Previous articles in this series have discussed strategies to support student midwives in training from the academic's perspective, covering topics such as the importance of building students' resilience (Power, 2016a); the potential impact of introducing the role of the Professional Midwifery Advocate (PMA) into the university setting (Power and Thomas, 2018); ‘survival guides’ for assessments, theory and practice (Power, 2015a; 2015b; Power and Murray, 2017;) and how to prepare for interview (Power and Briody, 2016b). What has yet to be considered is the support that students receive in the clinical area, which makes up no less than 50% of the course (Nursing and Midwifery Council (NMC), 2009) and which has equal importance in terms of student retention, student satisfaction and quality of care. This article will discuss how one Trust has introduced the enhanced role of student support midwife to coordinate student placements, and will consider its effect on the student experience.
The journey to becoming a student support midwife: Laura's story
I started my degree in midwifery aged 18, straight after A Levels, and finished my studies at University of Hertfordshire in August 2014. I started working at Milton Keynes Hospital in October 2014 and gained experience on the various ward areas before spending 18 months as a community midwife. In the summer of 2017, the internal post for a student support midwife was advertised; I applied and was successful. I was attracted to the role as I enjoyed mentoring and teaching students in practice and was keen to improve students' experiences.
Role and responsibilities
I work part of my time with the practice development team, spending 15 hours per week as a labour ward midwife and the remainder of the time in the student support role. I oversee and support more than 130 students including 50 student midwives, medical students, student nurses and student paramedics. This involves preparing their rotas and clinical shifts, allocating suitable mentors, facilitating student reflection sessions and providing learning opportunities. I act as a liaison between the hospital and university, which has improved our links and communication, thereby reducing the theory-practice gap.
As third-year students approach qualification, I help them to acquire skills such as managing the elective caesarean section list, which involves watching them from the corner of the room and using coaching methods to assist them when questions or issues arise. The aim of supporting senior students in this way is to help them to grow in confidence in managing care independently before qualification, and to help bridge the gap between being a student and becoming a qualified midwife.
Part of my role involves supporting mentors in practice, especially if they have concerns regarding a student. It is recognised that ‘failure to fail’ is an issue in healthcare placements (Houghton, 2016) and there are many reasons for this. As soon as I am made aware of a problem, I support mentors to give early feedback and document an action plan in a timely manner, in order to give the student the opportunity to develop and succeed during their placement.
Student evaluation
The feedback from students has been overwhelmingly positive since the role was introduced, and students have commented on the positive influence the role has had on their overall experience while on placement (Box 1).
What next?
The Trust is pre-empting the requirements of the 2020 Standards (Nursing and Midwifery Council, 2017) by looking at moving away from the more traditional style of mentoring towards embedding coaching in clinical placement areas. This also includes the possibility of adopting some aspects of the Collaborative Learning in Practice (CLiP) model, which is based on the Amsterdam Model developed at the VU Medical Centre in Amsterdam (University of East Anglia, 2014; Arthur, 2015; Ashton et al, 2016). The aim of this is to enable mentors to ‘step back’ and allow students to ‘step forward’, thereby encouraging them to become critical thinkers (Cosgrove, 2016). Box 2 shows the contrast in approaches between mentoring and coaching.
| Mentoring/Teaching | Coaching |
|---|---|
| Answers questions | Asks questions |
| Steps in and provides care | Steps back and allows the student to learn by providing care |
| Is watched by the student | Watches the student |
| Directs the student's learning | The student demonstrates what they have learnt (usually self-directed) to the coach |
| Shows the student how | Is shown how by the student |
| Allocates work to the student | Is allocated work by the student |
| Talks | Listens |
| Does the same work as before, but with a student | Works differently, while coaching the student |
| Identifies individual learning opportunities in the ward environment | Uses the whole ward as a learning environment |
Conclusion
It is crucial that higher education institutions and clinical placement providers work in partnership to support students by implementing a range of strategies to ensure that they successfully navigate the significant emotional and physical demands of their studies, qualify as a midwife and join the workforce. The introduction of the role of student support midwife has made a very positive impact on the student experience in Milton Keynes University Hospital Foundation Trust and is a model of support that could be easily replicated elsewhere.