Celia Woolf¹ & Adele Hamilton²
¹Institute of Health Sciences Education, Queen Mary University of London
²School of Community & Health Sciences, City University London
C. Student Focus Groups
- We piloted interprofessional peer-learning for fourth year medical and final year midwifery students on practice placement in the maternity unit of a busy London teaching hospital.
- Enhance understanding of professional roles
- Challenge negative stereotypes
- Create opportunities for interprofessional team working in practice
- Good communication and collaboration between doctors and
- midwives improves women’s experience of labour and birth
- Poor interprofessional teamwork contributes to serious failures in
- care of mothers and babies(e.g. Lewis, 2005)
- Interprofessional education aims to improve collaboration and the
- quality of care (Barr, 2005)
- Peer learning benefits students as teachers and learners.
- Barr, H (2005) Interprofessional education: today, yesterday and tomorrow: a review. London, UK : Higher Education Academy, Health Sciences and Practice Network.
- Lewis G (Editor) (2005) The Confidential Enquiry into Maternal and Child Health (CEMACH). Why Mothers Die 2000-2002. London: RCOG Press
- The qualitative data from group feedback was analysed using the Framework approach (Ritchie and Spencer, 1994).
- 1. Involvement
- Medical students in the peer learning group found that working with midwifery students helped them get more involved in practice:
- “Made me more part of the team”
- “Able to get into labour ward more easily”
- This contrasted with the experience of some students in the control group:
- “I always feel in the way as a medical student – I don’t like to push – I don’t like to be underfoot”.
- “In most …. ways I cause more trouble than help – makes me feel like I am wasting my time … Everyone’s so busy. I feel like I’m imposing”
- 2. Role Clarification
- Students in the peer learning group learnt about each other’s roles and perspectives:
- “We have common ground”
- “Was good to get midwives view of doctors, sticking people on IV drugs”.
- “Because we all have a better understanding of each other’s roles and have more respect for each other, will work better together in multidisciplinary team”
- 3. Learning
- Students in the peer learning group felt that the interprofessional exchange of knowledge enhanced their learning:
- “Was useful to see that midwives and medical students asked different questions and have different perspectives”.
- “I am learning from midwifery students, for example how to assess the placenta. Midwives can also learn from medics… was good”
- “By teaching it to someone else it affirms it in your own mind”
- 4. Interprofessional experience
- Students in the peer learning group valued the interprofessional contact
- “Much better than other IPE experiences”
- “joint teaching sessions really good, much better than any teaching we have had”
- Students in the control group would have liked more opportunities to learn interprofessionally:
- “It would be useful to have student doctors and student midwives meeting together”
A. Role Perception Questionnaire (McKay, 2004)
Pre-training : students held preconceptions about both professions, including some negative stereotypes
- Post-training some of these preconceptions changed and some differences emerged between students in the peer learning and control groups.
- For instance:
- medical students in both groups showed increased awareness of medical
- aspects of the midwifery role.
- midwifery students in the peer learning group felt that the professional
- role of doctors became more transparent , while those in the control
- group rated it as less transparent.
- medical students in the peer learning group perceived both professions
- as working more autonomously than before training.
- medical students in the control group strengthened their view that
- midwives work less effectively in teams than doctors. This negative
- stereotype did not increased among the peer learning students.
- Student volunteers gave informed consent to take part.
- Peer learning group n = 38
- Control group n = 26
- Peer learning programme
- Practice-based reciprocal peer teaching between medical and
- midwifery students
- Students explored medical and midwifery roles in antenatal
- care, normal labour and complicated labour through
- joint clinical observations
- working together to care for women on labour ward
- interviewing woman about experience of maternity care
- and consequences of teamwork
- researching information together
- Peer-learning handbook gave guidance
- Students gave case presentations focusing on
- interprofessional teamwork in maternity care.
- Students also attended joint weekly facilitated seminars on:
- normal labour
- pregnancy induced hypertension
- diabetes in pregnancy
- complicated labour and assisted birth
- 4 weeks duration x 3 student cohorts
B. Student Feedback Questionnaires
Medical and midwifery students valued the peer learning experience equally:
Students deepened their understanding of the role of other health professionals:
Students believed that they learned to collaborate more effectively with other team members:
- Peer learning between medical and midwifery students had additional benefits beyond those gained through opportunistic interprofessional contact in practice. Peer learning:
- was valued and enjoyed by students
- helped clarify professional roles
- developed understanding of how doctors and midwives collaborate
- in practice
- helped medical students get greater experience of involvement
- with women during labour and childbirth
- broke down barriers between the professions.
- The peer learning model has potential for extending to other practice areas.
- Role Perception Questionnaire pre and post
- Student feedback questionnaires
- Student focus groups
- Control data from students on the same maternity unit allowed between-group comparisons to explore whether the peer learning experience enhanced learning compared with opportunistic interprofessional contact.