Mary Sidebotham, Primary Maternity Care, Post Graduate Programs Director
Context
Receiving continuity of care (CoC) from a known midwife is immensely beneficial to women. This approach enables the translation of evidence into practice, through the reorientation and redesign of maternity services to enable women to receive this model of care. This level of service transformation is highly dependent on the sustained availability of a well prepared skilled midwifery workforce. Despite enabling legislative and policy changes implementation of midwifery led care in Australia has been slow, and one contributory factor is the lack of preparedness or willingness within the existing midwifery workforce to change their approach. Under the leadership of Professor Jenny Gamble the Griffith University Bachelor of Midwifery (BMid) degree was developed to prepare a future-focussed, culturally capable midwifery workforce able to work to the full scope of practice, and committed to driving the provision of evidence based woman centred care. The degree launched in 2010 was one of the first in the country developed to meet the accreditation requirements of the National Midwifery Education Standards. The CoC requirement was introduced into the accreditation standards to provide students with practical experience of working flexibly in order to prepare them to provide midwifery care outside of an institutionalised shift based system to meet changing workforce needs.
In order to create the flexibility needed to prioritise the learning potential of the continuum of care requirement and actually enable the student to follow women across the CoC, the BMid was the first degree in the Health Group to use a heavily blended learning delivery model (fully integrated). The work undertaken within Griffith’s BMid degree is providing evidence on how to maximise the potential of this learning experience through degree design and implementation. This work is attracting international acclaim leading to reputation growth as evidenced by an increasing number of keynote speaker invitations to share our work. These achievements will have contributed to the recent ranking of the School of Nursing and Midwifery as first in Queensland and 29th in the world, and continue to drive demand for our degrees.
Rationale
Whilst the Bachelor of Midwifery degree provides an appropriate entry to practice pathway it was clear from ongoing industry, professional, student and alumni consultation that the lack of preparedness of the current midwifery workforce was a barrier to the implementation of midwifery led care and the subsequent stagnation and lack of opportunity to work in CoC models potentially created disillusionment within the emerging workforce. To combat this and provide a solution focussed approach we consulted extensively with industry and other stakeholders to identify specific workforce educational needs. This led to the staged introduction of educational degrees aimed at enabling and empowering the existing midwifery workforce to work to full scope of practice and transition into midwifery led models of care, either within an employed model or as a private practice self-employed midwife.
Description
Single subject of study
Midwives moving into self-employed practice must successfully complete an Australian Nursing and Midwifery Accreditation Council (ANMAC) accredited prescribing subject. Following wide spread industry consultation in 2013 we developed and submitted a single ten credit point subject to ANMAC for accreditation. The subject was accredited with four commendations from ANMAC and is now acknowledged to be the current market leader as evidenced by student demand and enrolments, consistently high scores on student evaluations, external validation on social media sites and peer recommendations to enrol. The subject has generated targeted research on the enablers and barriers to midwifery prescribing in the world, which will inform future degree development.
Midwifery@Griffith Short Courses
In 2014 a series of one day on-campus professional development skills-based workshops were introduced to meet the immediate needs expressed by local employers to up-skill their workforce. This has proved to be an extremely valuable engagement strategy with industry and there are proposals being developed by other disciplines within the Health Group to introduce similar models.
Primary Maternity Care Degrees
Following extensive consultation with industry, the Office of the Chief Nursing and Midwifery Officer in Queensland Health, the regulator and professional bodies, the Master of Primary Maternity Care degree was designed to provide a supportive educational pathway to enable maternity care providers to gain the prerequisite skills to develop deliver and evaluate maternity care within a social model. Demand and performance in the first 18 months of the degree has been exceptional with clear links to practice transformation and role transition apparent in the current student cohort.
Approaches to teaching and learning that inspire students to learn.
In 2010-2012 a formal program of work commenced to document, identify, refine and then embed the Midwifery@Griffith values and philosophy across all educational/programmatic activity. The M@G metavalues are now shared with staff, practice partners, and potential employees to clearly identify the purpose and direction of the M@G team and confirm the commitment to developing a strong values focused midwifery workforce.
The purposeful inclusion of consumers in all aspects of undergraduate and postgraduate degree design and delivery adds authenticity and clearly demonstrates to students the purpose of their degree and highlights the importance of working in partnership. Feedback from students attending orientation and throughout their BMid and PMC degrees confirm how this early and ongoing engagement with consumers is highly motivational and strongly contributes to a developing or reinvigoration of sense of purpose and identity.
Development of M@G’s online component
The BMid degree led the way for the introduction a whole of degree blended learning design within the health group. Following on from this success the Master of Primary Maternity Care was the first Health Group degree to be developed within the emerging Griffith on line model. The goal is to create relevant purposeful content that inspires and motivates students to learn through the clear visible links to purpose and career goals. The international networking capacity, reputation for excellence and commitment to values within the M@G team have enabled us to build unique content within the online subjects in order to meet these goals.
“I found that having a group assignment that was presented to a group of people really showed what it will be like once we are working in the field.”
This vicarious connection to international and local leaders and demonstration of successful implementation of evidence into practice helps to close the theory-practice gap while further building a sense of identity and professional belonging that sustains students and motivates students to be aspirational.
Linking employability to assessment
Industry partners stressed the need to develop effective team working within the re-development of the curriculum in 2013. A decision was therefore made to introduce group based assessment early in the degree and set an expectation that students’ capacity to work effectively in a team would be developed as they progressed through the subject. Students in the first year of offering of the revised assessment plan found the requirement to work in group to be very challenging – especially as they were away from base and needed to use technology to connect and work together. By third year students are more prepared for group work and are required to complete an assessment that uses the root cause analysis model to investigate a clinical incident (based on published coroner’s reports) and present their findings as group within the subject to invited guests and industry partners. Again this provides a unique opportunity to demonstrate key employability attributes such as the application of critical thinking, effective team work and complex problem solving to an audience of potential employers.
In 2013 Queensland Health recommended that the NeoResus subject be standardised across public hospitals for ongoing competency training in neonatal resuscitation. Maintaining currency with contemporary workforce needs is a key goal of clinical assessment, accordingly with the support of GU’s industry partners this interdisciplinary degree was embedded into the BMid complex newborn care subject. This enables BMid graduates to demonstrate the same industry standard competency as doctors, nurses and midwives in practice to employers. The e-portfolio Capstone assessment item embedded in the third year subject provides students with the opportunity to consolidate learning and demonstrate their readiness for employment through the production of a personalised e.portfolio – based on the industry standard Midwifery Practice Review Program. The e.portfolio provides a platform for recording and an awareness of the need for ongoing reflection on personal learning needs in order to inform ongoing professional development. The validity of this assessment item was assessed by a panel of international academics who acknowledged the clear links to employability and the effectiveness of the item in promoting reflection and application of critical thinking. Following on from completion of the e.portfolio students in their final semester have the opportunity to complete a formative assessment item in the form of a simulated employment interview with industry partners on the panels.
“It was also a good preparation for job applications and the interview process by giving us the opportunity to put our strength and weaknesses and our midwifery philosophy into words.”
The process has been refined since its introduction in 2014 based on academic, industry and student feedback. A formal evaluation is now underway and early analysis of the qualitative data from industry partners involved in the panels confirms the value and ability of this activity to enable students to learn how to demonstrate employability skills to future employers.
Impact
The innovation and strength of the BMid Clinical Education Degree developed in partnership with industry was recognised by the receipt of the Griffith Award for Excellence in Teaching in the ‘Degrees and Teams that Enhance Learning Category in 2013. M@G continues to grow in influence and work in partnership with industry to enable students to work at the’ cutting edge of maternity care in Australia. In 2013 GU partnered with the My Midwives organisation and was successful in winning a competitive tender from Queensland Health for 2.1 million dollars to develop and provide a degree of education for unemployed registered nurses to undertake a midwifery degree to prepare them to work in continuity of care models in rural or private practice (RPMEP project). The project goal was to develop appropriately educated and philosophically aligned graduates who were willing and able to work in these models to drive the government agenda to implement these models of care. The project was completed on time and all 17 graduating students’ secured employment. Graduates from the degree have shared their experience by participating in state and national conferences and their ongoing visibility within the rural units is contributing to culture change. This is reflected in a more positive attitude to the implementation of CoC models and a willingness within rural units to support the placement of GU BMid students. As a result we can offer an increasing number of students the opportunity to work with midwives in private practice and remain the only university in Australia able to provide students with the opportunity to gain active practical experience with midwives in private practice providing home birth.
Media
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IRU: Griffith University
Mary Sidebotham
Licence
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Preferred Citation
(2017). Midwifery@Griffith. Retrieved from https://app.secure.griffith.edu.au/exlnt/entry/4352/view