Does number crunching make a proficient midwife? Exploring the challenges and experiences of student midwives in developing proficiency in conducting spontaneous vaginal births.

About the Project

The project seeks to develop evidence-based strategy for assessing the proficiency of student midwives in conducting spontaneous vaginal births: a fundamental part of the midwife’s role globally1. In current midwifery education programme standards2, student midwives are required to have the knowledge and skills to be proficient and confident in conducting 40 spontaneous vaginal births along with other specific clinical activities that are assigned a measurable quantity. These were originally based on the European Community Directives for practical and clinical training of midwives3. Since the United Kingdom’s (UK) exit from the European Community, the Nursing and Midwifery Council (NMC) has removed all reference to this Directive, but chose to retain the numerical values as a means of assessing the skill development and proficiency of student midwives in clinical practice.

The pedagogical basis of assigning a numerical value as a means of assessing proficiency however is poor and does not provide any detail of the extent or quality of maternity /newborn care provided by the student midwife to service users, their babies and families. Furthermore, with the increasing rise in caesarean sections world-wide and in some areas of the UK, there are reports of rates being over 50%, the consequential impact is a reduction in the number of available spontaneous births required by student midwives to complete their pre-registration programmes4, 5.

This project aims to develop a more effective pedagogic approach to assessing proficiency in midwifery, knowledge, skills and attitudes of student midwives, particularly during the intrapartum period. A qualitative phenomenological approach is proposed comprising of:

1. A systematic review of the international literature surrounding defining the concept and process of assessing proficiency in clinical skills with a narrative analysis, including modes of documenting the evidence.
2. Interviews with key experts: i.e. local, national and international midwifery education leaders, as well as, student midwives and newly qualified midwives for their views on assessing proficiency in clinical skills.
3. Interviews with different professional groups to explore their opinion of assessing proficiency without setting a total number of clinical activities as a requirement.

Ethical approval will be obtained by the University of Leicester Ethics Research Committee.

Data analysis will be managed by NVivo and data coded into themes.

Training opportunities:

The student will be based in the well-respected School of Healthcare at the University of Leicester. We have a highly collaborative working environment, with weekly seminar or journal clubs to discuss new and emerging research. The student will have access to high-quality training through the University of Leicester’s masterclass series which is designed to provide all students with strong foundations in research methods. We will also introduce to student to external organisations (e.g., Health Data Research East Midlands) to enhance their collaborations and opportunities.

Outputs:

The aim is to develop an evidence-based pedagogical framework that supports the development of proficient, safe and confident midwives and that does not focus on “number crunching”. This framework will be shared with the NMC to inform the development of guidelines / standards relating to the proficiency for midwives that are contemporary and realistic to implement and achieve. Findings from the project will be disseminated through peer reviewed pedagogical journals and via national / international Education Conference presentations.