A complex and demanding situation – Midwifery preceptors and midwifery students’ experiences of teaching and learning prevention of severe perineal trauma |
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| Institution: | 1. Department of Women’s Health and Health professions Karolinska University Hospital, Stockholm, Sweden;2. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden;3. Department of Health Sciences, Faculty of Medicine, Lund University, Sweden;4. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden;1. Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia;2. School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;3. The Royal Women’s Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia;1. Faculty of Health Southern Cross University, Australia;2. Senior Executive Member Health, Medibank Private, Australia;3. De Montford University, England;4. Vanderbilt University, Nashville, Tennessee, USA;1. Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium;2. Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom;3. School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom;4. University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L′Hospitalet de Llobregat, Barcelona, Spain;5. University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain;6. Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic;7. Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria;8. Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany;1. School of Nursing and Midwifery, Deakin University, Victoria, Australia;2. Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia;3. Western Health, Victoria, Australia |
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| Abstract: | BackgroundMany high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described.AimTo describe midwifery preceptors and midwifery students’ experiences’ of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma.MethodsA qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis.Results“A complex and demanding situation with mutual need for feedback, reflection and safety” was the overall theme describing the conditions. Three sub-themes were identified. “Adapting to a unique situation” refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. “Hindering and limiting circumstances” describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. “A trustful and communicative relationship” describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part.ConclusionAn increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors’ confidence in teaching. |
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| Keywords: | Midwifery education Clinical learning Clinical supervision Preceptorship Student midwife Active second stage of labour Severe perineal trauma |
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