Is educating health students on teamwork skills the answer to bullying and adverse outcomes in maternity care?

Through the Pinard is a podcast dedicated to exploring midwifery research.

In Episode 19, the wonderful Liz McNeil from Flinders University interviews me about my research on developing undergraduate midwifery students' social and emotional skills required for good teamwork.  If you are interested in learning about interviewing, you would learn a lot from listening to Liz. 

The development of health students teamwork skills is vital. Review after review and root cause analysis after root cause analysis, identifies poor teamwork, suboptimal communication and inadequate collaboration as core contributors to poor outcomes for health service users and bullying cultures. 

We used a structured whole of program approach, with a specifically developed rubric for self and peer assessment, to the development of these skills through midwifery students' groupwork projects. The rubric functioned as a teaching and assessment tool. 

Listen here to find out more Through the Pinard Listen to Episode 19. There are other fabulous podcasts there to enjoy as well. 

Now I'm keen to promote the importance of this process of developing students' ability to be effective team members along with their discipline-specific skills to universities and encourage them to incorporate this learning into their curriculums.  

What do you think of this approach to improving intra and inter professional relationships and ultimately safety in maternity care? Do you think it has application to other health professions? 

A third year midwifery student posted this on Twitter after listening to the podcast: 

Great listen so many times I’ve shouted ‘yes!’ to this conversation

It can be difficult as a #studentmidwife to navigate team dynamics in clinical practice. Relationships are key - ‘It’s who you know and how you know them’ I look forward to hearing future outcomes

Here's my thesis if  you are interested in exploring further: 

A Participatory Action Research Project: Investigating a Structured, Whole-of-degree Approach to Developing Undergraduate Midwifery Students’ Teamwork Skills

I'm delighted to share the news that I've passed examination for my PhD.

 

The abstract for my thesis is presented below.  I've added the link to the thesis to anyone who would like to explore further. 

Teamwork skills are an intrinsic part of day-to-day activities of maternity services, influencing workplace culture, midwife retention and quality, safe care. Effective teamwork depends upon the social and emotional competencies involved in interpersonal interactions in the workplace. Intra- and inter-professional relationship components of effective teamwork are contingent upon the individual’s social and emotional skills. A regional university implemented a whole-of-degree educational strategy aiming to facilitate the development of midwifery students’ teamwork skills that are sustainable in real-world practice following graduation. A PAR methodology to develop and refine the strategy, which engaged educators and students in an iterative process over 3 years of their undergraduate degree, was approved by University Ethics Committee. The study resulted in theory and evidence to describe, explain and predict the effects of implementing the strategy designed to teach and assess teamwork skills. Newly graduated midwives who had been taught teamwork skills and practice, and developed those skills throughout their degree, appeared to be more effective team members, despite their junior status. Implementing a whole-of-degree educational strategy to develop teamwork skills in undergraduate midwifery students may improve inter-professional interactions, reduce the incidence of bullying and make health care safer. The study contributes to understanding how to teach and assess undergraduate health students’ teamwork skills in ways that students find effective and satisfying. It adds to the midwifery body of knowledge about teaching and assessing teamwork skills and may provide a useful template for professional development in teamwork skills for graduate midwives and doctors.

A Participatory Action Research Project: Investigating a Structured, Whole-of-degree Approach to Developing Undergraduate Midwifery Students’ Teamwork Skills

Preparing midwifery students to provide continuity of care

Continuity of midwifery care provides superior maternal and neonatal outcomes (Sandall et al., 2016). Access to continuity of care models is limited, both for women and for midwifery students who have the opportunity to gain direct experience of such models. There is also concern that placing students in a continuity of care model rather than a standard hospital model of care may reduce their learning.

New research from Professor Kathleen Baird, Ms Carolyn Hastie, Ms Paula Stanton and Emeritus Professor Jenny Gamble of the Transforming Maternity Care Collaborative focussed on the learning experiences of students who complete an extended placement in a midwifery group practice providing continuity of care at one university (Baird et al., 2021). Final year midwifery students were able to elect to take part in a six-month placement in a midwifery group practice team. The research team conducted focus group interviews to explore the experiences of fifteen students who had taken part in the placement.

Students reported that their placement in the midwifery group practice was the highlight of their degree and was not as demanding as they had anticipated. Being able to develop skills in providing relationship-based care was highly valued by students and was enabled and supported by the midwives they were working with. The culture of the midwifery group practice in which students were placed provided a supportive environment were students learned to take care of themselves and their team members, and to collaborate with other members of the team. Students felt that they were valued members of the team. Returning back to the hospital shift-based system was challenging for most students. They were aware of a loss of autonomy and a faster pace of care. Some were supported well in this transition, while others were criticised for their choice to spend time in the midwifery group practice.

This research enables midwifery educators to feel confident that prolonged immersive student placements in midwifery continuity of care models provides positive learning experiences. The students described feeling and acting like a “real midwife” during their placement, with six being adamant that they would apply for a position in a midwifery group practice immediately after graduation. Increased access to midwifery continuity of care models for women would provide more opportunities for midwifery students to gain experience of working in this model.

 

Baird, K., Hastie, C. R., Stanton, P., & Gamble, J. (2021). Learning to be a midwife: Midwifery students’ experiences of an extended placement within a midwifery group practice. Women and Birth. https://doi.org/10.1016/j.wombi.2021.01.002

 

Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016, Apr 28). Midwife-led continuity models versus other models of care for childbearing women. [Meta-Analysis]. Cochrane Database Syst Rev, 4(11), CD004667. https://doi.org/10.1002/14651858.CD004667.pub5

 

This précis of our research has been reproduced from the Transforming Maternity Care Collaborative website