Background This research explored the follow-through experience in three year, pre-registration Bachelor of Midwifery programs in Australia. The follow-through experience involves midwifery students following women on their journey through pregnancy, labour and birth and into the early parenting period. The concept was introduced to midwifery education in Australia in 2001 when it was embedded in the foundational Australian College of Midwives. National Education Standards for Bachelor of Midwifery programs. The inclusion of the follow-through experience in Bachelor of Midwifery education programs was a deliberate strategy to ensure midwifery students would experience midwifery continuity of care. Aims The aims of this research were to: explore the follow-through experience in order to better understand its impact on students, midwifery education providers and midwives, and, to identify the learning that is associated with this experience. Setting This research was conducted in Australia. Students from all three-year pre-registration Bachelor of Midwifery programs were invited to participate. Design A qualitative study was undertaken. In-depth interviews were conducted with key stakeholders who had been involved in the development and implementation of the follow-through experience. Data were collected from former and current Bachelor of Midwifery students through an online survey and telephone interviews. A thematic analysis was undertaken and situated learning and constructivist theories were used to identify whether learning occurred in the context of the follow-through experience. Results The findings provided a unique insight into the follow-through experience from the perception of students and stakeholders. This research established that students do learn from their engagement in this experience. This learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced in undertaking these experiences, including problems with recruitment and time commitment. Difficulties were identified around requirements of the follow-through experience, the lack of support at times for students, and the lack of congruence with the existing Australian maternity system. These difficulties were identified as having a significant impact on the students. ability to engage in, and to maximise their learning from, this experience. A conceptual model was developed to provide a synthesis of the results of this research and a framework for effective implementation and management of the follow-through experience. Implications This research has implications for midwifery education, particularly in Australia but also internationally. This experience does indeed provide unique learning opportunities for students. It is however essential that the student is given adequate support to aid their learning and to ensure they gain the most from these experiences. Conclusions The follow-through experience is an innovative education strategy and this research identified that learning occurred within this experience. This learning was identified as being situated in the context of students being placed with women. This research clearly identifies the value of the follow-through experience as an important component of student learning.

Background This research explored the follow-through experience in three year, pre-registration Bachelor of Midwifery programs in Australia. The follow-through experience involves midwifery students following women on their journey through pregnancy, labour and birth and into the early parenting period. The concept was introduced to midwifery education in Australia in 2001 when it was embedded in the foundational Australian College of Midwives. National Education Standards for Bachelor of Midwifery programs. The inclusion of the follow-through experience in Bachelor of Midwifery education programs was a deliberate strategy to ensure midwifery students would experience midwifery continuity of care. Aims The aims of this research were to: explore the follow-through experience in order to better understand its impact on students, midwifery education providers and midwives, and, to identify the learning that is associated with this experience. Setting This research was conducted in Australia. Students from all three-year pre-registration Bachelor of Midwifery programs were invited to participate. Design A qualitative study was undertaken. In-depth interviews were conducted with key stakeholders who had been involved in the development and implementation of the follow-through experience. Data were collected from former and current Bachelor of Midwifery students through an online survey and telephone interviews. A thematic analysis was undertaken and situated learning and constructivist theories were used to identify whether learning occurred in the context of the follow-through experience. Results The findings provided a unique insight into the follow-through experience from the perception of students and stakeholders. This research established that students do learn from their engagement in this experience. This learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced in undertaking these experiences, including problems with recruitment and time commitment. Difficulties were identified around requirements of the follow-through experience, the lack of support at times for students, and the lack of congruence with the existing Australian maternity system. These difficulties were identified as having a significant impact on the students. ability to engage in, and to maximise their learning from, this experience. A conceptual model was developed to provide a synthesis of the results of this research and a framework for effective implementation and management of the follow-through experience. Implications This research has implications for midwifery education, particularly in Australia but also internationally. This experience does indeed provide unique learning opportunities for students. It is however essential that the student is given adequate support to aid their learning and to ensure they gain the most from these experiences. Conclusions The follow-through experience is an innovative education strategy and this research identified that learning occurred within this experience. This learning was identified as being situated in the context of students being placed with women. This research clearly identifies the value of the follow-through experience as an important component of student learning.

Background This research explored the follow-through experience in three year, pre-registration Bachelor of Midwifery programs in Australia. The follow-through experience involves midwifery students following women on their journey through pregnancy, labour and birth and into the early parenting period. The concept was introduced to midwifery education in Australia in 2001 when it was embedded in the foundational Australian College of Midwives. National Education Standards for Bachelor of Midwifery programs. The inclusion of the follow-through experience in Bachelor of Midwifery education programs was a deliberate strategy to ensure midwifery students would experience midwifery continuity of care. Aims The aims of this research were to: explore the follow-through experience in order to better understand its impact on students, midwifery education providers and midwives, and, to identify the learning that is associated with this experience. Setting This research was conducted in Australia. Students from all three-year pre-registration Bachelor of Midwifery programs were invited to participate. Design A qualitative study was undertaken. In-depth interviews were conducted with key stakeholders who had been involved in the development and implementation of the follow-through experience. Data were collected from former and current Bachelor of Midwifery students through an online survey and telephone interviews. A thematic analysis was undertaken and situated learning and constructivist theories were used to identify whether learning occurred in the context of the follow-through experience. Results The findings provided a unique insight into the follow-through experience from the perception of students and stakeholders. This research established that students do learn from their engagement in this experience. This learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced in undertaking these experiences, including problems with recruitment and time commitment. Difficulties were identified around requirements of the follow-through experience, the lack of support at times for students, and the lack of congruence with the existing Australian maternity system. These difficulties were identified as having a significant impact on the students. ability to engage in, and to maximise their learning from, this experience. A conceptual model was developed to provide a synthesis of the results of this research and a framework for effective implementation and management of the follow-through experience. Implications This research has implications for midwifery education, particularly in Australia but also internationally. This experience does indeed provide unique learning opportunities for students. It is however essential that the student is given adequate support to aid their learning and to ensure they gain the most from these experiences. Conclusions The follow-through experience is an innovative education strategy and this research identified that learning occurred within this experience. This learning was identified as being situated in the context of students being placed with women. This research clearly identifies the value of the follow-through experience as an important component of student learning.

Background This research explored the follow-through experience in three year, pre-registration Bachelor of Midwifery programs in Australia. The follow-through experience involves midwifery students following women on their journey through pregnancy, labour and birth and into the early parenting period. The concept was introduced to midwifery education in Australia in 2001 when it was embedded in the foundational Australian College of Midwives. National Education Standards for Bachelor of Midwifery programs. The inclusion of the follow-through experience in Bachelor of Midwifery education programs was a deliberate strategy to ensure midwifery students would experience midwifery continuity of care. Aims The aims of this research were to: explore the follow-through experience in order to better understand its impact on students, midwifery education providers and midwives, and, to identify the learning that is associated with this experience. Setting This research was conducted in Australia. Students from all three-year pre-registration Bachelor of Midwifery programs were invited to participate. Design A qualitative study was undertaken. In-depth interviews were conducted with key stakeholders who had been involved in the development and implementation of the follow-through experience. Data were collected from former and current Bachelor of Midwifery students through an online survey and telephone interviews. A thematic analysis was undertaken and situated learning and constructivist theories were used to identify whether learning occurred in the context of the follow-through experience. Results The findings provided a unique insight into the follow-through experience from the perception of students and stakeholders. This research established that students do learn from their engagement in this experience. This learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced in undertaking these experiences, including problems with recruitment and time commitment. Difficulties were identified around requirements of the follow-through experience, the lack of support at times for students, and the lack of congruence with the existing Australian maternity system. These difficulties were identified as having a significant impact on the students. ability to engage in, and to maximise their learning from, this experience. A conceptual model was developed to provide a synthesis of the results of this research and a framework for effective implementation and management of the follow-through experience. Implications This research has implications for midwifery education, particularly in Australia but also internationally. This experience does indeed provide unique learning opportunities for students. It is however essential that the student is given adequate support to aid their learning and to ensure they gain the most from these experiences. Conclusions The follow-through experience is an innovative education strategy and this research identified that learning occurred within this experience. This learning was identified as being situated in the context of students being placed with women. This research clearly identifies the value of the follow-through experience as an important component of student learning.

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Background: The transition to clinical practice is a phenomenon that all health care professionals experience and one that has been studied in many fields of health care, yet remains largely unexamined for Canadian midwives. This study asked the question: How do new registrant midwives in Ontario navigate the transition from student to clinician during their first year of clinical practice? Methodology: In this grounded theory study, a total of 13 semi-structured interviews were conducted with Ontario midwives from three participant groups: A) New registrants in their first year of clinical practice; B) Registered midwives with 1-5 years of clinical experience; C) Registered midwives who work with new registrants as supervisors or mentors. Findings: The Building, Bridging, and Being theory describes how new registrants transitioned to clinical practice. During the Building phase, individuals developed the knowledge and skills for clinical practice; midwifery students experienced elements of this phase during their final clinical placement. The Bridging phase occurred when new registrants embarked on independent clinical practice; this phase was characterized by providing clinical care without the safety net of a preceptor. Finally, the Being phase occurred when new registrants developed confidence in their skills and professional identity as midwives. A final theme, Bettering, encompassed participants’ suggestions of ways to help improve the transition process. Conclusion: The Building, Bridging, Being theory contributes to the present understanding of the transition to clinical practice for midwives in Ontario. This study highlighted the importance of strengthening the Preparation, Orientation, Mentorship, and Ongoing Education of new registrants through their transition to clinical practice. The findings of this study are relevant to individuals and organizations invested in educating and integrating midwives into the Ontario health care system and provides a starting point for further research centered on the transition to clinical practice for midwives in Ontario and throughout Canada. / Thesis / Master of Science (MSc) / The transition to clinical practice is a phenomenon that all health care professionals experience and one that has been studied in many fields of health care, yet remains largely unexamined for Canadian midwives. This study asked the question: How do new registrant midwives in Ontario navigate the transition from student to clinician during their first year of clinical practice? Thirteen interviews were conducted with Ontario midwives from three participant groups: A) New registrants in their first year of clinical practice; B) Registered midwives with 1-5 years of clinical experience; C) Registered midwives who work with new registrants as supervisors or mentors. The findings of this study led to the development of the Building, Bridging, and Being theory, which helps explain how midwives in Ontario transition to clinical practice and provides a starting point for further research centered around the transition to clinical practice midwives in Ontario and throughout Canada.

<p dir="ltr">Nurse managers recognize clinical judgment as a core competency of practice readiness (Boyer et al., 2019; Harrisona et al., 2020). Reflection is vital for novice nurses’ clinical judgment development (Tanner, 2006), enhancing their ability to deliver safe care. Despite its importance, nurse educators lack the ability to measure reflection in simulation debriefings. To address this gap, the Student-Centered Reflection Scale (SCRS) was created to assess reflection during simulation debriefings. This study aimed to conduct item testing and evaluate the psychometric properties of the SCRS to measure the presence of reflection during simulation debriefings.</p><p dir="ltr">Four sequential psychometric studies conducted initial item testing and evaluated the SCRS’s reliability and validity. The first two studies, a content validity study with 11 experts and pretesting study with 16 undergraduate nursing students, provided feedback for item revision and evidence of validity. Then an exploratory factor analysis (EFA) and item analysis study, involving 92 undergraduate nursing students from a Midwest public baccalaureate nursing school, was completed. Finally, a confirmatory factor analysis (CFA) and convergent validity study were completed using the SCRS and Groningen Reflective Ability Scale (GRAS; Aukes et al., 2007) in a convenience sample of 218 nonoverlapping undergraduate nursing students from the same educational institution.</p><p dir="ltr">The EFA revealed 20 items with four factors or subscales: (a) comparison of previous knowledge (four items); (b) analysis of biases, beliefs, and consideration of moral and ethical criteria (five items); (c) analyzing the scenario (eight items); and (d) challenging assumptions and considering a change in practice (three items). These subscales explained 82.78% of the variance and demonstrated acceptable item loadings ranging from .50–.83 and inter-item reliability ranging from .219–.664. The CFA demonstrated acceptable global fit (RMSEA = .071, CFI = .914, TLI = .900) and component fit. The SCRS also demonstrated reliability (α = .92) and convergent validity (<i>r </i>= .496) with the GRAS.</p><p dir="ltr">In conclusion, the SCRS demonstrated adequate reliability and validity with this sample. The SCRS is a resource for educators to evaluate and foster reflective skills in undergraduate nursing students during simulation debriefings, thereby promoting nursing students’ overall practice preparedness.<br></p>

Background: The relationship between interpersonal trauma (IPT) and substance misuse is complex and multi-factorial, but has not been examined fully in the existing few studies involving pregnant women who misuse substances. UK based midwifery education and practice is unique, but there is limited evidence regarding midwives experiences and perceptions of supporting this client group. Aims: The aim of this study was to chronologically map out pregnant women's past experiences of abuse and substance use, explore their experiences and perceptions of their journey to motherhood and explore midwives' experiences and perceptions of supporting this client group. Methods: A qualitative study was conducted. Five eligible pregnant women supported by specialist midwifery services in Central Scotland were recruited. Data were collected using a life history calendar (LHC), followed by an in-depth, semi-structured interview. Six eligible midwives were recruited from one NHS board in Central Scotland. In depth, semi-structured interviews were carried out. Findings: Individual LHCs were converted into chronological timelines. Transcribed interviews were analysed using Interpretative Phenomenological Analysis. The life history calendars revealed the pregnant participants' experiences of IPT and substance misuse as complex, interconnected and ongoing, including during pregnancy and motherhood. Three major overarching themes emerged from the pregnant participants' interview transcripts: “psychological trauma”, “dabbling to addiction” and “addiction and the identity of pregnancy and motherhood”. Three major overarching themes emerged from the midwifery participants' interview transcripts: “psychological trauma”, “stigma” and “managing unmanageable situations”. Conclusions: This study sheds new light on the lived experiences and perceptions of a previously under-researched and largely misunderstood group of vulnerable women. It highlights some of the challenges faced by midwives in clinical practice. Important areas for future research are highlighted, along with implications for multi-disciplinary education, policy and practice.

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Yes