability within low-/middle-income countries and in contexts where climate change risks (and appropriate responses) are cross-national in scope.     

Detoxing feels good: dieting and affect in 22Days Nutrition and goop detoxes

In this paper, I examine the online platforms that present and facilitate two highly profiled diets: the vegan meal service 22Days Nutrition and goop.com’s detoxes. 22Days Nutrition and the goop detoxes are noteworthy case studies because they showcase a shift in the way dieting is approached in the contemporary moment. Rather than being concerned exclusively with weight loss, these diets stress the emotional value and reward that their highly restrictive approach to eating offers. The diets rarely equate restrictive eating with attaining thinness or weight loss, but rather with an abstract sense of “feeling good” and overall emotional wellbeing. However, this articulation of dieting as an opportunity to enable a “positive” affective experience has larger social and political implications. The article unpacks these implications, finding that the diets’ promises of wellbeing depend on not only individual, continual self-transformation but also the formation of collectives from which some bodies must necessarily be excluded.     

Social inequality of reading literacy: A longitudinal analysis with cross-sectional data of PIRLS 2001 and PISA 2000 utilizing the pair wise matching procedure

In accordance to Boudon's structural-individualistic action model, it is the aim of this paper to investigate the casual effects of individual abilities, resources of the parental home, socially selective educational transitions as well as teaching and learning conditions in schools on the development of reading literacy and its dispersion in respect of social origin. It is assumed that the socially selective transition into the secondary school tracks contributes to the general deterioration of the mean reading literacy when controlling for social origin and individual achievement. The socially selective transition from primary to secondary school contributes to the increase of social inequality of reading literacy existing already since the start of the pupils’ schooling. Since it is not possible to isolate these causes with comparative-static cross-sectional data like PIRLS or PISA empirically, we use a design of generating quasi-longitudinal data with three time references, namely reading literacy at the point of enrolment into elementary school, at the age of 9–10 years, and at the age of 15 years by the pair wise matching of “synthetic twins” with identical status criteria. The empirical analysis of the German data of PISA 2000 and PIRLS 2001 confirm the effects of the individual abilities depending on social origin, the social selectivity of transition into the secondary schools, the sorting and selection performances of the school system, the allocation of children into different learning contexts, and the schooling of both the individual development of reading competences and the social inequality of reading literacy.     

Revising the Harris-Todaro framework to model labour migration from the Canadian Northern frontier

The Harris-Todaro model of labour migration was developed almost four decades ago, and since has become a classic method of migration analysis in less developed countries. This paper explores the applicability of the Harris-Todaro (HT) framework outside its traditional use, by modelling frontier-metropolis migration in Canada. If appropriate, the framework can potentially be used in other countries with similar regional dichotomies, such as Russia and Australia. The paper argues that the HT model is generally applicable in the context of migration from the resource frontier to large metropolitan areas of the Canadian south, although it requires several modifications. The classic HT model is extended to account for northern labour-force heterogeneity (Aboriginal and Non-Aboriginal), the possibility of having or losing jobs in the declining and undiversified frontier economy, and living cost differentials. Further analysis is focused on Aboriginal migration from isolated northern communities. The plausibility of the modified HT model is demonstrated using an empirical test, in which the model is used to assess migration probabilities of Aboriginal labour migrants. These new insights into the mechanisms of frontier-metropolis migration could provide a better basis for developing planning strategies, aimed to sustain human capital in the Canadian North, and for optimizing welfare policies both in the North and in the South.