Continuing midwifery education beyond graduation : student midwives' awareness of continuous professional development

Midwifery education plays an important role in educating graduates about engaging in continuous professional development (CPD) but there is a lack of empirical research analysing student midwives’ awareness of CPD beyond graduation. We aimed to explore student midwives’ awareness of the need to become lifelong learners and to map their knowledge of CPD activities available after graduation. Therefore, forty-seven reflective documents, written in the last week of student midwives’ training programme, were analysed in a thematic way. Content analysis confirmed student midwives’ awareness of the importance of CPD before graduation. They mentioned different reasons for future involvement in CPD and described both, formal and informal CPD-activities. Respondents were especially aware of the importance of knowledge, to a lesser degree of skills-training and still less of the potential value of the Internet for individual and collective learning. Respondents perceived a need for a mandatory preceptorship. Supporting learning guides were highly valued and the importance of reflection on CPD was well-established. This could have resulted from an integrated reflective learning strategy during education

A Delphi study to validate competency-based criteria to assess undergraduate midwifery students' competencies in the maternity ward

Background: workplace learning plays a crucial role in midwifery education. Twelve midwifery schools in Flanders (Belgium) aimed to implement a standardised and evidence-based method to learn and assess competencies in practice. This study focuses on the validation of competency-based criteria to guide and assess undergraduate midwifery students’ postnatal care competencies in the maternity ward. Method: an online Delphi study was carried out. During three consecutive sessions, experts from workplaces and schools were invited to score the assessment criteria as to their relevance and feasibility, and to comment on the content and their formulation. A descriptive quantitative analysis, and a qualitative thematic content analysis of the comments were carried out. A Mann-Whitney U-test was used to investigate diferences between expert groups. Findings:eleven competencies and fifty-six assessment criteria were found appropriate to assess midwifery students’ competencies in the maternity ward. Overall median scores were high and consensus was obtained for all criteria, except for one during the first round. Although all initial assessment criteria (N=89) were scored as relevant, some of them appeared not feasible in practice. Little difference was found between the expert groups. Comments mainly included remarks about concreteness and measurability. Conclusion: this study resulted in validated criteria to assess postnatal care competencies in the maternity ward

Perceptions of midwifery students, mentors, and supervisors on the use of clinical teaching portfolio in Rwanda

Background and objective: The clinical teaching portfolio is a practical tool for integrating theory and practice towards the growth of midwifery students. Both paper-based portfolios (PBP) and electronic portfolios (EP) are known and recognized as tools that can assist midwifery educators to develop students’ analytical and critical thinking. Hence, midwives are required to maintain a professional portfolio to reflect their development of knowledge, skills, and attitude. The aim of this study was to explore the perceptions of midwifery students, mentors, and supervisors about the use of paper-based and electronic clinical teaching portfolios. Methods: A qualitative descriptive design was carried out with 20 participants including midwifery students, mentors, and supervisors. Using purposive sampling, participants were recruited from two selected clinical teaching hospitals. All interviews were audio-recorded and transcribed verbatim by the research team members. Six steps of thematic analysis were followed during the inductive analysis of collected data. Results: Three themes emerged from data analyses which include clinical teaching and learning, encountering barriers in the use of the clinical teaching portfolio, and preference among the clinical teaching portfolio users. Conclusions: The findings of this study highlighted the importance of a clinical teaching portfolio in the promotion of midwifery clinical teaching. This study indicated that there is a need to respect the student-clinical instructor ratio and to equip the users with the required skills in order to fully benefit from the use of a clinical teaching portfolio

Improving student midwives’ workplace learning by moving from self- to co-regulated learning!

Background Contemporary perspectives on regulated learning are moving beyond models, emphasising individual learning (self-regulated learning) to models that position social transactions at the core of learning (co-regulated learning). In discussing this paradigm shift, it is important to study self- and co-regulated learning in situational context but research in the context of midwifery education is scarce. Objective This study aimed to improve our understanding of regulating midwifery students’ learning by exploring factors that promote or inhibit the capacity to independently self-regulate learning during internships. Design We conducted a qualitative study involving semi-structured group discussions with final year undergraduate midwifery students (Belgium). Focus groups were audio-taped, transcribed verbatim and analysed in a thematic way. Findings The majority of respondents did not experience an education intended to stimulate continuous self-regulated learning. They identified many social transactions (with mentors, teachers, teams of midwives, students, peer students, personal environments, personal coaches and curriculum managers) that were instrumental in promoting or inhibiting the ability to independently self-regulate. Flexibility and resilience to cope with the differences in practices, guidance, beliefs and behaviours of individual midwives within and between workplaces, was seen as paramount. Conclusion Broadening the perspective of the individual learner to the complex interplay between all the stakeholders involved with workplace learning is an essential step to move forward in the effort to improve student midwives’ learning in the workplace

Workplace-based learning and eportfolio use in post-graduate medical education in Flanders (Belgium) : what are the perceived needs?

Background Workplace-based learning (WBL) is crucial within post-graduate medical education (PGME), as learning is embedded in clinical work. The focus has increasingly been put on acquiring predefined competencies. It is therefore no longer deemed sufficient to simply be exposed to clinical practice for a fixed amount of time. To timely achieve these competencies, working conditions within WBL and learning experiences need to be fully optimised. Self-directed learning (SDL) is a prerequisite to fully benefit from learning experiences. Research has shown that the development of SDL skills can be facilitated with an ePortfolio. However, current conditions for workplace learning and ePortfolios are not always adapted to the learner-centred approach of SDL. Objective The aim of the present study is to explore the perceptions of both supervisors and residents about current WBL conditions and ePortfolio use in hospital-based PGME in Flanders, with the objective to develop a state-of-the-art ePortfolio supporting SDL. Methods Semi-structured focus group interviews with supervisors (n = 11) and residents (n = 33), from both surgical and medical PGME were conducted using the online format FocusGroupIT. A PDF file from each focus group was exported, and data were analysed in NVivo 12 using an inductive approach to thematic analysis. Results Predefined competencies were not always known nor met. The current ePortfolio was considered more an administrative burden than a support for WBL. The use and relevance of evaluation tools within this ePortfolio were perceived differently by supervisors and residents. Receiving and giving feedback was evaluated as not optimal, where supervisors and residents tended to blame each other for this. Residents indicated a need for more supervision and teaching. They frequently perceived an imbalance between autonomy and a safe learning environment. Time constraints were paramount. Residents frequently mentioned they missed learning opportunities because of the lack of structured time and attention for education in a busy hospital environment. Conclusion There are many opportunities to improve current WBL conditions. The current ePortfolio is not used to its full potential to support the SDL process. Further research should focus on exploring achievable interventions to optimise busy hospital environments for learning purposes, as well as optimisation of ePortfolios to truly support SDL

An online Delphi study to validate the canmeds competence framework to support workplace learning in undergraduate healthcare education in Flanders

Background and aim(s) – Nowadays, workplace learning in healthcare education is often guided by competency-based educational methods. Various competence frameworks have been constructed but have not been interdisciplinary validated in undergraduate healthcare education. Therefore, we conducted a Delphi study 1) to validate the CanMEDS roles (7) and key competencies (27) in 8 different undergraduate healthcare educational programs, and 2) to provide recommendations for the validation of the CanMEDS competence framework. Methods – A three round online Delphi method with experts i.e. teachers, mentors, internship coordinators and educational experts from audiology, dental hygiene, midwifery, nursing (bachelor and associate degree), occupational therapy, podiatry and speech therapy, was used. Experts scored the relevance, clarity and measurability of each key competency (27). Consensus was defined as 70% or more of the experts scoring positively on a 6-point Likert scale. The level of consensus was calculated and quantitatively analyzed using SPSS26. Differences in scoring behavior between expert groups (e.g. healthcare profession, experience level etc.) were explored after each round using a one-way-ANOVA design. In round 1, experts could also give qualitative comments to clarify their score, adjust key competencies without consensus and form recommendations. In round 2, we presented the non-validated key competencies to the experts for further validation using the same scoring methods as used in round 1. Round three is still ongoing. Results – Round 1 and 2 respectively included 38 and 37 experts. After quantitative analysis of round 1, there was no consensus about the relevance of 2 key competencies, the clarity of 3 key competencies and the measurability of 19 key competencies. Qualitative remarks were used to clarify (21) or adjust (3) key competencies. After round 2, 3 of the 27 competencies were not validated. There was no significant difference in scoring behavior between expert groups. The analysis further revealed that 1) key competencies needed concrete enabling competencies to maximize measurability, that 2) not all key competencies could be assessed at any moment during the program, and that 3) some key competencies could never be assessed during the program which emphasizes the importance of continuous professional development (CPD). Discussion and conclusions – The CanMEDS competence framework might be used to support interprofessional education across 8 different undergraduate healthcare professions. Thereby, we can conclude that with this Delphi study, we can confirm the possibility of successfully validating a generalizable competence framework to support workplace learning processes. Future research - Future research is necessary to validate (newly) formulated enabling competencies to optimize measurability