‘Time, fatigue, money’ Understanding the Personal Cost of Continuity of Care Experiences on Midwifery Students.

Author: Wendy Foster

Foster, Wendy, 2019 ‘Time, fatigue, money’ Understanding the Personal Cost of Continuity of Care Experiences on Midwifery Students., Flinders University, College of Nursing and Health Sciences

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Continuity of Care Experiences (CoCE) are a mandated component of all midwifery programs leading to registration in Australia. Through CoCE the midwifery student is afforded the opportunity to follow the woman and her family across the perinatal period. Educational benefits of CoCE are well reported, and the benefits to the pregnant woman have also been evaluated. Currently, students are required to undertake 10 CoCE across their program, however this number has changed significantly across Australian midwifery programs since the introduction of the three-year degree in 2002. Despite these changes, students continue to cite difficulties in achieving success in this component of their midwifery program. Although CoCE is a mandated component of midwifery education, there is minimal guidance on how it should be situated within the course, nor how to best support students as they undertake learning within this aspect of their course. To establish how to best support students in CoCE, the potential barriers and challenges faced by students should be evaluated. Current literature provides only limited evidence on the financial and time costs of undertaking CoCE. A mixed methods approach was chosen to collect both qualitative and quantitative data to explore the experiences of midwifery students undertaking CoCE. Surveys were used initially to collect demographic and qualitative comments regarding students’ perceptions of CoCE. Following this, diaries were used to prospectively collect quantitative data to reflect time and financial impact, as well as qualitative data to provide context to the experiences. An integrated analysis of the data corpus resulted in four themes; perception of CoCE, personal safety, impact on self and family, and professional relationships. Findings indicated that although students found CoCE to be a valuable learning experience, they often felt pressured to simply achieve numbers and that the current methods of CoCE was not reflective a true continuity model. Safety concerns particularly around fatigue and parking were identified, as well as significant impact on relationships, finances, children and psychological health. Finally, professional relationships were highlighted as a factor that impacted on the students’ ability to be successful in meeting the learning outcomes and requirements of the CoCE program. This study used a model of social interdependence to discuss the findings of this study and the resulting recommendations to improve student outcomes in the CoCE program, as well as potential strategies to support students. Education regarding CoCE and the role of the student in the woman’s care is required for all stakeholders. Additional education for the student regarding communication, collaboration and stress management is suggested, as well as university enforced breaks from CoCE. Further, it is suggested that a review of the number of CoCE be commenced with alternative methods of achieving continuity to be explored.

Keywords: Midwifery student, midwifery education, continuity of care experience

Subject: Midwifery thesis

Thesis type: Masters
Completed: 2019
School: College of Nursing and Health Sciences
Supervisor: Linda Sweet