Gail Anderson, Lead Midwife for Education, Queens University Belfast
An inter-professional educational initiative was developed within the Schools of Nursing and Midwifery and Medicine. The collaborative aim was to provide interactive workshops focusing on the concepts of normal labour and birth to fourth year medical students and were led by final year midwifery students. Significant emphasis is placed upon the importance of relationship building with women in labour and the concept of being ‘with woman’ is a core focus. Introducing inter-professional simulation education has been suggested to reduce stereotypical views and promote better understanding of the respective roles of the professional in addition to enhancing future collaborative practice. However, the logistics of incorporating inter-professional education (IPE) within the University setting is challenging not least due to the competing demands of separate educational curricula but also due to the respective differing sizes of student cohorts and ensuring equity of experience for all students. A small team of midwifery lecturers and medical colleagues met to explore ways of promoting inter-professional learning and overcoming some of these barriers within the University setting.
It was felt that providing an opportunity for medical students and midwifery students to interact and communicate prior to the undertaking of an obstetric placement within labour ward would help to improve the overall student experience and potentially enhance inter-professional relationships. Midwifery students would benefit from the opportunity to teach and facilitate learning in relation to normal labour and birth, whilst medical students would benefit by learning about the process of birth and familiarisation with the birth environment. This opportunity could provide midwifery students with a positive, confidence building forum where the utilised teaching and learning strategies would be transferable to their professional role as registered midwives and additionally in their health promoting role in providing parent education to women and their partners. Equally, medical students would be supported to understand their role and feel comfortable with assessing and supporting women in normal physiological labour.
The teaching strategy which was developed involves final year midwifery students providing an interactive labour and birth scenario whereby various roles, including mother, partner, midwife and narrator are adopted. A member of the midwifery teaching team facilitates the sessions and ensures a high quality learning experience for both sets of students. The midwifery students use a variety of birth mannequins and support aids to promote learning and the sessions also encourage ‘hands on’ participation and interaction by medical students to enhance the learning experience. Artistic licence is encouraged with the midwifery students to allow them to deliver a unique workshop that demonstrates their own personalities and identities. Low fidelity simulation is the chosen approach for the simulated workshops. Whilst low fidelity simulation does not imitate the realism of the mother in labour it does provide the medical students with an appropriate learning opportunity prior to undertaking their first maternity placement. A low fidelity simulated approach is considered more beneficial for novice learners in addition to which midwifery students may also feel more comfortable and confident with their own teaching abilities using this approach.
Following the interactive workshops the students complete an evaluation questionnaire. To date the results of the evaluation questionnaires strongly suggest a distinct benefit of this education initiative for both sets of students. The findings support much of the current evidence regarding the benefits of inter-professional learning particularly in relation to promoting increased levels of confidence and the understanding of professional roles within the multidisciplinary team. Furthermore the inter-professional learning workshop serves to highlight the importance of all health professionals aiming to promote normal birth for low risk women. This education initiative provides an opportunity for medical students to recognise how to care for healthy low risk women in labour whilst also gaining an insight into their own role within this setting and the role of the midwife as the expert in normal birth. The midwifery students perceive themselves to have achieved a greater level of confidence which will be of benefit to them in their future educative role as health promoting midwives in teaching women and their families as well as other health professionals. This perceived increase in confidence will also enhance their ability for future inter-professional collaboration.
Low fidelity simulation offers ideal opportunities for improved interaction and provides a safe non-threatening learning environment. The benefits of this innovative education initiative have been recognised. Such is the considered success of this education initiative that a commitment has been made by both Schools to embed this education strategy within each of their respective curriculums with a vision for further growth and development of undergraduate inter-professional education involving student midwives and medical students. This innovative education strategy holds promise for the future of inter professional collaboration and goes some way to eradicating a ‘them and us’ culture in clinical practice. However, this concept requires further research to identify the long term benefit of undergraduate inter professional education within the university setting.