Some changes in health service provision within the United Kingdom (UK) have made it very difficult for universities to meet the practice requirements of undergraduate, pre-registration midwifery programmes. Within a local Hospital National Health Service (NHS) Trust, the introduction of maternity support workers (MSWs) to undertake care in the postnatal period for low risk women and babies, are having an impact on the quality and variety of clinical experience that student midwives are required to undertake in order to meet the standards set by the regulatory body for midwives, and receive a license to practice.
The Student Midwife integrated Learning Environment (SMiLE) Clinic: To met this deficit an innovative collaboration between a university and local Hospital NHS Trust of the SMiLE clinic was organised and implemented; a student-led clinic (SLC) that could provide a valuable solution to these challenges, while at the same time improving the care for mothers and babies. The aim of this research is to explore and identify the experience of the student midwives in regards to learning strategies that occur in this novice midwifery educational learning environment.
With the approval of university ethics, this research adopted a single revelatory qualitative case study approach, incorporating a variety of data collections methods, reflective electronic diaries, focus group interviews and direct observation. This approach allowed the researcher to collect valuable multiple perspectives and account of the SMiLE clinic from all of the stakeholders involved; student midwives, midwife mentors, senior and clinical midwifery managers, university academics and service users.
Analysis and findings
Thematic analysis supported by NVivo computer software was applied to produce three main themes and nine subthemes, the three main themes were as follows: It is a special place to learn in (environment), It is all about the learning (identified learning strategies) and preparing for the real world of midwifery (responsibility and autonomy).
Results and discussion
The benefits and challenges of this practice model in the form of the SMiLE clinic are now known, with positive findings from this research supporting student midwives to gain valuable transferable skills to take them forward into the midwifery workforce. Evaluation of the clinic suggests that students found it beneficial to their learning, built their confidence and gave them opportunities to develop their postnatal skills and competencies in low risk postnatal care.
From a social constructivist standpoint the key findings of this study suggest that practice based learning (PBL) and communities of practice are the encasing learning strategies of this specific practice model, which encompasses other strategies such as, experiential learning, peer to peer learning and collaborative learning. The stakeholders within the study also valued the feeling of ownership and belonging, a protected space and time for learning this environment created, as well as creating a variety of opportunities for preparation for qualification.
New knowledge has been created from this research, which compliments, challenges and builds on previous knowledge and literature regarding learning strategies and their use and effectiveness in SLCs. A new understanding in regards to this model of learning has now been established with the key facets promoting PBL with a specific community of practice within an established organisation, the importance of respectful mentoring and working in partnership with students, a strong sense of identity and inclusivity to the students who participate in them, learner centred and a unique environment in regards to social being, co-construction and interaction.
An understanding of the impact of this particular student-led clinic approach has created a favourable response from this study and as highlighted by other studies may also be transferable to other professional groups and training situations, providing higher education institutions and health care providers with a flexible approach to learning in health care education.
The SMiLE clinic offers an alternative, reliable collaborative student-led clinic practice education model for equipping midwives of the future with the knowledge, social and clinical skills and competencies they will need to provide safe and effective postnatal care for mothers and babies.
Collaborations and Outputs
Marsh W, Colbourne DM, Way S, & Hundley V., 2015. A postnatal clinic run by student midwives as a means of learning? The Royal College of Midwives – Midwives (Summer Edition)
Marsh W, Colbourne DM, Way S, & Hundley V., 2014. Would a student run postnatal clinic make a valuable addition to midwifery education in the UK? A systematic review. Nurse Education Today.