Following on from last issue's Birthwrite article, Ruth Sanders and Kelda Folliard discuss teaching research skills to midwifery students through practical technique

Folliard, Kelda

Sanders, Ruth

University of East Anglia digital repository

Research in practice: a core midwifery skill Our previous paper noted that the evidence-based practice and research (EBPR) skills which are core to midwifery curricula do not always remain with student midwives beyond qualification (Folliard and Sanders, 2022). We suggested this was due to these skills being somewhat opaque, less tangible than hands on midwifery skills (Lee & Peacock, 2020), and not reliably modelled by the midwives with whom students and newly qualified midwives learn. So how do we as midwifery educators ensure parity of esteem between these different types of midwifery skills? With the daily challenges of busy workloads leaving little time for experienced midwives to actively engage with research (Toolhill et al. 2017), how can clinical and academic educators effectively facilitate prioritising and mastering EBPR skills? How do supervising midwives assess students’ ability to translate theory into practice? This paper outlines some approaches that have been taken and focuses on whether there is an opportunity for collegiate learning which capitalises on the privileged position of student midwives, who have dedicated time to specifically focus on these skills. The aim of this is to ensure that EBPR skills are maintained beyond the point of registration and nurture a research-positive maternity culture with safe practice at its core. Simulation approach for research within the clinical environment Learning through simulation is a widely used and effective pedagogy for clinical skills, encouraging students to think flexibly, develop competence, safe practice and understanding and close the gap between theory and practice (Weeks et al. 2019; Harder 2018). Simulation also offers an opportunity to assess critical thinking (Chitongo and Suthers 2019, Lee & Peacock, 2020). With the correct resources and support, facilitating the emulation of practical physical midwifery skills is very achievable, but how to take a similar approach with the modelling of research knowledge?  Efforts have been made to embed evidence-based practice by increasing the research exposure of student nurses and midwives through involvement in research projects and undertaking research for their undergraduate thesis (Borelli et al. 2020; Groenning et al. 2022). In the authors’ experience students may independently seek research exposure through elective placements within specialist teams. However, this activity is often limited to the students who seek these opportunities rather than being a universal expectation. So, the issue remains how to excite every student to the power of translating research into practice?  We question whether students acknowledge evidence-based practice to be the integration of clinical expertise with critical appraisal of the best available clinically relevant evidence (Sackett 1997) and suggest that only with the joining of these elements is current with safe practice at the fore.   Relationships, coaching and mutual knowledge exchange Previous reports (Francis, 2013; Kirkup, 2015) suggest a closer relationship between education and practice environments can place safety and quality at the centre of student learning. Through using a positive relational framework, educators in the clinical and AEI environments can offer an opportunity for students to nurture skills and enrich learning (Dewar et al. 2020). Coaching is grounded in relationship-based knowledge acquisition, whereby students undertake focused learning with flexibility about the subject and the ability to interact with colleagues and practice supervisors (Tweedie et al. 2019). This enables a reflexive approach to future learning moments, with the breadth of exposure widening the range of practice students can emulate.  Coaching provides an opportunity for students to proactively seek underpinning evidence in relation to real-time practice, bring this back to supervisors and fellow students and prompt collaborative critical thinking. If students can identify links with research during clinical situations and actively promote research-focused discussion this may bring evidence-based practice alive (Aglen, 2016). The relationship between the student and supervisor creates a partnership approach to embedding research in practice through reciprocal learning.  To facilitate students effectively, supervisors must recognise their own knowledge gaps and embrace coaching as a positive opportunity to work alongside the student without fearing criticism of their expert role. Although there is a need to acknowledge the hierarchy in placement learning, there is space in coaching for mutual knowledge exchange between coach and student. This provides an opportunity for midwives’ professional development as they too benefit from this learning, which may address issues of incongruence between theoretical learning and practice (Panda et al. 2021). Coaching then enables multiple ways of seeing from both sides of the teaching and learning relationship, with the resourcefulness and experiences of both parties embraced (Mezirow, 1991). While coaching may provide a means to collaboratively embed EBPR in the practice setting, all midwifery educators need to consider their role in this, including within the AEI. As previously discussed, AEIs have embedded research within curricula but also need to give attention to how the research content of theoretical learning is delivered, finding a way to ignite a research interest among students who might view this aspect of their midwifery education as dry (Aglan, 2016; Lee & Peacock, 2020). In asking students and midwives to view research through a practical lens we are encouraging the development of phronesis, or practical wisdom (Kinsella and Pitman 2012), challenging the perception that practice and research knowledge are separate and enabling students to see EBPR as a practical skill they can learn to apply. Conclusion Curiosity and criticality are the skills that need to be fostered in student midwives in a meaningful way that is carried through into their practice. Educators must equip students with an untethered curiosity. The use of an EBPR focus within the coaching model, linked with classroom learning where research is celebrated and enlivened may be an approach which holds merit, and would warrant further exploration and evaluation.      References Aglen, B. (2016). Pedagogical strategies to teach bachelor students evidence-based practice: A systematic review. Nurse Education Today 36: 255-263 Borrelli, S., Walker, L., Jomeen, J., Roberts, J., Edgley, A., Bennett, B., Spiby, H. (2020). Introducing midwifery students to the world of research: building the basis for future leaders in evidence-based practice. Midirs Midwifery Digest, 30(3), 324-329 Chitongo, S. and Suthers, F. (2019) ‘Use of technology in simulation training in midwifery’, British Journal of Midwifery, 27(2), pp. 85–89. doi:10.12968/bjom.2019.27.2.85. Dewar, B. et al. (2020) ‘Exploring and developing student midwives’ experiences (ESME)-An appreciative inquiry study’, Midwifery 91. doi:10.1016/j.midw.2020.102844. 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Developing and integrating nursing competence through authentic technology-enhanced clinical simulation education: Pedagogies for reconceptualising the theory-practice gap. Nurse Education in Practice 37:29-38.  

Research in practice: a core skill

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