Reflective positioning : the impact of conversations in the social and cultural environment of midwifery practice settings on professional learning for students

Literature reviews on the topic of reflection and reflective practice encompassed midwifery, nursing, medicine, allied health, education and professional education. This investigation also included socio-psychological theories by leading authors such as Benner (nursing), Sch&ouml;n (professional education) and positioning theory by Harr&eacute; and others. Positioning is a psycho-sociological ontology in which individuals metaphorically position themselves within three entities: people, institutions, and societies, where conversations are constructed and make an impact upon the social world. The social and cultural structures and interactions developed in Archer&rsquo;s morphogenesis were examined in terms of the impact of possible encounters and the transformational effects of learning experiences in practice settings. These bodies of work provided the theoretical framework for the author&rsquo;s research of students&rsquo; experiences in midwifery education for postgraduate students from which selected excerpts with three participating students and their supervising midwives are presented. These excerpts are related to reflective practices and the professional conversations conducted between students and midwives. It was found that reflective positioning applied in midwifery education by students can serve as an analytical tool in explaining social and cultural elements of clinical placements to influence and transform their learning. The potency of conversations that occur in everyday moment-to-moment interactions do contribute to students&rsquo; induction in professional midwifery practice and their identity formation as a midwife.<br /

Informing Traces: The Social Practices of Collaborative Informing in the Midwifery Clinic

The concept of “traces” is useful for understanding the collaborative practices of informing. Readers of documents leave traces of their use, and institutional talk embeds traces of collaborative work, including work done and elsewhere and at other times. This chapter employs a multifaceted qualitative strategy of analytic bracketing to analyze traces in midwives’ and clients’ discussions of clinical results. Results are used to identify and evaluate trends in relation to the current case or to universal norms. Conflicting forms of evidence may need to be negotiated. Barriers may arise when results or sources are inadequate or unavailable. Midwives and women manage these barriers by flexibly assigning the role of information provider in official and unofficial ways. The analysis of traces provides insight into the hows and whats of collaborative work and reveals it to be a complex set of practices that go well beyond the immediately visible contributions of others

Information Provision for Informed Prenatal Decision Making

Abstract: In decision making in maternity care, midwives provide information to support clientcentred decisions. Although midwives are expected to maintain neutrality, a variety of concerns limit nondirectiveness. The impact of these concerns is explored through qualitative analysis of midwife-client interactions. The results provide insight into what counts as “information” in these interactions. Résumé : Lors de la prise de décision dans les soins de maternité, les sages-femmes offrent des informations pour soutenir les décisions de leurs patientes. Bien que l’on suppose que les sages-femmes doivent conserver une certaine neutralité, de nombreuses préoccupations limitent le manque de directives. L’impact de ces préoccupations est exploré à travers une analyse qualitative des interactions entre sages-femmes et patientes. Les résultats présentent un aperçu de ce qui est considéré comme « information » dans ces interactions

A case study exploring the definition and application of the concept of woman centred care in a pre-registration midwifery education programme

Woman centred care is a concept frequently promoted as a core aspect of midwifery practice, policy and education. However, woman centred care often remains ill-defined and an elusive feature of clinical practice. The impact of woman centred care as part of pre-registration midwifery education is underreported and has largely only been investigated as a theoretical concept. Consequently, there is limited evidence of how pre-registration midwifery education not only understands woman centred care but how the concept is contextualised into clinical practice environments. A case study methodology, according to Yin’s deductive framework (Yin, 2014) was utilised to investigate student midwives, midwifery lecturers, Heads of Midwifery and the Lead Midwife for Education perceptions and experiences of woman centred care as part of a pre-registration midwifery programme. The single case study was based on a UK based university that typified pre-registration midwifery programmes. The case study methodology identified pre-ordained theoretical propositions and related variables that guided the entire research design. The case study also aligned to a critical realism ontology with a belief that there was an objective reality to be discovered. The sampling strategy involved programme documents, semi structured telephone interviews and a focus group. Collectively these were analysed using Yin’s (2014) pattern matching and explanation building data analysis strategy. This strategy identified the extent to which the findings aligned to pre-ordained theoretical propositions alongside the identification of rival explanations that could not be explained through the data. The case study found that the theoretical concepts of choice, control, mutual collaboration, continuity of care and individualised care were indicative of a pre-registration midwifery programme promoting woman centred care. However, there was differentiation in the understanding and experiences of these concepts that impacted on the ability for woman centred care to be contextualised in clinical practice. The differentiation was influenced by the powerful tendencies of professional identity, type of clinical context, ideologies, the profile of a woman and organisational aspects such as time constraints and policies. As a result, the student midwives were caught between often competing expectations between the university and the clinical practice context. The study contends that woman centred care needs to be reconceptualised so able to integrate often currently competing ideologies and therefore, able to meet the changing future needs of woman centred care. New models for a critical realist framework and a programme planning tool for a contextual application have been developed as part of new understanding for woman centred care in pre-registration midwifery education

Childbirth Supporters’ Experiences in a Built Hospital Birth Environment: Exploring Inhibiting and Facilitating Factors in Negotiating the Supporter Role

© 2016, © The Author(s) 2016. Objective: To explore inhibiting and facilitating design factors influencing childbirth supporters’ experiences. Background: Birthing women benefit from the continuous, cooperative presence of supporters. However, little research has investigated how birth room design facilitates or inhibits supporters’ role navigation. Methods: We conducted an exploratory video ethnographic single case study of childbirth supporters’ experiences, within an Australian hospital birth environment. Video, field notes, and video-cued reflexive interviews with the woman, her midwives, and supporters were thematically analyzed using ethnographic/symbolic interactionist perspectives to frame supporters’ understandings. Results: Findings suggest supporters’ experiences are complex, made more complicated by sparse understanding or accommodation of their needs in the built environment. Supporters’ presence and roles are not facilitated by the physical space; they experience “an unbelonging paradox” of being needed, yet uncertain and “in the way” during “tenuous nest-building” activities. Conclusions: Suggested design guidelines to facilitate supporters’ well-being and their roles in designed hospital birth spaces are provided

SPARC 2017 retrospect & prospects : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2017 SPARC conference. This year we not only celebrate the work of our PGRs but also the 50th anniversary of Salford as a University, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 130 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to exploit this great opportunity to engage with researchers working in different subject areas to your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

Gatekeeping access to the midwifery unit: managing complaints by bending the rules

While poor communication between service users and front line staff causes many service user complaints in the British National Health Service (NHS), staff rarely reflect on the causes of these complaints. We discuss findings from an action research project with midwives which suggest that the midwives struggled to fully understand complaints from women, their partners and families particularly about restricted visiting and the locked door to the midwifery unit. They responded to individual requests to visit out of hours while maintaining the general policy of restricted visiting. In this way the door was a gatekeeping device which allowed access to the unit within certain rules. The locked door remained a barrier to women and their families and as a result was a common source of informal complaints. We argue that the locked door and restricted visiting to the midwifery unit were forms of gate-keeping and boundary making by midwives which reveals a tension between their espoused woman-centred care and contemporary midwifery practice which is increasingly constrained by institutional values

The concept of collaboration : a critical exploration of the care continuum

This thesis critically explored the concept of collaboration through an analysis of the experiences of midwives, child health nurses and women in the process of transition from hospital to community care and related policy documents. The research concluded that the concept serves an important social function in obscuring the complexity of social relations in healthcare. Rather than adopt an unquestioning attitude to what is represented as collaboration this thesis argues for a more critical examination of what is occurring, what is potentially hidden and how specific interests are served through its use