Medical students learning experiences of the labour ward: a qualitative research study

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Abstract

Objective

To study the educational value to medical students of a labour ward rotation.

Design

Qualitative research study was performed in two tertiary level obstetric hospitals attached to a large medical school in Dublin. Medical students attending a six-week rotation in Obstetrics and Gynaecology in University College Dublin were invited to participate. As part of this rotation, students spend one week as part of the clinical team working on the labour ward. Focus groups were held in order to identify common themes and experiences of medical students during this labour ward week. Grounded theory with thematic analysis was used. The main outcome measures were the educational experience and value of a labour ward rotation to medical students.

Results

Five distinct themes developed from the focus groups of 19 students. A high value was placed on patient centred bedside teaching. Midwives were identified as excellent teachers and facilitators of learning. There was a clear sense of teamwork and belonging by the students. However, students reported frustration with unclear learning objectives. Students identified extra pre-learning with pre-specified learning aims before the labour ward week as being important.

Conclusion

Bedside teaching was highly valued as it advanced student’s knowledge of obstetrics theory and improved communication skills. In general, medical students reported a positive experience from working in the labour word but there is scope for improvement.

Introduction

The safe delivery of a mother and baby is a joy. Spending time on a labour ward as a medical student introduces doctors-to-be to normal labour, and to the privilege of being involved in a woman’s care at one of the most special time in her life. After years of teaching by scientists and medical academics, it is often the first time that the students are taught directly by midwives, who work as independent practitioners and teach students the normal and abnormal variants of labour. Much of the research in this area focuses on midwives experiences of teaching medical students, or patient’s perceptions [1], [2], [3], [4]. A successful teaching strategy should also involve the experiences of medical students, including determining whether learning objectives were achieved.

The aim of this study was evaluate medical student’s experience of both the labour ward placement and the teaching they experienced.

Section snippets

Materials and methods

Medical students in University College Dublin study Obstetrics and Gynaecology throughout medical college, but concentrate their learning in a six-weeks hospital based rotation, normally occurring within the last 18 months of medical school. The first day of the rotation consists of an orientation to the six weeks, including a brief orientation to the labour ward. Further orientation is provided by both written documentation, online documentation and staff support.

The rotation comprises of over

Results

Nineteen students were interviewed in focus groups until thematic saturation was reached. No differences were identified between males and female students, nor between the students attending different hospitals.

Five distinct themes were identified—the value of patient centred care in education, midwives as excellent teachers and facilitators, a feeling of teamwork and belonging, the frustration of unclear learning goals and a wish for specific pre-rotation learning interventions.

Students placed

Main findings

This research indicates the beneficial value of integrated teaching between midwives and medical students, with concrete feelings of team membership and fulfilment reported by the students, as well as defined recommendations for future teaching programmes.

The respect shown by the students towards the midwives in this study is especially important as in a previous publication from another centre nearly half of nurses and midwives (43.9%) reported that their contributions to medical education was

Conclusion

Medical students showed respect for the excellent teaching of midwives on the labour ward with a clear sense of teamwork and belonging by the students after only one week of placement on the ward. Though this study was not meant to be an assessment of teaching, the faculty has identified negative aspects such as unclear learning objectives as priority items for future educational programmes. In particular, a suggestion of pre-learning before the labour ward week was considered to be potentially

Disclosure of interests

None.

Contribution to authorship

DC, MT, FMcA and MH made substantial contributions to conception and design, DC acquired, analysed and interpreted data; DC, and MH drafted the article; DC, MT, FMcA and MH revised it critically for important intellectual content; DC, MT, FMcA and MH gave final approval of the version to be published; DC, MT, FMcA and MH agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and

Ethical approval

This study was approved by the Ethics Committee of University College Dublin.

Funding

Not applicable.

Acknowledgements

With thanks to the excellent midwives working in both the National Maternity Hospital and the Coombe Womens and Childrens University Hospital—as ever, a pleasure to work with you.

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