Elsevier

Women and Birth

Volume 26, Issue 1, March 2013, Pages e21-e25
Women and Birth

Exploring the impact of clinical placement models on undergraduate midwifery students

https://doi.org/10.1016/j.wombi.2012.06.004Get rights and content

Abstract

Background

Learning undertaken through clinical placements provides up to 50% of the educational experience for students in pre-registration midwifery courses. However little is known about of the impact various models of clinical placement have on the learning experiences of undergraduate midwifery students. Two clinical placement models have been employed for undergraduate midwifery students at Monash University, including the block placement model and the continuous two days per week model.

Objective

This project sought to explore the learning experiences of students in these two models of placement.

Method

Focus groups were held on two campuses with a total of 17 students from different cohorts and programs.

Discussion

No one type of placement was favoured over another both had benefits and disadvantages. Further, this study found that regardless of program and clinical placement model the major learning impact for students was related to the midwife they worked with each day on placement rather than to the model.

Conclusion

No one type of placement was favoured over another both had benefits and disadvantages. Further, this study found that regardless of program and clinical placement model the major learning impact for students was related to the midwife they worked with each day on placement rather than to the model.

Introduction

Undergraduate midwifery programs were first introduced in Victoria in 2002 providing new pathways into a career as a midwife. This initiative was partly driven by the Australian College of Midwives to reform the midwifery profession.1 However, it was also in response to serious midwifery workforce shortages that could not be resolved via reliance on the traditional postgraduate midwifery pathway that required a nursing qualification for entry.2 Monash University responded by supplementing the number of graduate midwives entering the workforce from the Graduate Diploma Midwifery (GDM), through the introduction of two undergraduate entry pathways including the Bachelor of Midwifery (BMid)3 and Bachelor of Nursing/Bachelor of Midwifery (BNBMid).4 Variation in structure between the two undergraduate courses required different clinical models to be employed. These differences included the BMid course using an integrated two days per week model of clinical placement, in contrast to the BNBMid course reliant on a 2–4-week block placement model. Additionally a small number of BMid students experienced both a block placement and the two days a week model due to a larger than normal sized cohort. This study sought to compare student experiences between the two undergraduate models of clinical placement.

Section snippets

Background

The nursing literature advises that students on clinical placements are exposed to a range of unplanned activities in a complex social context with many formal and informal learning opportunities.5, 6 Warne et al. reported a wide variation in how clinical placements were organised for nursing students in nine European countries, noting that overall student satisfaction was associated with the quality of the supervisory relationship.7 Brown et al.6 confirmed that effective two way communication

Methods

A descriptive qualitative approach using focus groups was utilised to explore the impact of the clinical placement environment for midwifery students. The purpose of this study was to discover whether the two undergraduate models of clinical placement offered similar experiences and learning opportunities. Prior to commencing data collection, the study was approved by the university's Human Research Ethics Committee. All participants signed a consent form and were free to withdraw at any time

Findings

Three main themes were identified: ‘Student role’; ‘Facilitated learning’; and ‘Belonging to the team’.

Quotes from the interviews are used to illustrate the findings of the study as each theme is discussed.

Student role

This theme encompassed the transitional period of establishing themselves as a midwifery student. The students with minimal midwifery clinical experience were more than ready to have the opportunity to develop their skills after one full year of theory. This theme was reflected in the voices of the students as they identified the ‘reason for being there’ (FG1), the ‘challenges’ (FG3) and ‘the ability to consolidate theory’ (FG4). Students talked about how they ‘loved it’ on clinical placement

Facilitated learning

The relationships that students develop within their clinical placements affect how well they progress, how supported they feel and how quickly they settle into the hospital environment. Discussions revolved around ‘good’ midwives and ‘bad’ midwives. Midwives who work ‘with’ the students providing support and education were perceived as ‘good’. Those who excluded students, who were reluctant to teach and portrayed an overriding attitude against students were perceived as the ‘bad’ midwives.

One

Belonging to the team

This third theme reflects the socialisation process that occurs during placements that contributes to a student feeling supported and valued.

Students valued clinical placements as the vehicle where most of their learning happened. Being remembered was one of the influences that impacted positively or negatively on students’ feelings of belonging. The process of being remembered in the day-to-day activities of ward routine contributed to students feeling that their presence was welcome.

Staff

Discussion

The findings of this study reflect the importance of the midwife as the facilitator for student learning during clinical placement. While this study did not specifically use the term preceptor all midwives allocated to work with students are engaging in an informal buddy role that shares elements of preceptorship responsibility. Students readiness to learn was optimised when they perceived themselves in a safe place, supported and facilitated by a midwife they could trust and who was interested

Conclusion

No one type of placement was favoured over another both had benefits and disadvantages. This study highlights the influence ‘good’ or ‘bad’ midwives have on student learning outcomes, irrespective of clinical placement model. Midwifery student's ideal learning environment is one where all midwives are motivated to teach and facilitate learning in a context where students can work with midwives in the same unit over a continuous period of time. Lack of continuity when working with midwives on

References (28)

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    McKenna et al.’s study goes on to say that students will learn better if they have a sense of belonging as a consequence of being made to feel part of a team by their preceptors [15]. Gilmour et al.’s study adds that students feel less anxious, develop the ability for self-directed learning, are motivated to learn, and have the confidence to ask questions, if they feel they belong [16]. Gilmour et al.’s study discussed good methods that preceptors can utilise to encourage a sense of belongingness in their students [16].

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