Dissertations / Theses: 'Clinical midwifery'

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Vuso, Virginia Zanyiwe. "Enhancing clinical preparedness of basic midwifery students: perceptions of midwifery educators." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/13204.

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Since the inception of the student supernumerary status, both globally and in South Africa, nursing and midwifery educators have been concerned about the clinical competencies of their students. Student clinical competency levels in South Africa are critical to midwifery practice, especially as most litigation against the Department of Health in South Africa concerns negligence in midwifery practice. In addition, the litigations mostly involve newly qualified midwives, thus suggesting a link with practice competency levels. Several challenges exist in the academic and practice environments regarding student learning, practice and clinical preparedness. Lack of support during clinical placement and a lack of facilities for use during clinical practice modules are among these challenges. Some students, due to the challenges they face with clinical learning and practice, fail to meet the practical competencies for examination entry requirements. Consequently, some of these students have to repeat the year or exit the programme. The current study sought to identify how to assist midwifery educators in their activities to prepare students for clinical placement readiness. The first objective of the study was to explore and describe the perceptions of midwifery educators regarding the need for additional measures to enhance the clinical preparedness of basic midwifery students before they are allocated to the clinical areas. The second objective sought to make recommendations that would further assist the midwifery educators to clinically prepare midwifery students before being allocated and placed in different clinical areas. A qualitative, explorative, descriptive and contextual research design was used for the study and the study was conducted at a nursing college in the Eastern Cape Province from August 2014 to January 2016. The research population consisted of midwifery educators at a nursing college and a purposive sampling technique was used guided by set criteria. Data were collected using focus group interviews. Four focus groups were used making a total of 17 participants. The principles applied for data analysis were those of Tesch’s method of data analysis, which were used to develop the themes and sub-themes. An independent coder assisted with the coding of the data for the purposes of trustworthiness. In addition, Lincoln and Guba’s model of trustworthiness consisting of the criteria of credibility, transferability, dependability and conformability was used to confirm the validity of the study while the ethical principles adopted were informed consent, justice, non-maleficence, privacy and confidentiality. The study found that the participants perceived numerous challenges that hindered the clinical preparedness of their students. These related to increased workload, lack of support from management and a lack of commitment on the part of students towards their studies. The participants also identified inconsistencies in clinical practice between the clinical midwives and the educators, and even among the educators themselves. This lack of consistency in turn causes confusion among the students and thus impacts negatively on their clinical practice preparedness. Based on these findings recommendations for clinical nursing practice, nursing education and research were made.

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Barnes, Margaret. "Becoming a midwife : a case study of a women-centred midwifery curriculum." Thesis, Griffith University, 1998. http://hdl.handle.net/10072/380712.

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Midwifery education is in transition in Australia. Courses are being implemented in the university sector at a time when there is increasing debate and concern over the provision of maternity services. The idea of women-centred midwifery practice is developing as a guiding philosophy for midwifery, in order to focus the activities of midwifery practice on the needs of the childbearing woman. In response to these issues in midwifery, the Graduate Diploma Of Midwifery (Griffith University) was developed and implemented with an underpinning philosophy of women-centred practice and a commitment to teaching and learning approaches which emphasised self-direction, reflection and the idea of praxis. This research project has sought to under students' experiences of learning midwifery. In doing so, particulars of the curriculum are evaluated. The research approach draws on a feminist theoretical underpinning and uses processes and approaches congruent with qualitative evaluation. The findings of this research are expressed in terms of students' experience of learning midwifery in this program but reflect broader concerns of the profession. These broader concerns include the potential of the relationship between woman and midwife and the issues of power in the progression. These issues have an impact on students' impressions of midwifery and their ability to interact with the midwifery community in the process of learning. The findings in relation to what helps students learn midwifery point to a different perception of clinical learning and have significance for developments of relationships between university and clinical agencies. The findings of the study will contribute to midwifery knowledge as new insights, particularly in relation to the midwifery relationship and professional issues, are drawn. In considering the students experiences, professional concerns and the identified needs of childbearing woman, a theoretical framework for midwifery education is proposed. This theoretical framework has significance for the profession as it is applicable at the level of curriculum development, course planning or development of learning activities, and importantly, it contributes to knowledge in area of midwifery as a beginning theory of midwifery education.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health and Behavioural Sc.
Griffith Health
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Cornell, Peta Kathleen. "An exploration of midwifery students’ perceptions of clinical facilitators and experiences of clinical facilitation during midwifery clinical placements in Perth, Western Australia." Thesis, Curtin University, 2022. http://hdl.handle.net/20.500.11937/89146.

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Clinical facilitation is a model of supervision for students during professional practice experiences, with little known about this important aspect of midwifery education. A qualitative descriptive exploratory approach with thematic analysis was used to develop knowledge and understanding of undergraduate midwifery students’ experiences with such supervision in Western Australia. Midwifery clinical facilitation was highly valued by midwifery students. Respondent insights and recommendations will be instrumental in further developing and enhancing midwifery models of clinical supervision.

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Bäck, Lena. "Confidence in Midwifery : Midwifery students and midwives’ perspectives." Licentiate thesis, Mittuniversitetet, Avdelningen för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-33560.

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A confident midwife has an impact on a pregnant woman’s clinical outcome and birth experience. Knowledge acquisition, competence, and confidence develops over a lifetime and is of great importance in developing and forming personal skills and allowing the personal traits to grow and mature. Previous international studies have shown that midwifery students do not feel confident in many areas in which they are supposed to practice independently. The aim of this thesis was to investigate confidence levels in basic midwifery skills in Swedish midwifery students in their final semester just before entering the midwifery profession. An additional aim was to describe clinical midwives’ reflections about learning and what factors that developes professional competence, and confidence. Study I was a cross-sectional survey with Swedish midwifery students (n=238). They assessed their own confidence in all competencies that a midwife should have and could practice independently. The results of study I confirmed that Swedish midwifery students feel confident in dealing with the most common procedures during normal pregnancy, childbirth, and postpartum and newborn care. However, they do not feel fully confident in cases in which there are deviations from the normal procedures and obstetric emergencies. When comparing groups of midwifery students, the younger group of midwifery students felt more confident in general compared to the older group. Students at a university with a medical faculty were also more confident than the students at a university without a medical faculty. In study II, focus group discussions were held with 14 midwives emphasizing the way in which midwives reflect on learning and the development of competence and confidence. Content analysis was used to analyze the focus group discussions. Four categories were identified as a result of study II: 1.) feelings of professional safety evolve over time; 2.) personal qualities affect professional development; 3.) methods for knowledge and competence expansion; and 4.) competence as developing and demanding. The conclusion of this thesis is that more practical and clinical training during education is desirable. Midwifery students need to have access and the opportunity to practice obstetrical emergencies within a team of obstetricians and pediatricians. Learning takes time, and one improvement is to extend midwifery education to include and increase in clinical training. This would strengthen the students theoretical, scientific, and clinical confidence. Clinical midwives claim that it takes time to feel confident and that there is a need to develop professionalism.
En trygg barnmorska har en positiv inverkan för förlossningsutfall samt förlossningsupplevelse. Kunskap, kompetens och trygghet är ett livslångt lärande och har stor betydelse för att utveckla och forma personliga färdigheter, att låta de personliga egenskaperna växa och mogna. Tidigare internationella studier har påvisat att barnmorskestudenter känner sig otrygga inom områden där förväntas vara självständiga. Syftet med denna avhandling var att undersöka graden av trygghet hos svenska barnmorskstudenter strax innan de var färdigutbildade. Ett annat syfte var att utforska hur kliniskt verksamma barnmorskor reflekterar över lärande och vilka faktorer som bidrar till att utveckla yrkesmässig kompetens och trygghet. Studie I var en tvärsnittsundersökning med svenska barnmorskestudenter (n = 238). De bedömde egen trygghet inom alla kompetenser som en barnmorska förväntas kunna samt utföra självständigt. Resultaten av studie I bekräftade att svenska barnmorskestudenter känner sig trygga att hantera de vanligaste rutinerna vid normal graviditet, förlossning, eftervård samt nyföddhets vård. De känner sig emellertid inte fullt så trygga när något avviker från det normala samt vid obstetriska nödsituationer. Vid jämförelse mellan yngre och äldre barnmorskestudenter samt grad av trygghet, var det den yngre gruppen av barnmorskestudenter som kände sig tryggare i allmänhet jämfört med den äldre gruppen. Studenter vid ett universitet med en medicinsk fakultet var också mer trygga än studenterna vid ett universitet utan en medicinsk fakultet. I studie II hölls fokusgrupper med 14 barnmorskor, de diskuterade och reflekterade över hur barnmorskor utvecklar kompetens. Metod för att analysera var innehållsanalys, i resultatet framkom fyra kategorier 1.) känslor av professionell trygghet utvecklas över tid ; 2.) Personliga kvaliteter påverkar yrkesutveckling. 3.) metoder för kunskap och kompetensutveckling; och 4.) Kompetens som utveckling och krävande. Slutsatsen av denna avhandling är att mer klinisk träning under utbildning är önskvärt. Barnmorskestudenter behöver tillgång och möjlighet att öva obstetriska nödsituationer tillsammans i team bestående av förlossningspersonal och barnläkare. Det tar tid att lära samt att känna trygghet, en möjlighet att underlätta för studenter vore att utöka samt förlänga barnmorskeutbildningen, att inkludera mer klinisk träning. Detta skulle innebära att stärka studenters möjligheter till en utökad klinisk trygghet. Kliniska barnmorskor hävdar att det tar tid att känna sig trygg och att det ett finns behov av att utveckla professionalism.

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Deery, Ruth. "Engaging with clinical supervision in a community midwifery setting : an action research study." Thesis, University of Sheffield, 2004. http://etheses.whiterose.ac.uk/3544/.

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The main aim of this research study was to explore midwives' views and experiences of their support needs in clinical practice and then to identify how they would wish to receive such support. There was much literature to support the existence of stress and burnout in midwifery but no research that addressed ways of alleviating this. Further aims were to redress that imbalance by planning and facilitating a model of clinical supervision devised by the participating midwives. The study took an action research approach that involved working with a group of eight National Health Service (NHS) community midwives in a collaborative, non-hierarchical and democratic way in order to achieve change. This accorded with a woman-centred approach to working with clients that was being encouraged within midwifery. The midwives were typical of many community-based midwives in the United Kingdom (UK) who were working in increasingly stressful, complex and changing environments. Wider organisational and cultural issues are considered that affect working relationships. The nature of the way the midwives worked when they were offered and received support, and how they reacted and coped when their work team and work situation was threatened, was also explored. Each midwife was interviewed twice; before and after the experience of clinical supervision. They also participated in two focus groups before clinical supervision. In- depth individual interviews lasted up to two hours, as did the focus groups. The interviews and the focus groups were taped, transcribed and then analysed using a relational voice-centred methodology. The main findings were that recent and ongoing change plus the organisational demands placed on the midwives by the NHS and their managers were detrimental to working relationships with their colleagues and clients. This also inhibited the process of change. A discourse of denigration became apparent within the interviews and the midwives behaviour and coping strategies revealed some well developed defence mechanisms, as well as an apparent lack of understanding on their part and that of their midwifery managers in relation to emotion work. Resistance to change was a key defence mechanism used by the midwives. Strong messages emerge about certain 'performances' being available to midwives and the use of defence mechanisms as a way of 'getting the work done'. There are also messages about the cultural legacy of midwifery and how this can inhibit autonomous behaviour by midwives. Developing and increasing self awareness is still not viewed as being intrinsic to the work of the midwife and midwives are being asked to undertake a level of work that they have not been adequately prepared for. Neither do there appear to be effective role models for midwives. The bureaucratic pressures of working in a large maternity unit are also addressed where the system is seen as more important than the midwives.

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Nallen, Kathleen. "Midwifery graduates' perceptions of the impact of enquiry based learning on their clinical practice." Thesis, Queen's University Belfast, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709681.

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In recent years Enquiry Based Learning (EBL) has been embedded in a variety of healthcare related programmes and has become a fundamental component of curricula delivery. EBL research suggests that positive experiences outweigh limitations including enhancing links between theory and practice. Development of transferable skills such as decision making, problem solving and critical thinking is attributed to EBL in some studies. Overall however, very little high quality evidence exists to advocate EBL’s efficacy and subsequently justify widespread curriculum change. Limited research is available on the effectiveness of EBL in midwifery education, additionally there is a paucity of EBL related research with midwifery graduates, an anomaly this evaluation attempts to ameliorate. EBL was recently introduced into Higher Diploma in Midwifery education in the Republic of Ireland. As EBL is frequently credited with being positively influential on clinical practice, it was considered fitting to undertake an evaluation based on this premise. The aim of the study was to elicit perceptions of Higher Diploma in Midwifery graduates regarding the impact of Enquiry Based Learning on their clinical practice. Fourteen graduates took part in a qualitative study which used semi-structured interviews. Findings centred on three major themes: ‘Impact of EBL on the experience of learning’, ‘Impact of EBL on the quality of learning’ and the ‘Impact of EBL on clinical practice’. These three themes incorporated fourteen categories which were then used to provide the framework for discussing the research findings within the context of wider literature. Findings support the assertion that EBL helps relate theory to clinical practice as well as enhancing personal development and the quality of learning. Recommendations are made based on the findings and the implications for stakeholders in midwifery education, practice and management are discussed.

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Ntlokonkulu, Zukiswa Brenda. "The effectiveness of medium-fidelity simulation on the clinical readiness of student midwives." Thesis, University of Fort Hare, 2017. http://hdl.handle.net/10353/4503.

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Simulation affords the student a safe and supportive environment in which to practise skills repeatedly without causing any harm to a real patient. The Department of Nursing Sciences at the University of Fort Hare has a laboratory that offers lowto medium-fidelity simulation in the form of task trainers and mannequins. These task trainers and mannequins are used in general nursing, and in community and midwifery nursing sciences, for the demonstration of skills, the practising of skills by students and for formative assessments. In midwifery, task trainers are used for vaginal examinations, abdominal palpation breech and vaginal deliveries and the management of post-partum haemorrhage (PPH). Given that in a real-life clinical environment limited opportunities exist for students to practise during an obstetrical emergency, medium-fidelity simulation (MFS) in midwifery ideally positions the student in a practical environment without risking the patient’s safety. Despite the availability of MFS at UFH, its benefit on the clinical readiness of student midwives is not known. The present study was designed to assess the effectiveness of MFS in enhancing the clinical readiness of student midwives at the University of Fort Hare. The main research objective of the study was to explore, describe and analyse the effect of medium-fidelity simulation on student midwives’ confidence, critical thinking ability, communication, satisfaction and team work in an obstetrical clinical emergency environment. This was a qualitative, interpretive, phenomenological analysis designed to explore the student midwives’ lived experiences regarding the effectiveness of mediumfidelity simulation and the effect of these experiences on clinical readiness. The target population was fourth-year Bachelor of nursing student midwives at the University of Fort Hare. Purposive sampling was used to select five student midwives who were team leaders during the management of PPH using MFS. Ethical approval was granted by the University of Fort Hare Ethics Committee. Informed consent was obtained from the participants prior to data collection. Trustworthiness was ensured by observing the principles of transferability, credibility, confirmability and dependability. Data was collected through individual face-to-face interviews and a semi-structured interview guide. All fourth-year student midwives had viewed an on-line video entitled Essential Steps in Management of Obstetrical Emergency(ESMOE) Postpartum Haemorrhage, in which the procedure was demonstrated. The video, sent via Backboard, was presented in such a way that student midwives had the opportunity to watch it repeatedly in order to thoroughly comprehend the demonstrated skill. A semi-structured interview guide was used for data collection. Interviews were conducted in the simulation laboratory. A Samsung smartphone was used to record interviews and a notepad was used to make notes of gestures, such as smiles or other facial expressions. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using the six steps: reading and re-reading; initial noting taking; developing emergent themes; searching for connections across the emergent themes; moving to the next case and lastly, looking for patterns across cases. The major findings indicated that the participants had differing views regarding the concept of clinical readiness; some held that clinical readiness meant being ready or prepared to handle any eventuality in the course of work, others opined that it was a state of being conversant with the policies and procedures in the clinical ward. Participants believed that clinical readiness was parallel to being competent and that midwives should always be ready to anticipate complications that might arise with the patient, endeavouring to analyse and interpret such conditions clinically. Participants expressed the need to see the simulation skill demonstrated repeatedly for thorough understanding of the technique, so that they could work independently in an obstetrical emergency situation. During simulation, participants were confident in delegating duties to team members, affirming that in order to ensure that tasks were carried out, team leaders should receive regular updates from team members.

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Bluff, Rosalind. "Learning and teaching in the context of clinical practice : the midwife as role model." Thesis, Bournemouth University, 2001. http://eprints.bournemouth.ac.uk/339/.

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The purpose of this study was to develop a theory in order to explain the meaning and process of learning the role of the midwife from midwives in the clinical setting. To achieve the depth and detail required in the absence of literature on this topic, the grounded theory approach was adopted. The sample consisted of twenty student midwives and seventeen midwives. Data were collected by means of unstructured interviews which were tape-recorded. Each participant was interviewed on a minimum of two separate occasions. The constant comparative method was used to analyse the data. The findings of the research contribute to knowledge by making explicit how the role of the midwife is interpreted and enacted, the effect this has on what role students learn, how it is learned and hence how the role is transmitted from one generation of midwives to the next. The `emic' perspective facilitated the emergence of a number of theoretical ideas. Central to these are the rules of practice. When midwives rigidly follow written and unwritten rules they prescribe midwifery care which corresponds to the medical model. In doing so they act as obstetric nurses or handmaidens to the doctor. When everything is interpreted as rules to be followed prescriptive midwives appear to be uncaring and detached from the experience of childbirth. The individual needs of women are not met and the relationship between midwife and client is superficial. Midwives who rigidly follow the rules inhibit the growth and development of students providing them with few opportunities to achieve beyond the level of their role model. Midwives are flexible when they interpret the rules for the benefit of women and provide a woman-centred model of care. These midwives therefore act as autonomous practitioners. When rules are interpreted and adapted to meet the needs of women, flexible midwives demonstrate involvement in women's experiences and are empathic, supportive and caring. Midwives who use professional judgement to interpret the rules provide an environment in which senior students can become autonomous practitioners. When midwives demonstrate the role of autonomous practitioner, practise a woman-centred model of care and meet the learning needs of students, they are appropriate role models and teachers. There is conflict in the clinical setting when practitioners who hold opposing attitudes, values and beliefs practice together. Conflict can be avoided when flexible midwives adopt strategies that involve becoming prescriptive or practising by subterfuge. In accordance with Bandura's social learning theory students learn by observing and emulating the example of their role models. Learning is vicarious when students observe the consequences of their role models' actions. When learning the role from a role model is interpreted as a passive process, a behaviourist and pedagogical approach to learning and teaching ensures perpetuation of the obstetric nurse role that is no longer considered acceptable. Role modelling serves as a vehicle for transmitting new behaviour when learning is perceived to be an active process. In this case a humanistic, andragogical and cognitive approach to learning and teaching is adopted giving students the freedom to determine their own role. Practice from a number of role models is emulated. In this way each midwife acquires a unique identity which is derived from an abstract role model rather than a particular person. Students are prepared for the autonomous role of the midwife, and it is this role they wish to emulate.

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Rasetshwane, Itumeleng. "Evaluating The Psychometric Properties of the Clinical Assessment Tool Used in The Midwifery Programme In Botswana." Diss., University of Pretoria, 2021. http://hdl.handle.net/2263/78119.

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Background: Clinical assesssment tools play an essential role in clinical practice and assessment. Clinical assessment tools have to be evaluated for pyschometric properties to enhance objectivity and fairness when evaluating students. Reliability and validity are considered the main psychometric properties of clinical assessment tools. However, determining the psychometric properties of clinical assessment tools still remains a major problem. Hence, some tools are designed and used without adequate assessment of their reliability and validity. There is no evidence of the psychometric properties, mainly internal consistency, reliability and content validity of the clinical assessment tool used in Midwifery Programme in Botswana. Aim/Purpose: The aim of the study was to evaluate the internal consistency reliability and content validity psychometric properties of the clinical assessment tool used in the Midwifery Programme in Botswana. Design: A methodological design was used to evaluate the internal consistency reliability and content validity psychometric properties of the clinical assessment tool used in the Midwifery Programme in Botswana. Research process: Data was collected from the completed clinical assessment tools which were used to assess midwifery students registered for intrapartum care (MID 421) in semester 2 and intrapartum care practicum (MID 543) in semester 4 in 2019, from the midwifery training schools, n=114. Data collected from these clinical assessment tools was captured and analyzed using the downloaded IBM® Statistical Package for the Social Sciences (SPSS) software, version 25. Inter-item analysis and the corrected item–total correlation were calculated to determine the internal consistency reliability of the clinical assessment tool used in midifery programme. Cronbach’s alpha was used to determine the reliability of the entire clinical assessment tool. The Subject Matter Expects in midwifery working in the academic field and those working in the Nursing and Midwifery Council in Botswana, were used to evaluate the content validity regarding the relevance and clarity of the competencies in the clinical assessment tool. The Content Validity Index (CVI), Item Content Validity Index (I-CVI), Content Validity Ratio (CVR), the overall scale (S-CVI/Ave) and Scale Content Validity Index using Universal Agreement (S-CVI-UA) were calculated to determine the content validity of the clinical assessment tool used in the Midwifery Programme in Botswana. Results: The results of this study with regard to internal consistency reliability, revealed an overall Cronbach’s alpha of the clinical assessment tool of 0.837. The results of this study, with regard to content validity, revealed an overall CVR of 0.95 and an overall CVI of 0.97. The I-CVI value of the competencies for content validity ranged from 0.8 to 1. The S-CVI/Ave and the S-CVI/UA values of the competencies for content validity were 0.97 and 0.75 respectively. Conclusion: The clinical assessment tool used in the Midwifery Programme in Botswana is reliable and valid. However, there is a need to review some of the competencies to improve its internal consistency reliability and content validity. Keywords: Clinical Assessment, Clinical Assessment Tool, Midwifery Training Institutions, Midwifery Students, Midwifery Programme, Botswana, Reliability, Validity, Psychometric Properties.
Dissertation (MNSc)--University of Pretoria, 2021.
Nursing Science
MNSc
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Ross-Davie, Mary C. "Measuring the quantity and quality of midwifery support of women during labour and childbirth : the development and testing of the 'Supportive Midwifery in Labour Instrument'." Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/9796.

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The thesis describes the development and testing of a new computer based systematic observation instrument designed to facilitate the recording and measurement of the quantity and quality of midwifery intrapartum support. The content of the systematic observation instrument, the ‘SMILI’ (Supportive Midwifery in Labour Instrument), was based on a comprehensive review of the literature. The instrument was found to be valid and reliable in a series of studies. The feasibility and usability of the SMILI was extensively tested in the clinical setting in four maternity units in Scotland, UK. One hundred and five hours of direct observation of forty nine labour episodes were undertaken by four trained midwife observers. The clinical study demonstrated that the study and the instrument were feasible, usable and successful in measuring the quantity and quality of midwifery intrapartum support. The data collected has provided significant new information about the support given by midwives in the National Health Service of Scotland, UK. Continuous one to one support was the norm, with 92% of the observed midwives in the room for more than 80% of the observation period. Emotional support, including rapport building, encouragement and praise, was the most frequently recorded category of support.

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Ramahlo, Tebogo. "The self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa." University of the Western Cape, 2020. http://hdl.handle.net/11394/8158.

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Magister Curationis
Background: Globally, nurses and midwives are the most important healthcare providers. In most countries, nurses and midwives are often the first point of contact to healthcare, and in many rural areas, they are the only point of contact for patients. Skilled midwives are essential for the care of pregnant women and the safe delivery of their infants. Midwives play an important role in promoting the health and wellbeing of women, newborns and their families. In South Africa, slow progress in reducing maternal mortality can be partially attributed to a lack of appropriately trained health professionals to render some basic maternal care services. Aim & objectives: The aim of this study was to investigate the self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa. The objectives of the study were to: identify midwifery skills final-year nursing students found challenging to perform independently, determine the level of confidence of final-year nursing students for managing patients in the maternity unit, determine the level of comfort/confidence of final-year nursing students in key practice skills performance, and collect baseline evidence of nursing students’ perceptions of self-preparedness to inform the higher education institution of gaps and needs identified by nursing students. Methodology: A quantitative research approach using a descriptive survey design was implemented to gather information. A self-administered questionnaire using the Casey-Fink Readiness for Practice Survey was used. Due to the limited size of the population, an all-inclusive sampling strategy was utilised, with a sample size of N=217. At the time of the survey, only 164 nursing students attended class. Only 112 questionnaires were returned, yielding a response rate of 70.88%. All returned questionnaires had no missing data. SPSS Statistics version 25 was utilised for data analysis. Descriptive statistics, frequencies and tests for association were utilised.

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Phuma, Ellemes Everret. "Development of neonatal nursing care clinical competency-based assessment tool for Nurse-midwife technicians in CHAM nursing colleges, Malawi." University of the Western Cape, 2015. http://hdl.handle.net/11394/5079.

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Philosophiae Doctor - PhD
Literature has shown that Malawi is experiencing a shortage of qualified healthcare providers, with the greatest burden on maternal and neonatal health. The majority of health service providers are Nurse-Midwife Technicians (NMT), contributing to 87% of the nursing and midwifery workforce. However, research has shown that the NMTs lack the ability to transfer skills into different clinical settings. It was not known what competencies were taught in Christian Health Association of Malawi colleges to equip the NMTs with clinical competence in neonatal nursing practice and how the clinical teachers assisted these NMTs to acquire the competencies. Furthermore, there was no documentation on the availability of a clinical competency-based assessment tool to validate the NMTs’ achievement of clinical competence in neonatal nursing. The purpose of this study was to develop a neonatal nursing care clinical competency-based assessment tool to validate NMTs’ achievement of clinical competence in CHAM nursing colleges. The competency, outcomes and performance assessment (COPA) model and the skills acquisition model were the conceptual frameworks used as the foundation of the study. The study adopted a sequential mixed method approach in which both qualitative and quantitative methods were utilized. Data collection was conducted using focus group discussions, document review and cross-sectional survey. The design and development model developed by Reeves (2006) and steps to development of assessment tools identified by the Department of Training and Workforce Development (2012) guided the study and development of the competency-based assessment tool. The study was conducted in eight CHAM nursing colleges. The researcher employed purposive, convenient and proportional stratified sampling to select the participants. Ethics clearance was obtained from the University of Western Cape and the National Health Sciences Ethical Research Committee in Malawi, prior to data collection. The data collection involved 31 midwifery clinical teachers and 140 third year students for the FGD and 48 midwifery clinical teachers and 195 third year students for the cross section survey. Document analysis was conducted at all the eight nursing colleges. The qualitative data was analysed using content analysis with Atlas.ti 7 and the quantitative data was analysed using descriptive analysis with SPSS 22. The research findings showed that the NMTs were taught basic nursing skills to enable them provide basic care to the health newborn baby. However, there were inadequate clinical assessments done to validate the NMT’s achievement of clinical competence in this setting. In addition, the clinical teachers used skills checklists to evaluate the NMTs clinical performance on specific procedures. The outcome of this study was the establishment of neonatal nursing clinical competencies, and development of a neonatal nursing care clinical competency-based assessment tool for the validation of NMT’s achievement of clinical competence. The tool provides a framework for neonatal nursing clinical teaching and assessments as well as tracking of the NMT’s clinical performance in this setting. It is recommended that training institutions should reinforce mechanisms to track the students’ clinical experience and performance assessments using this tool to ensure quality student outcomes. Furthermore, the clinical teachers should be oriented on the use of the developed assessment tool for familiarisation; thereby enhancing consistency and objectivity in the students’ performance assessments.
ICAP-NEPI Project Malawi

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Kabamba, Beatrice Mubanga. "An inquiry into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the district health system: the Zambian experience." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Research has shown that there is a problem in the delivery of quality care in maternal and child health services in Zambia. The 1996 Zambia demographic and health survey estimated maternal mortality rate as high as 649 per 100,000 live birth, with this reason among others, human resource constraints and low number of supervised antenatal clinics, deliveries and postnatal clinics by skilled personnel as some of the reasons for the high maternal mortality. Selected studies identify the role of a clinical nurse specialist in advanced midwifery and neonatology who has acquired the knowledge and practical skills to bring about the desired impact of quality care in safe mother hood in order to bring down the high maternal mortality rates. In order to achieve this, the government needs to integrate the advanced midwifery and neonatology clinical nurse specialist in the health system. It was the purpose of the study to inquire into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the Ndola District Health system .

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Chan, Seung-chuen, and 陳湘銓. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong: a comparative analysis of nurse practitioner, clinical nursespecialist, nurse midwife, and nurse anesthetist." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31972809.

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Mettler, Gretchen G. "Growing into a Midwife: A Theory of Graduate Nurse-Midwife Students' Process of Clinical Learning." Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1271258271.

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Chan, Seung-chuen. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong a comparative analysis of nurse practitioner, clinical nurse specialist, nurse midwife, and nurse anesthetist /." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B31972809.

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MacVane, Fiona E. "Midwifery knowledge and the medical student experience. An exploration of the concept of midwifery knowledge and its use in medical students' construction of knowledge during a specialist obstetric rotation." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/4904.

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The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

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MacVane, Fiona Ellen. "Midwifery knowledge and the medical student experience : an exploration of the concept of midwifery knowledge and its use in medical students' construction of knowledge during a specialist obstetric rotation." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/4904.

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The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

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Yimer, Endris Mekonnen, Firew Ayalew Desta, Kefyalew Muleta Akassa, Tadele Bogale Yitaferu, Mesfin Goji Abebe, Mebit Kebede Tariku, and Hannah Gibson. "Assessment of Midwifery and Nursing Students’ Nutrition Competence in Ethiopia: A Cross Sectional Study." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/ijhse/vol4/iss2/2.

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Background: Malnutrition is a major public health problem in Ethiopia contributing to half of infant and child mortality. The 2014 mini Ethiopian Demographic and Health Survey revealed that four out of ten children under five are stunted, nearly one out of ten are wasted, and a quarter are underweight. One of the factors that contributed to the high stunting rate is the shortage of capable providers who are competent to provide nutrition services. The purpose of this study was to assess graduating midwifery and nursing students’ nutrition competence and explore the factors that influence their competence. Methods: A cross-sectional survey was employed in June 2015. Students’ knowledge was assessed using objective written assessment questions; and their skills were assessed using a five-station objectively structured clinical examination. Students’ perception of the nutrition learning environment and their learning experience was obtained by administering a structured questionnaire using interviews. Bivariate and multivariable analysis, including Chi-square test and independent sample t-test, were used to detect statistically significant associations or differences. Results: A total of 113 students from four public universities in Ethiopia participated in the study. Only 38.1% of students demonstrated adequate competency in nutrition. The mean percentage score for nutrition knowledge and skills were 63.8% and 46.6% respectively. There was no statistically significant difference between midwifery and nursing students’ nutrition competence (P>0.05). Both cadres scored a mean value above 50% in the knowledge assessment, except in the competency areas of nutrition and HIV. However, both showed lesser competence in performing basic nutrition skills such as anthropometry. Midwives scored higher than nurses on counseling mothers on optimal breast feeding (p=0.001). The majority (98.2%) of students reported that they had no access to nutrition skills laboratory when they took the nutrition course. In multivariable analysis, students who perceived the practice sites as conducive for nutrition skills learning achieved higher levels of competence. Conclusions: The target students were deficient in nutrition competencies. The study suggests revision of midwifery and nursing curricula for adequacy and relevance of nutrition contents, learning and assessment techniques. Nutrition skills learning both in skills lab and at clinical and practical settings need to be strengthened.

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Sohlin, Viktoria, and Karin Kullgren. "Barnmorskestudenters upplevelser av verksamhetsförlagd utbildning på förlossningsavdelning." Thesis, Umeå universitet, Institutionen för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-184573.

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Bakgrund: Barnmorskans yrkesområde är inom sexuell, reproduktiv och perinatal hälsa. Detövergripande målet i barnmorskeutbildningen är att utveckla självständiga och kompetenta barnmorskor. Den verksamhetsförlagda utbildningen (VFU) motsvarar ungefär halva studietiden och är en viktig del i barnmorskeutbildningen. Förlossningsavdelningen är en viktig miljö för barnmorskestudenter att inhämta kunskaper om graviditet och förlossning. Motiv: VFU på förlossningsavdelning är en känslomässig och intensiv period för barnmorskestudenter. Barnmorskestudenters uppfattningar om vad som främjar utveckling behöver studeras vidare för att kunna optimera framtida verksamhetsförlagda utbildningar. Syfte: Det övergripande syftet var att belysa barnmorskestudenters upplevelser av verksamhetsförlagd utbildning på förlossningsavdelning. Metod: En kvalitativ design med induktiv ansats har använts. Semistrukturerade intervjuer med sju barnmorskestudenter i Sverige genomfördes. Intervjuerna har analyserats genom en kvalitativ innehållsanalys. Resultat: Genom analysprocessen framkom ett tema, VFU på förlossningsavdelning – en känslomässig berg- och dalbana samt tre kategorier; Att både ge och ta emot stöd där en mängd faktorer som kan påverka mötet med kvinnan och stödpersonen beskrevs. Andra kategorin Att hålla ihop hela vägen beskrev hur barnmorskestudenternas hälsa varierade samt svårigheter i att gå från en trygg yrkesroll till en studentroll. Tredje kategorin Hinder i utvecklingsprocessen visade hur Covid-19-pandemin påverkade barnmorskestudenternas VFU, optimeringar inför framtida VFU samt tankar om den framtida yrkesrollen. Åtta subkategorier bildades. Konklusion: Barnmorskestudenterna upplevde sin VFU på förlossningsavdelning som en känslomässig berg- och dalbana. Flertalet faktorer som tidigare erfarenheter, relationen till handledaren och reflektionsmöjligheter påverkade barnmorskestudenters möte med kvinnan och stödpersonen. Att belysa dessa faktorer och inkludera barnmorskestudenter i den kvinnocentrerade vården kan leda till ökat självförtroende och kompetens hos barnmorskestudenter vilket i sin tur kan leda till optimeringar av den kvinnocentrerade vården.
Background: The midwife's profession is within the sexual, reproductive and perinatalhealth. The overall purpose of midwifery education is to develop independent and competent midwives. The clinical internship is an important part of the education. The labour ward is an important environment for midwifery students to acquire knowledge about pregnancy and childbirth. Motive: Clinical internship in the labour ward is an emotional and intense period for midwifery students. Midwifery student’s perceptions of what promotes development needs to be studied further, in order to optimise future clinical internships. Aim: The aim was to investigate midwifery students experiences of clinical internship at labour wards. Methods: A qualitative design with an inductive approach was used. Semi-structured interviews with seven midwifery students in Sweden participated. The interviews were analysed with qualitative content analysis. Result: A theme emerged, Clinical internship at the labour ward - an emotional roller coaster and three categories; To both give and receive support where a number of factors that can affect the meeting with the woman and the support person were described. Second category Holding together all the way described how the midwifery student’s health varies as well as difficulties in the student role. The third category Obstacles in the development process showed how the Covid-19-pandemic affected midwifery student’s clinical internship, optimisations and thoughts about the future professional role. Conclusion: The clinical internship at the labour ward was described as an emotional roller coaster. Previous experiences, the relationship with the supervisor and opportunities for reflection influenced the midwifery student's encounter with the woman and the support person. Elucidating these factors and including midwifery students in women-centered care can lead to increased self-confidence and competence among midwifery students, this couldlead to optimisations of the women-centered care.

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Crouch, Anna. "The perceptions of how dyslexia impacts on nursing and midwifery students and the coping strategies they develop/use to manage difficulties associated with dyslexia in clinical practice : an embedded case study." Thesis, University of Northampton, 2017. http://nectar.northampton.ac.uk/10128/.

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The aims of this research were to explore the perceptions of the impact of dyslexia on nursing and midwifery students in practice, and of the coping strategies they develop and/or use to help them cope. To achieve the above aims, the following questions were set and addressed: 1. What is the perceived impact of dyslexia on the nursing and midwifery student in clinical practice? 2. How are any difficulties associated with dyslexia managed by the nursing or midwifery student? 3i. What strategies can help and support nursing and midwifery students with dyslexia? 3ii. What are students’ and mentors’ perceptions of the poster guidelines (developed following a previous study), which are designed to help and support nursing and midwifery students with dyslexia in clinical practice? A qualitative study underpinned by a constructivist, interpretive ontological perspective was undertaken, based on a grounded theory case study approach. After seeking and gaining research ethics approval and informed written consent from potential participants, a purposive sample of 12 nursing and midwifery students with dyslexia, and 22 mentors was recruited and used for the study. Varied methods including tape recorded semi-structured interviews and content analysis of students’ practice portfolios (n=8) and files (n=12) were used to collect data from the students. Evaluative comments from the mentors were also collected. The data were then analysed using Glasarian grounded theory method. Findings suggest that dyslexia impacts on the student negatively as well as positively. There was expression of strong support with reference to demonstration of empathy and acceptance of students with dyslexia in both academic and practice settings, however, disclosure remained an issue for some students. Apart from already available strategies, the students managed to develop and used simple and effective coping strategies in a non-stressful environment. In a busy environment however, they became stressed and frustrated with cascading effects. Many of the strategies used including the poster guidelines were identified as very useful and or helpful and suggestions made by both students and mentors led to the development of a tool kit to be use used interactively by the students and their mentors in practice.

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Spiby, Helen. "Clinical trials and their tribulations : a midwife's perspective." Thesis, Sheffield Hallam University, 1998. http://shura.shu.ac.uk/20836/.

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From the late 1970's, there was an increasing criticism of hospital maternity care. Conventional practices were challenged, including that of recumbency for birth. ofessionals responded to these criticisms in a variety of ways: more homelike decoration in labour wards, information for women through birth plans and new equipment to use in labour. Some obstetricians utilised the randomised controlled trial to evaluate new methods of management. Inevitably, midwives attending women in labour came into contact with these trials. This thesis utilises the experiences of one such clinical trial. A case study methodology was used to identify the impact of the trial on the work and experiences of midwives attending women in labour. The effects on midwives' work include changes of philosophy, changes to practice, increased work, exacerbation of existing inter-disciplinary tensions and difficulties with communication. The effect of the presence of a midwife research assistant has been explored. Midwives' contact with research at the time of the trial is also included. This programme of research has added to the body of knowledge by demonstrating the extent of the impact of clinical trials on the work and experiences of midwives attending women in labour. The appropriateness of the case study approach for use by midwifery researchers has also been demonstrated. Issues arising from the case study have been further reviewed in the light of contemporary midwifery practice, education and research and related to the wider research agenda. Recommendations are made for the conduct of clinical trials in the labour ward and for future avenues of enquiry.

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Barasinski, Chloé. "Pratiques obstétricales maïeutiques lors de l'accouchement : État des lieux et évaluation des types de poussée." Thesis, Université Clermont Auvergne‎ (2017-2020), 2017. http://www.theses.fr/2017CLFAS009/document.

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Les pratiques obstétricales utilisées lors des accouchements sont nombreuses et certaines peuvent avoir un impact sur son déroulement ainsi que sur les issues maternelles et foetales. Durant le travail, ces pratiques reposent sur l’utilisation de différentes positions ou de techniques antalgiques pharmacologiques (analgésie péridurale, protoxyde d’azote) ou non (déambulation, utilisation de la baignoire, de la douche, du ballon etc.). Au moment de l’accouchement, il existe également différentes techniques de poussée, de maintien de la tête foetale, de soutien périnéal ou encore différentes positions d’accouchement. Cependant, à ce jour, ces pratiques ne sont pas ou très peu étudiées en France et ne répondent à aucune recommandation pour la pratique clinique. Dans le premier volet de cette thèse (n=1496), nous avons réalisé un état des lieux des pratiques déclarées par les sages-femmes et étudié si les pratiques différaient en fonction du lieu d’exercice et de l’ancienneté. Les sages-femmes françaises proposaient largement le recours à l’analgésie péridurale, surtout celles exerçant en maternité de type II ou III. Le décubitus latéral était la position préférée des sages-femmes durant le 1er stade avec analgésie péridurale et durant la phase de descente du 2ème stade. Pour l’accouchement, la plupart des sages-femmes conseillaient des positions en décubitus. La poussée en bloquant était celle la plus conseillée par les sages-femmes et majoritairement par celles ayant ≤ 5 ans d’ancienneté. Ces données ont montré que les pratiques des sages-femmes françaises étaient hétérogènes et variaient selon le niveau des maternités et l’ancienneté des sages-femmes. Notre deuxième volet repose sur un essai randomisé multicentrique (n=250) dont l’objectif principal était d’évaluer l’efficacité de la poussée dirigée à glotte ouverte vs celle à glotte fermée. Le critère de jugement principal était un critère de jugement composite : accouchement spontané, sans lésion du périnée (épisiotomie ou lésion spontanée des 2ème, 3ème ou 4ème degrés). Les femmes éligibles étaient celles ayant suivi intégralement la séance de formation aux types de poussées, avec une grossesse monofoetale en présentation céphalique, un accouchement par voie basse acceptée, admises en maternité entre 37 et 42 semaines d’aménorrhée pour un travail spontané ou induit, à partir d’une dilatation cervicale utérine ≥ 7 cm. Les critères d’exclusion étaient une pathologie contre-indiquant des efforts expulsifs ou un antécédent d’utérus cicatriciel, ou une anomalie du rythme cardiaque foetal avant la randomisation. Nous n’avons pas retrouvé de risques absolus ou bruts statistiquement différents en terme d’efficacité de la poussée, ni sur la morbidité maternelle (déchirures périnéales sévères ou hémorragies du post-partum) et néonatale immédiate (pH défavorable). Après prise en compte des facteurs de confusion et des facteurs pronostiques cliniquement pertinents, l’efficacité de la poussée n’était pas, non plus, statistiquement différente entre les deux types de poussées (RR ajusté : 0,92 [IC95% : 0,74-1,14]). En conclusion, les pratiques maïeutiques différent durant l’accouchement en France et il n’y a pas lieu de conseiller un type de poussée plutôt qu’un autre. Les femmes doivent, toutefois, être informées des différentes positions et des types de poussées lors des préparations à l’accouchement et doivent pouvoir choisir la position et la poussée qui leur conviennent, voir en changer, au cours du travail (Fédération Internationale de Gynécologie Obstétrique, 2012)
Many different obstetric practices are used during delivery, and some of them can affect the course of labor and delivery as well as maternal and fetal outcomes. During labor, these practices mainly concern the use of different positions and of analgesic techniques, both pharmacological (epidural analgesia, nitrous oxide) or not (walking, water immersion in a pool, large tub, or shower, birthing balls, etc.). At delivery, there are also different techniques of pushing, of fetal head management, perineal support, and birthing positions. Nonetheless, until now, the use of these practices in France has been studied little if at all, and there are no Clinical Practice Guidelines to help midwives choose their practices based on scientific evidence.The first component of this dissertation describes our inventory of practices reported by midwives (n=1496) and examines whether these practices differ as a function of either place of practice or experience. French midwives very frequently offer women epidural analgesia, especially those practicing in level II or III maternity units. Lateral decubitus was the position midwives preferred during the first stage for women with epidural analgesia and during the descent phase of the second stage. For delivery, most midwives advised decubitus positions. Pushing with Valsalva breathing was advised most often, mostly by midwives with ≤ 5 years of experience. These data show that French midwives use heterogeneous practices that vary according to the maternity unit level and the midwife's experience.The second component of this dissertation is based on a multicenter randomized trial (n=250) to assess the effectiveness of directed pushing when used with open glottis or closed glottis (Valsalva) breathing. The principal endpoint was a composite criterion: spontaneous delivery without perineal lesion (episiotomy, or spontaneous 2nd, 3rd, or 4th degree lacerations). Women were eligible if they have taken an antenatal class that includes a specific training in the types of pushing, and had a singleton pregnancy in cephalic presentation, planned vaginal delivery, and were admitted to the maternity ward between 37 and 42 weeks of gestation in spontaneous or induced labor when cervical dilation was ≥ 7 cm. The exclusion criteria were a disorder contraindicating expulsive efforts, previous cesarean or other uterine scar, or a fetal heart rate anomaly before randomization. The unadjusted analysis show no difference between the groups in the effectiveness of pushing, in maternal morbidity (severe perineal lacerations or postpartum hemorrhage), or immediate neonatal morbidity (unfavorable pH). After adjustment for confounding factors and clinically relevant prognostic factors, there was still no statistically significant difference in the effectiveness of the type of pushing (RR adjusted: 0.92, 95% CI 0.74-1.14).In conclusion, midwifery practices during delivery in France differ, and there is no evidence to recommend one type of pushing over another. Women must nonetheless be informed about the different positions and types of pushing during their preparation for delivery and must be able to choose the position and type of pushing they prefer, and be able to change it, during labor (International Federation of Gynecology and Obstetrics, 2012)

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Demeester, Anne. "Formation initiale au raisonnement clinique en sciences maïeutiques : Bénéfices, limites et perspectives d'utilisation des cartes conceptuelles." Thesis, Aix-Marseille, 2014. http://www.theses.fr/2014AIXM3112/document.

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Introduction. Le raisonnement clinique (RC) est une compétence médicale clé. Cette thèse soutient que l'organisation et la mise en lien systématique et explicite entre les données d'une patiente ou d'un nouveau-né et les connaissances d'un étudiant améliore sa performance dans la résolution de cas cliniques courants de la pratique sage-femme. Objectifs. Identifier les difficultés de RC d'étudiants en maïeutique et leurs causes explicatives ; identifier l'utilisation des cartes conceptuelles (CC) en lien avec le raisonnement clinique ; solliciter le RC des étudiants par la résolution de cas cliniques courants, identifier leurs perceptions et analyser leurs performances en fonction de leur niveau d'acquisition des CC.Méthodes. Etude exploratoire mixte, revue de la littérature, et expérimentation auprès de 97 étudiants de trois écoles de maïeutique. Analyse de 570 questionnaires et 352 CC. Résultats. Sept causes de difficultés de RC identifiées, parmi lesquelles le défaut de mise en liens entre les connaissances. Le potentiel d'utilisation des CC est confirmé par la littérature. L'expérimentation montre l'acceptabilité des CC et une aide à la résolution dans 50% des cas. Il existe un lien entre la maîtrise des CC, la cohérence du RC et le niveau de performance de résolution des cas. Cette dernière dépend de la représentation initiale du cas (concept de départ) et de la hiérarchisation des concepts, mais pas de la forme de la CC. Les CC permettent également d'identifier les difficultés des étudiants et d'établir un diagnostic pédagogique. Conclusion. La recherche valide l'hypothèse de départ et débouche sur des propositions pour utiliser les CC dans la formation au RC
Introduction. Clinical reasoning (CR) is a key competence that students in health sciences must acquire. This thesis argues that concept mapping improves midwives students' performance in clinical problem solving. Objectives. Identify midwives students CR difficulties and their explanatory causes; identify the use of concept mapping and show compatibility between concept mapping and recommendations for clinical reasoning; introduce concept maps (CMs) in clinical solving learning sessions and observe their effects.Methods. Mixed exploratory study, literature review and experimentation including 97 students nested in three schools of midwifery: 570 questionnaires and 352 CMs were analysed. Results. Seven causes of CR difficulties were identified. Literature confirms CMs may be a relevant tool for clinical reasoning teaching and learning. By making knowledge explicit CM helps one out of two students to improve clinical problem solving performance when CM include a correct core concept and when concepts are hierarchically organized. The best performing students are those who acquire the construction of CMs.Conclusion. The research validates the starting assumption and leads to proposals of using CMs in CR learning. Concept mapping might be an interesting activity to foster CR and identify the difficulties that students may encounter

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Kleinsmith, Debora Ann. "Student midwives' experiences of the Objective Structured Clinical Examination (OSCE) at a University in the Western Cape." University of the Western Cape, 2017. http://hdl.handle.net/11394/5663.

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Magister Curationis - MCur
The Objective Structured Clinical Examination (OSCE) is a formative and summative assessment method used in several health science disciplines. The primary focus of this research study was to explore and describe the experiences of student midwives of the OSCE as used in a specific university context and determine how effective it is in preparing student midwives for clinical practice. However the researcher acknowledges the value of the OSCA (Objective Structured Clinical Assessment), which was not used in the context where the study was conducted. Due to the scarcity of academic literature in South Africa and internationally regarding the experiences of student midwives of OSCE assessments, this research study attempted to increase evidence of students’ experiences for improving the OSCE as an assessment method at a school of nursing used in this study. Research purpose: The purpose of the study was to explore and describe student midwives’ experiences of the Objective Structured Clinical Examination, at the SoN, at a university in the Western Cape, and ascertain whether it prepared them adequately for clinical practice. Research design: A qualitative approach with an exploratory descriptive design was used for the investigation of the student midwives' experiences of this assessment method. Sample: Purposive sampling was utilised to select third year Bachelor of Nursing students, who completed the OSCE during semester one in 2014, at a University in the Western Cape. Nine participants were interviewed. Data collection: The data collection was obtained through semi-structured interviews. Data analysis: The data analysis was done manually using the Thomas (2003) data analysis process. Saturation was reached after nine interviews, when no new relevant knowledge was being acquired. Findings: OSCE preparation was supported by theory and clinical learning opportunities. The OSCE environment was found to be challenging and stressful. Alignment of OSCE stations to clinical skills, theory, clinical practice and appropriateness of time allocation. Students had differing views about their level of confidence and competence. Recommendations: Although the OSCE is a valued instrument in the summative assessment of midwifery students, attention must be given to the careful planning of the OSCE environment and the use of simulation techniques. Adequate support for students is essential, and adherence to a standard method of facilitation in clinical learning, in the skills laboratory, is crucial to fairness in learning and assessment. The direct input from valuable stakeholders in clinical training, such as educators and clinical supervisors, must be considered in order to identify ways to improve the OSCE.

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Ireson, Deborah. "Antenatal clinic: Using ethnographic methods to listen to the voices of pregnant adolescents." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1752.

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Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice. Research design: Using ethnographic methods, this research positioned a midwife to observe pregnant adolescents for a period of nine months while they attended a public antenatal clinic in Western Australia. Data collection and analysis: Data from participant observation was supplemented by in-depth key informant interviews. Analysis of the data was concurrent with data collection and guided by Spradley’s Developmental Research Sequence (1980). Findings: Findings revealed four themes influencing attendance for antenatal care during pregnancy: a) connecting with midwives b) the importance of the maternal mother c) supportive relationships and d) engaging with pregnancy. Themes highlighted maternal mothers are pivotal to antenatal clinic attendance; they provide guidance and antenatal advice that pregnant adolescents accept in preference to that of midwives. Adolescents are influenced to attend antenatal clinic by different milestones than those represented in midwifery care; this may provide opportunity for midwives to align themselves alongside adolescents to provide pregnancy education at moments most relevant to them. Conclusion: Information discovered will increase midwifery knowledge of what factors bring pregnant adolescents to antenatal clinic, aiding midwives to influence regular attendance in this group. To increase pregnant adolescents’ comfort and perceptions of value, midwives may need to reconsider the traditional environment of the antenatal clinic to make better use of waiting times and become more inclusive of adolescents’ supportive relationships. Embracing web-based technology is a pathway, which may effectively assist in the successful provision of antenatal education to this age group. Non-judgemental midwives offering a caring approach to antenatal care, verifying pregnant adolescents’ individual understanding, is identified as essential to engagement with this group.

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Huhta, Jonna, and Katarina Svensson. "Young man, there's a place you can go : Unga män på Ungdomsmottagningen i Uppsala city 2012." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-295699.

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Lindblom, Emilia, and Josefin Jonsson. "Att möta oplanerat gravida unga kvinnor som beslutar sig för att genomgå en abort : En kvalitativ intervjustudie med barnmorskor på ungdomsmottagningar." Thesis, Högskolan Dalarna, Vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:du-24415.

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Bakgrund: Barnmorskeyrket har gått från att främst fokusera på vård under graviditet och förlossning till ett bredare arbetsfält inom sexuell och reproduktiv hälsa som även innefattar arbete på ungdomsmottagning. Barnmorskan på ungdomsmottagningen arbetar förebyggande mot oönskade graviditeter och möter unga kvinnor och män i samtal om graviditet och abort. Att ställas inför ett oväntat graviditetsbesked kan vara omvälvande och barnmorskan är central i att finnas till hands för den unga gravida kvinnan, samt för hennes partner och familj så att hon lättare kan utföra ett informerat beslut. Syfte: Att beskriva barnmorskans erfarenheter av att möta oplanerat gravida unga kvinnor på ungdomsmottagning som beslutar sig för att genomgå en abort. Metod: Semistrukturerade individuella intervjuer användes som insamlingsmetod och analys utfördes med kvalitativ innehållsanalys. Resultat: Två kategorier och sju subkategorier identifierades: Att vara en inlyssnande samtalspartner; Vid graviditetsbeskedet, Inför abortbeslutet och Efter aborten. Individanpassat stöd; Att ge praktiskt och kunskapsmässigt stöd vid den oplanerade graviditeten, Att se till det sociala sammanhanget, Ge stöd för en fortsatt säker sexualitet och Att stödjas för att stödja. Slutsatser och klinisk tillämpbarhet: Barnmorskan fångade in tankar och känslor hos den unga kvinnan och bemötte henne där hon befann sig. Barnmorskan tydliggjorde att abortbeslutet var den unga kvinnans och skyndade inte på beslutet. De betonade vikten av att inte förutsätta abort som det enda handlingsalternativet. Genom att lyssna in individuella behov av stöd kunde barnmorskan tillgodose det stöd som saknades. Att stödja för en fortsatt säker sexualitet såg barnmorskorna som en viktig men utmanande arbetsuppgift som väckte mycket känslor och därför var det viktigt med stöd för barnmorskan i form av kollegor, fortbildning och riktlinjer. Genom att öka kunskapen om barnmorskornas möten med oplanerat gravida unga kvinnor har författarna en förhoppning om ökad förståelse för arbetet och dess utmaningar. Genom fortbildning, hospitering, tydligare riktlinjer och stöttning inom preventivmedelsrådgivning efter aborten kan barnmorskan få mer stöd i sitt arbete och därmed möjlighet att förbättra mötet individanpassat utifrån den unga kvinnans behov.
Background: The midwifery profession has developed from focusing solely on pregnancy and childbirth to a broader field of sexual and reproductive health, including also meeting young people at youth clinics. The midwife at the youth clinic works preventively against unplanned pregnancies and meet young women and men in conversations about pregnancy and abortion. Facing a positive pregnancy notice may be overwhelming and the midwife is central in supporting the young woman, her partner and family in order for her to carry out an informed decision. Objective: To describe the midwife's experiences in meeting unplanned pregnant young women at the youth clinic who decide to have an abortion. Design/Methods: Semi-structured individual interviews were used as the method of data collection and analysis was conducted using qualitative content analysis. Results: Two categories and seven subcategories were identified: Being a listening partner; At the pregnancy announcement, In front of the abortion decision and After the abortion. Individualized support; To provide practical and knowledge based support related to the unplanned pregnancy, To consider the social context, Providing support for a continuing safe sexuality and Achieving support to support. Conclusion and clinical applicability: The midwife captured the thoughts and feelings of the young woman and responded to her where she was. The midwife made it clear that the decision about abortion should be the young woman’s own and not to rush the decision. They stressed the importance of not pre-assume abortion as the only treatment option. By listening to the individual needs of support midwife could meet the support that the young woman was missing. To support the continued safe sexuality were considered important but a challenging aspect of the work evoked emotions, and therefore support to the midwife in the form of colleagues, training and guidelines is important. By increasing the knowledge of the midwives' meetings with unplanned pregnant young women, the authors hope to contribute to a better understanding of Midwifery work and challenges. Through training, field studies, clearer guidelines and support in post abortion contraceptive counseling the midwives can get more support in their work and thus the opportunity to improve person-centered care based on the young woman's needs.

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Dyeli, Nolwando. "An investigation into the implementation of the basic antenatal care programme by midwives in Mdantsane clinics." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/425.

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Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.

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Blomqvist, Sara, and Johanna Thor. "Barnmorskans arbete kring kostråd till gravida kvinnor : En deskriptiv tvärsnittsstudie." Thesis, Uppsala University, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-105101.

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Syftet med denna undersökning var att undersöka barnmorskans syn på kostrådgivning till gravida kvinnor, om och hur de ger information om kost och i så fall vad de informerar om. Vidare undersöktes till vilken grad barnmorskorna på mödravårdscentralerna följer de rekommendationer om kost till gravida kvinnor som Svenska Livsmedelsverket tagit fram. En deskriptiv tvärsnittsstudie genomfördes bland samtliga barnmorskor på mödravårdscentraler i Uppsala län. Det var 36 barnmorskor som deltog i studien (53 % svarsfrekvens) och som besvarade ett webbaserat frågeformulär. Resultatet från undersökningen visar att barnmorskorna ofta ger kostråd till den gravida kvinnan i samarbete med dietisten. Informationen ges då för det mesta både muntligt och skriftligt. Vidare visar resultatet att barnmorskorna anser att det är viktigt att ge kostråd till gravida kvinnor och att de allra flesta kvinnor får kostrådgivning på mödravårdscentralen. Barnmorskorna anser att de och den gravida kvinnan har ett gemensamt ansvar när det gäller information angående kost. Barnmorskorna grundar kostrådgivningen främst på Svenska Livsmedelsverkets rekommendationer och undersökningen visar att de informerar om det mesta som det Svenska Livsmedelsverket tar upp angående kost under graviditeten. Slutsatsen av denna undersökning är att barnmorskorna ger en individuellt anpassad kostrådgivning som följer det Svenska Livsmedelsverkets rekommendationer.

The aim of this study was to examine what view the midwives have on nutritional guidance towards pregnant women, if they give information regarding diets, and if so, how they inform pregnant women, and also what the information consists of. Furthermore, the aim of this study was to determine how the midwives comply with the recommendations given by the Swedish National Food Administration. A descriptive cross-sectional study was carried out among all midwives at the maternity clinics in the county of Uppsala. There were 36 midwives that participated in the study (53 %) which consisted of a web based questionnaire. The result of this study indicated that the midwives frequently give nutritional guidance to the pregnant woman in collaboration with the dietician. The pregnant woman often receives both verbal and written information. The results also indicate that the midwives believe that it is important to give nutritional guidance to pregnant women and that most of them get this guidance at the maternity clinic. The attitude of the midwives is that they, together with the pregnant woman, have a mutual responsibility when it comes to information about nutrition during pregnancy. The midwives nutritional guidance is based on the given recommendations of the Swedish National Food Administration, and the study also shows that the information given by the midwife corresponds with the information that the Swedish National Food Administration emphasise. Therefore the conclusion of this study is that the midwives give an individually adjusted nutritional guidance which corresponds to the recommendations given by the Swedish National Food Administration.

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Berg, Amelie, and Karin Striegel. "Värkstimulering med oxytocin : En granskning av PM från Sveriges samtliga förlossningskliniker." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-90953.

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Bakgrund: I Sverige finns 45 förlossningskliniker. Varje klinik har egna PM/riktlinjer för olika tillstånd och omhändertagande. De är framtagna för att underlätta arbetet och främja jämlik vård. Det finns både risker med att ge oxytocin och att avstå från det. Därför är det viktigt att åtgärden används på ett sätt som minimerar riskerna för mor och barn samt ökar sannolikheten för ett positivt förlossningsutfall. Syfte: Att kartlägga svenska förlossningsklinikers riktlinjer för värkstimulering med oxytocin under aktiv förlossning utifrån frågeställningarna: Är förlossningsklinikernas riktlinjer utformade enligt Nationella Mediciniska Indikationer och uppvisar riktlinjerna en god kvalitét enligt bedömningsinstrumentet Apprasial of Guidelines Research and Evaluation II (AGREE II). Metod: En kvantitativ studie med beskrivande och jämförande design. Resultat: Resultatet grundar sig på samtliga förlossningskliniker riktlinjer för värkstimulering med oxytocin under aktiv förlossning. Jämförelsen mot Nationella Medicinska Indikationer visar på stora skillnader vad gäller innehållet i riktlinjerna. I 25 PM (69 %) saknas en eller flera delar av innehållet. Resultatet utifrån AGREE II visade att endast 20 PM (56%) kunde rekommenderas för användning. Slutsats: Kvalitén på riktlinjerna varierar och de förlossningskliniker som följt Nationella Mediciniska Indikationer är också de som uppvisar bäst resultat enligt AGREE II.
Background: In Sweden there are 45 delivery wards. Every ward has their own guidelines for different conditions and their management. They are composed to relieve the work and promote equal care. There are risks of both administering oxytocin and to refrain from it. It is therefore important that the course of action taken is used in a way that minimizes the risk for both the mother and the child at the same time increasing the probability for a positive delivery outcome. Purpose: To map the Swedish delivery wards local guidelines in inducing delivery with oxytocin during active delivery in regards to the following issues: are the delivery wards guidelines formed according to National Medical Indication and do they uphold the high quality standard according to the assessment tool Appraisal of Guidelines Research and Evaluation II (AGREE II). Method: A quantitative study with descriptive and comparable design. Results: The result is based on all delivery wards local guidelines for inducing delivery with oxytocin during active delivery. In comparison to NMI there are large differences in the content of the guidelines. In 25 guidelines (69%) there were one or several parts of content missing. The result according to AGREE II showed that only 20 local guidelines (56%) could be recommended for clinical use. Conclusion: The quality of the local guidelines vary and the delivery wards that have followed National Medical Indication recommendations are also the ones that present the best results according to AGREE II.

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Sumari, Ayo Eliaremisa Ndetaulo. "Factors influencing clinical teaching of midwifery students in a selected clinical setting in Tanzania." Diss., 2006. http://hdl.handle.net/10500/2258.

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A quantitative, descriptive non-experimental design was used to identify the factors that influence clinical teaching of midwifery students in selected postnatal clinical settings in Tanzania. Structured questionnaires were used to collect data from midwifery tutors/preceptors. The major findings of the study showed that both the professional and educational qualification of tutors was low; tutors and preceptors were overworked due to shortage of staff; the school skills laboratory and postnatal wards lacked equipment and necessary supplies; there were no clinical accompaniment guidelines, and overcrowding of postnatal patients. Recommendations included developing the clinical teaching guidelines, employing more tutors, preceptors and clinical staff; improving the tutors'/ preceptors' educational and professional qualifications and updating the qualifications of ward supervisors and clinical facilitators.
Health Studies
M.A. (Health Studies)

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(9885311), HM Donovan. "The experience of the double-degree nurse midwife in their transition to clinical practice." Thesis, 2016. https://figshare.com/articles/thesis/The_experience_of_the_double-degree_nurse_midwife_in_their_transition_to_clinical_practice/13443227.

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Dual degree nurse midwives graduate with a broader scope of practice which is welcomed and valued across a wide variety of health care settings. Transition to practice experiences for these beginning health practitioners reflect the breadth of their practice capabilities and are directly dependent on their roles and responsibilities as a nurse and a midwife, the support available to them and organisational expectations for autonomous practice. While literature exists that examines the transition to practice experiences of nurses and midwives, no literature was located for this study that explored the transition to practice experiences of dual degree graduate nurse midwives. As a result, the aim of this research project was to describe the transition to practice experiences of Bachelor of Nursing/Bachelor of Midwifery graduates working in a variety of health care settings across Australia as beginning health care practitioners. Face to face interviews were undertaken using a Husserlian Descriptive Phenomenological approach. Twenty-three graduate double degree nurse midwives employed as both nurses and midwives in a variety of health care settings across Australia described their transition to practice experiences. Four core themes emerged: A need to feel safe; A need to feel a sense of valued belonging; The path to exhaustion and work-life imbalance; and The daunting world of autonomous practice. Recommendations from this study include the need for graduates who are transitioning into more than one discipline to be acknowledged for their expanded scope of practice and be supported accordingly. This support needs to be context specific, holistic and include rostering and shift-work expectations that enable a satisfactory work-life balance.

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Alhusaini, Malak Alashal F. "Clinical Nursing and Midwifery Research in the Eastern Mediterranean Region." Thesis, 2018. https://doi.org/10.7916/D8GQ8FFV.

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Nurses and midwives are well placed to improve the health outcomes of patients in a number of areas, so the fields of nursing and midwifery must include the ability to conduct rigorous research, synthesize findings into relevant evidence, and use research to inform practice. However, clinical nursing issues in regions such as the Eastern Mediterranean Region (EMR) are often under-researched. The three projects included in this proposal are part of a larger study funded by the Columbia University President’s Global Innovation Fund in collaboration with the Office of Global Initiatives of Columbia University School of Nursing. This dissertation includes three aims: (a) conduct a scoping review of published clinical nursing research to assess the current state of research in the region, (b) conduct a formal program evaluation of a Research Summit that identified clinical nursing and midwifery research priorities and developed an action plan for the EMR, and (c) describe perceptions of barriers and facilitators to research utilization among nurse leaders in the EMR. The results of the scoping review demonstrated that there was limited clinical nursing and midwifery research that has been conducted in the Region. The program evaluation indicated that the Summit was successful and a number of actionable projects have been carried out as a result. Furthermore, the results of the Barriers Scale (Funk et al., 1991) showed that the main barriers to research utilization were lack of funding and resources, lack of support, lack of interest, and lack of training while the main facilitators were placed into the categories of improving support and research culture, resources, and education and training. GDP also significantly impacted the extent to which participants experienced barriers to research utilization. It is important that more Region-specific research be carried out. In order to do this, the research skills of nurse/midwife researchers need to be enhanced and the dissemination of their research supported. Nurse and midwife researchers in the Region should develop consensus regarding specific regional clinical research topics to be given priority and provide support so that nurse and midwifery researchers overcome any barriers they face regarding utilizing clinical research in their practice so that patients can be provided with better and safer care.

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Sun, Carolyn J. "Clinical Nursing and Midwifery Research in Southern and Eastern African Countries." Thesis, 2015. https://doi.org/10.7916/D8251HKK.

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Background: Although nurses provide the majority of healthcare, Africa also has the fewest healthcare workers in the world, including the least number of nurses and midwives in any WHO region. Concurrently, the majority of healthcare research is generated within the United States and Europe, creating evidence for practice that is potentially not applicable in African countries with limited resources and vastly different healthcare problems. Limited information is available regarding what determines which topics are studied in nursing, and even less is known regarding what predicts research trends in African countries. To maximize the use of the limited supply of nurse scientists available, it is important to understand what influences trends in nursing and midwifery research and whether these trends are correlated with what experts consider to be research priorities in a given geographical location and healthcare field. Objective: To address these gaps in the literature and to assist nurse scientists in southern and eastern African countries in directing their research toward those topics with the most critical needs, the aims of this study were to identify 1) what research is currently being conducted, 2) which topics local experts consider to be priorities and furthermore, 3) what influences trends in nursing research. The background and theoretical framework as well as an overview of the dissertation are presented in Chapter 1. Methods: This was accomplished through 1) an environmental scan (including a scoping and a grey literature review in Chapter 2) 2) a Delphi survey of clinical nurse research experts in southeastern African countries (Chapter 3), and 3) a statistical analysis of factors associated with current research topics (Chapter 4). Results: The results of the environmental scan suggest that overall, there is limited clinical nursing and midwifery research and it is less likely to be published in indexed literature. The Delphi survey suggested that critical research priorities in southern and eastern African countries include midwifery and maternal mortality and infectious disease and infection control. Although clinical nurse and midwifery research experts in the region are sensitive to the needs of the region, topics that they rank as critical priorities (such as midwifery and infectious disease) are under-researched. Publication in the grey literature (rather than an indexed source) appears to be associated with whether a topic has major funding, affiliations of the first author (such as international affiliations, or affiliation with a nursing school with a global research focus), and the education level of the first author. Conclusions (Chapter 5): Clinical nursing and midwifery researchers in southern and eastern African countries are generating research that is critical for developing and supporting evidence-based practice but may have difficulty publishing in indexed sources reducing the dissemination and impact of this research. Strategies to assist junior nurse scientists with broader dissemination of their work could include establishing a network of clinical nursing and midwifery researchers in the area for mentoring and resource sharing. Moreover, policy makers and funders from outside the region should consider expert opinion when developing health care policy and funding mechanisms for research to assist with the dissemination of research, reduce waste in research, and to ensure improvement of patient outcomes through relevant, translational research.

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Whitney, Elizabeth J., and Melanie Haith-Cooper. "‘Mobile Midwifery’, an innovative mobile application for student midwives in clinical practice." 2015. http://hdl.handle.net/10454/10850.

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Maaka, Seshwatlha Salome. "Strategies to enhance the adaptation of learner nurses regarding midwifery experiential learning in clinical settings of Limpopo Province." Thesis, 2017. http://hdl.handle.net/10386/1995.

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Thesis (M. Cur.) -- University of Limpopo, 2017
BACKGROUND Midwifery learning encompasses both theory and experiential components. Experiential learning plays an important role in midwifery training. Conducting the first normal vaginal delivery seemed traumatic for the learner nurses when they witness the bulging of the perineum when the head of the fetus is crowning. The trauma and stress of learner nurses resulted in negative reactions such as fainting, vomiting, and failing midwifery experiential assessments. The aim of the study was to design the strategies to enhance the adaptation of learner nurses regarding midwifery experiential learning in the clinical settings of Limpopo Province. RESEARCH METHOD A quantitative descriptive cross-sectional research method was used to collect numeric data with regard to the factors that hinder the adaptation of learner nurses regarding midwifery experiential learning in the clinical settings of Limpopo province. Data was collected using a self-administered questionnaire and analysed using the Statistical Package for Social Sciences (SPSS) version 23 with the assistance of the statistician. RESULTS The study revealed that the factors that hinder the adaptation of learner nurses regarding midwifery experiential learning are lack of accompaniment of learner nurses to the maternity units, the anxiety experienced by learner nurses when they witnessed the first delivery, learner nurses not being included in decision making processes in the maternity units and the hostile attitudes of registered midwives towards the learner nurses in the maternity units. Strategies were developed to enhance the adaptation of learner nurses regarding midwifery experiential learning in the clinical settings of Limpopo province. CONCLUSION The study concluded that learner nurses faced challenges that hinder their adaptation to midwifery experiential learning in the clinical settings of Limpopo Province.

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(9785537), Tanya Capper. "Workplace bullying: The midwifery student experience." Thesis, 2021. https://figshare.com/articles/thesis/Workplace_bullying_The_midwifery_student_experience/14776482.

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Aim: To explore and describe midwifery students’ experiences of being the target of workplace bullying whilst on clinical placement in Australia and the United Kingdom. Background: The incidence of workplace bullying has increased dramatically in recent years and is now a major global public health concern. Workplace bullying is generally referred to as repeated unwanted behaviour towards others that is intended to cause harm, occurring within the workplace. Students undertaking placement in the clinical environment, however, only need to experience a one-off incident of inappropriate or unfair treatment for it to have a lasting adverse effect upon them. Healthcare settings provide the ideal environment for such behaviours to flourish, particularly as they are places where power differentials are commonplace. This in turn can impact staff and student wellbeing, patient safety, staff absenteeism, turnover, and productivity. Midwives are reported to commonly experience workplace bullying, leading to work dissatisfaction and subsequent attrition from the profession. Limited research, which has been predominantly quantitative and mixed methods in nature has revealed that midwifery students too are being bullied whilst on clinical placement. Gaps in the literature exist where midwifery students offer their own personal experiences of being the targets of bullying whilst on clinical placement and how this impacts them and other relevant stakeholders. Methods: This study was a qualitative descriptive design. Midwifery students based in the United Kingdom (UK) and Australia that had experienced perceived workplace bullying whilst on clinical placement were recruited via purposive sampling. Approval was obtained from the CQUniversity Australia Human Research Ethics Committee to conduct this study. Data Collection and Analysis: Data was collected using an anonymous online qualitative survey. The survey consisted of two main parts; demographic questions and open-ended questions to enable the students to explain their experiences in more detail. In total, 335 midwifery students responded to the study advertisement and confirmed that they had experienced bullying whilst on clinical placement. A total of 215 participants completed just the demographic section of the survey however, 120 participants provided participant generated textual data by fully completing or partially completing the open-ended questions. Data were thematically analysed using Braun and Clarkes (2006) six phase process. Findings: Midwifery students indicated that being the target of bullying effected them on several personal and professional levels which has the potential to have further reaching impacts upon the reputation of the profession, the quality of care provided to mothers and babies, and the quality of midwifery education. Moreover, the findings suggested that different groups of midwifery students experience bullying in different ways and the social context of the maternity unit significantly influences the way in which bullying behaviours are enacted and are accepted by others towards them. Midwifery students perceive a number of antecedents to being bullied exist and feel that both academic and clinical organisations could do more to provide support to them and tackle the issue of bullying in order to help ensure the future sustainability of the midwifery profession. Conclusions: This study suggests that midwifery students being bullied may have a number of impacts upon students and other key stakeholders. In order to ensure and sustain the future of the midwifery profession, more needs to be done by academic and clinical organisations to address bullying towards midwifery students and prevent the continuation of the bullying cycle.

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Meyer, Rushaan. "The experiences of male nurses in midwifery clinical training at a regional hospital in the Eastern Cape." Diss., 2012. http://hdl.handle.net/10500/10572.

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The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings
Health Studies
M.A. (Health Studies)

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Setumo, Lefoka Johanna. "Midwifery students' experiences of clinical teaching at Sovenga Campus (Limpopo College of Nursing), Limpopo province." Diss., 2013. http://hdl.handle.net/10500/14362.

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The purpose of midwifery nursing education is to prepare midwives who are fully qualified to provide high-quality, evidence-based mother and child health care services. A quantitative descriptive explorative design was used to identify and explore midwifery students’ experiences of clinical teaching at Sovenga Campus, (Limpopo College of Nursing), Limpopo province. Structured questionnaires were used to collect data. The research sample consisted of fifty (50) midwifery students from Sovenga Campus. Ethical principles were adhered to. Validity and reliability were maintained. The findings showed that learning opportunities are being utilised and clinical accompaniment by tutors has improved. The findings indicated that clinical teaching in midwifery units does not include implementation of the maternity guidelines and protocols’ being used .A recommendation was that tutors be included in student orientation and the planning of monthly unit in-service programmes.
Health Studies
M.A. (Nursing Science)

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Malwela, Thivhulawi. "Integration of midwifery nursing science theory with clinical practice in selected training hospitals of Vhembe District, Limpopo Province." Diss., 2015. http://hdl.handle.net/11602/249.

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Zwane, Zanele. "Exploration of the perceived clinical competencies of newly qualified midwives working in hospitals at eThekwini Municipality." Thesis, 2011. http://hdl.handle.net/10413/10378.

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The reduction of the maternal mortality rate is part of the priority agenda of governments in Africa, including South Africa. Research shows that a large portion of maternal deaths are preventable because they are largely due to lack of inappropriately prepared staff. In South Africa, outcome studies on the quality of comprehensive prepared nursing graduates reflect some concerns regarding their levels of competence. These studies, however, are general; they did not directly target the competence of these graduates in their midwifery practice, therefore, the purpose of this study was to explore and describe the perceived level of competence of newly qualified-midwives functioning in midwifery units. Based on the positivist paradigm, an exploratory descriptive design, using a quantitative approach, was adopted in this study. Two structured questionnaires were used to collect data: one for the newly-qualified midwives and one for the supervisors. A total of 48 newly-qualified midwives and 26 supervisors from five hospitals at eThekwini District participated in this study. Ethics principles and other considerations were observed throughout the study. Data were analyzed statistically using a computer Software Package (SPSS, version 15.0) and a variety of statistical tests were carried out. . From the findings there was a positive congruence between graduates and their supervisors' ratings of the newly-qualified midwives clinical competencies. There were, however, significant differences in a few skills with graduates tending to rate themselves higher than did their supervisors. On the whole though one can conclude that although VI the findings in this study are not conclusive, compared to the previous studies in this area, there is an improvement in the level of competence of newly-qualified midwives. The improvement was noted in their level of competence in midwifery clinical practice, clinical teaching, management and research. The findine;s, however, revealed some areas that need special attention in the theory and clinical preparation of midwives. Recommendations included reviewing the curriculum and strengthening the research component. In midwifery clinical practice there needs to be more attention paid to neonatal care skills, problem solving and record keeping. Further research is also recommended.
Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

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Mthombeni, Courage Salvah. "A model to enhance training for male student nurses in midwifery nursing science in the Limpopo Province." Thesis, 2018. http://hdl.handle.net/11602/971.

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(9815639), Lydia Mainey. ""Doing the wrong thing for the right reason" Australian nurses' and midwives' experience of providing abortion care to people victimised by gender-based violence." Thesis, 2022. https://figshare.com/articles/thesis/_Doing_the_wrong_thing_for_the_right_reason_Australian_nurses_and_midwives_experience_of_providing_abortion_care_to_people_victimised_by_gender-based_violence/22273498.

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When a pregnancy-capable person is assaulted, abused, or killed, it is usually at the hands of a male partner or family member. Fatal and non-fatal injuries, chronic health conditions and risky behaviours are all outcomes of gender-based violence (GBV); furthermore, GBV can often lead to unplanned pregnancies. Abortion is, therefore, a predictable outcome for this population. Nurses and midwives are intrinsically involved in the care of pregnant people victimised by GBV. They could be instrumental in providing reproductive justice outcomes such as early intervention, support, and coordination of support services. However, limited research exists to explain how this occurs within abortion care. Effective GBV responses often require a multiagency approach; therefore, services across a range of Australian sectors such as health, women’s safety, and law enforcement could benefit from understanding how nurses and midwives provide abortion care to people victimised by GBV. To address this gap, I aimed to 1) explain the process through which Australian nurses and midwives provide abortion care to people victimised by GBV and 2) explore how the elements of the broader healthcare situation affect the provision of abortion care to people victimised by GBV. I approached the research with a third-wave feminist lens, designing a two-phased multiple methods study combining constructivist grounded theory and situational analysis—such an approach located research participants’ actions in the larger social and power contexts. To assist readers in understanding the scope of the research topic, I commenced the thesis with a scoping literature review of the role and scope of nurses and midwives in the provision of abortion care. The review demonstrates that abortion care is a common procedure performed across many healthcare settings and shows that nurses and midwives provide technical and psychosocial care within their roles. However, the review also highlights that the scope of practice of nurses and midwives within abortion care is probably unnecessarily restrictive. Notably (and foreshadowing the findings of this thesis study), it exposes a lack of person-centred models of abortion care. My research reveals that the Australian abortion arena is expansive and contains multiple sites of power and contested action, which contributed to the research participants’ belief that people seeking abortions in the context of GBV were mostly uncatered for. Participants described a workforce unprepared to provide abortion care generally, or a GBV safety-net more specifically. Pro-life colleagues were seen to centre conscientious objection over patient care, and the workplace environment placed clinicians’ and patients’ safety at risk. Consequently, participants underwent a process I labelled working with or against the system contingent on the degree to which the system was person-centred. When participants encountered barriers to person-centred abortion care, they bent or broke the law, local policy, and cultural norms to facilitate timely holistic care. Though many participants felt professionally compromised, their resolve to continue working against the system continued. They were aided by larger social groups – Smugglers, Navigators, Marie Stopes Australia, and the Family Safety Framework – which came together to resist systemic oppression in an attempt to achieve reproductive/social justice. I used the theoretical conceptualisation of resistance in health and healthcare to unify the findings of the thesis project. My thesis findings support a cultural shift and reorientation of health services to support reproductive justice. First and foremost, my findings support the involvement of nurses and midwives in the creation of healthcare policy, programming, and legislation. This includes their involvement in pro-choice hiring policies, design and facilitation of GBV and abortion care training, and the implementation and evaluation of comprehensive abortion care frameworks, that cater for diversity and offer trauma-informed and flexible care. Furthermore, expanding the scope of nurses and midwives to provide medical abortion, particularly in primary care, would address the current service gap, which compels these clinicians to undermine the current system. Many of these changes could be achieved if health services adopted the World Health Organisation’s technical and policy guidelines for abortion care. However, this will require amendments to regulatory structures, funding models and relaxation of prescribing and abortion procurement restrictions. My findings also highlight a dual loyalty issue between the Nursing and Midwifery Board of Australia’s (NMBA) requirement for clinicians to provide person-centred care and comply with legislation, regulations, policies, and guidelines. A key recommendation is that the NMBA reconsider their position where such complicity would lead to human/reproductive rights violations. This thesis has made a significant contribution to the body of knowledge concerning abortion care of marginalised people. Looking forward, the thesis findings and recommendations could be implemented at the practice level and beyond to improve reproductive justice outcomes for people in Australia.

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Masemola, Sizile Rose. "Implementation of clinical guidelines for the management of pre-eclampsia by midwives in uMgungundlovu District of KwaZulu Natal." Diss., 2017. http://hdl.handle.net/10500/25030.

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The purpose of the study is to determine the knowledge of midwives on implementing clinical guidelines for the management of pre-eclampsia with the aim of improving midwifery practice and preventing maternal and neonatal death due to pre-eclampsia. A quantitative, descriptive, cross sectional study design was used for the study. Data was collected using a self-administered questionnaire from 100 midwives working in the maternity section of the clinic referring to the regional hospital in UMgungundlovu District. The Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. The findings show that respondents to the study have a high mean value (3.6) of knowledge but need support in terms of providing training on the new guidelines. The study also showed that there is need to improve on distribution of guidelines. There was no significant association between demographic factors and the knowledge of midwives on clinical guidelines for the management of pre-eclampsia. A clinical audit of maternity records as well as a quality care project can be developed based on the findings
Health Studies
M.A. (Health Studies)

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Harris, Mary. "A hermeneutic investigation of the influences on and perceptions of breastfeeding and mother-child bonding from the perspectives of survivors of child abuse." 2008. http://arrow.unisa.edu.au/vital/access/manager/Repository/unisa:38417.

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This research investigated an issue that has implications for early breastfeeding cessation and impaired mother-child bonding. It focused on child abuse survivors' perceptions and reactions surrounding breastfeeding and bonding, the necessity of trust before disclosing abuse, and the transition to self-efficacy. It also provided recommendations for health professionals' practice.

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Boardman, Gayelene. "A problem-solving based peer support program for enhancing adherence to oral antipsychotic medication in consumers with schizophrenia." Thesis, 2012. https://vuir.vu.edu.au/22356/.

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Many people with schizophrenia are reluctant to take their antipsychotic medications, and this might have adverse implications for their recovery. Numerous approaches have been implemented to enhance medication taking for this population, but results have varied. The overall aim of the study was to assess if consumers with schizophrenia had improved adherence to their oral antipsychotic medication after participation in a problem-solving based peer support program.

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Habedi, Debbie Kgomotso. "A comparative analysis of fixed and mobile clinic HIV/AIDS services in Madibeng sub-district." Diss., 2007. http://hdl.handle.net/10500/919.

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The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread.
Health Studies
M.A. (Health Studies)

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Dissertations / Theses on the topic 'Clinical midwifery'

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