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Celia Woolf ¹ & Adele Hamilton ² ¹ Institute of Health Sciences Education, Queen Mary University of London ²School of Community & Health Sciences, City University London. _______________________________________________________________________________. C. Student Focus Groups.

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Celia woolf adele hamilton

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.

  • Aims

  • Enhance understanding of professional roles

  • Challenge negative stereotypes

  • Create opportunities for interprofessional team working in practice

  • Rationale

  • 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.

  • References:

  • 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.

  • Participants

  • 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.

  • Evaluation

    • 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.