References

Akkad A, Bonas S, Stark P. Gender differences in final year medical students' experience of teaching of intimate examinations: a questionnaire study. BJOG. 2008; 115:(5)625-632 https://doi.org/10.1111/j.1471-0528.2008.01671.x

Alberman S, Sagoe P, Fairhurst J, Lane A, Gafson I. A letter regarding maternity medical student experiences during the COVID-19 pandemic. The Obstetrician & Gynaecologist. 2020; https://doi.org/10.1111/tog.12694

Anderson G, Hughes C, Patterson D, Costa J. Enhancing inter-professional education through low-fidelity simulation. Br J Midwifery. 2017; 25:(1)52-58 https://doi.org/10.12968/bjom.2017.25.1.52

Bhoopatkar H, Wearn A, Vnuk A. Medical students' experience of performing female pelvic examinations: Opportunities and barriers. Aust N Z J Obstet Gynaecol. 2017; 57:(5)514-519 https://doi.org/10.1111/ajo.12634

Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017; 7:(7) https://doi.org/10.1002/14651858.cd003766.pub6

Brocklehurst P, Hardy P, Hollowell J Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011; 343:(7840) https://doi.org/10.1136/bmj.d7400

Brown B, Vause S. A career in O&G? No thanks!. BJOG. 2006; 113

Byrne B. Qualitative interviewing. In: Seale C (ed). London: Sage; 2012

Safety, equity and engagement in maternity services.London: CQC; 2021

Cheng H, de Costa C, Woods C. Medical students and midwives–How do they view each other?. Aust N Z J Obstet Gynaecol. 2018; 58:(5)586-589 https://doi.org/10.1111/ajo.12803

Coombs M. Power and conflict between doctors and nurses: breaking through the inner circle in clinical care.London: Routledge; 2004

Cotter D, Turner M, McAuliffe F, Higgins M. Medical students learning experiences of the labour ward: a qualitative research study. Eur J Obstet Gynecol Reprod Biol. 2016; 206:204-207 https://doi.org/10.1016/j.ejogrb.2016.09.022

Cumberledge J. National Maternity Review: Better Births.London: NHS England; 2016

Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and health care.London: The Stationery Office; 1999

Maternity Matters.London: The Stationery Office; 2007

Donnison J. Midwives and medical men: a history of inter-professional rivalries and women's rights.New York: Schocken; 1977

Downe S, Finlayson K, Fleming A. Creating a collaborative culture in maternity care. J Midwifery Womens Health. 2010; 55:(3)250-254 https://doi.org/10.1016/j.jmwh.2010.01.004

Francis R. Report of the Mid Staffordshire NHS foundation trust public inquiry: executive summary.London: The Stationery Office; 2013

Frank E, Carrera J, Stratton T, Bickel J, Nora L. Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey. BMJ. 2006; 333:(7570)

Promoting excellence: standards for medical education and training.Manchester: General Medical Council; 2015

Hastie C, Fahy K. Inter-professional collaboration in delivery suite: a qualitative study. Women and Birth. 2011; 24:(2)72-79 https://doi.org/10.1016/j.wombi.2010.10.001

Howe D, Crofts K, Billingham A. Can nurses teach tomorrow's doctors? A nursing perspective on involvement in community-based medical education. Medical Teacher. 2000; 22:(6)576-584

Kates RW. Assessing the assessors: The art and ideology of risk assessment. Ambio. 1977; 6:(5)247-252

Kirkup B. The report of the Morecambe Bay investigation.London: The Stationery Office; 2015

Knight M, Bunch K, Tuffnell D Saving lives, improving mothers' care - lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2015-17.Oxford: National Perinatal Epidemiology Unit; 2019

Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching. BMJ. 2004; 329:(7469)770-773 https://doi.org/10.1136/bmj.329.7469.770

Lincoln Y, Guba E. Naturalistic Inquiry.Newbury Park, CA: Sage Publications; 1985

Munro S, Kornelsen J, Grzybowski S. Models of maternity care in rural environments: Barriers and attributes of interprofessional collaboration with midwives. Midwifery. 2013; 29:(6)646-652

Better Births Four Years On: A review of progress.London: NHS England; 2020

Quality Standard 105: Intrapartum Care.London: National Institute for Health and Care Excellence; 2015

Standards to support learning in practice: NMC standards for mentors, practice teachers and teachers.London: Nursing and Midwifery Council; 2008

Standards of proficiency for midwives.London: Nursing and Midwifery Council; 2019

Ockenden D. Ockenden report. Emerging findings and recommendations from the independent review of maternity services at The Shrewsbury and Telford Hospital NHS Trust.London: The Stationery Office; 2020

Ogbonmwan SE, Ogbonmwan DE. Recruitment and retention in obstetrics and gynaecology in the UK. British Journal of Hospital Medicine. 2010; 71:(2)

O'Neill O, Thompson A, Vincent C, Macfarlane A, Page L, Penn Z. Safe births: everybody's business: an independent inquiry into the safety of maternity services in England.London: King's Fund; 2008

Olza I, Uvnas-Moberg K, Ekström-Bergström A Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth. PLoS One. 2020; 15:(7) https://doi.org/10.1371%2Fjournal.pone.0230992

Peters S, Nemunaitis M, Muller L, Higgins M. The evidence base for education-medical students in obstetrics and gynaecology. MedEdPublish. 2017; 6:(3) https://doi.org/10.15694/mep.2017.000121

Whose shoes? Engage people in delivering public services in more creative ways. 2016. http://nutshellcomms.co.uk/ (accessed 20 September 2016)

Pinki P, Sayasneh A, Lindow SW. The working relationship between midwives and junior doctors: A questionnaire survey of Yorkshire trainees. Journal of Obstetrics and Gynaecology. 2007; 27:(4)365-367

Quinlivan JA, Black KI, Petersen RW, Kornman LH. Differences in learning objectives during the labour ward clinical attachment between medical students and their midwifery preceptors. Medical Education. 2003; 37:(10)913-920 https://doi.org/10.1046/j.1365-2923.2003.01632.x

Radoff K, Natch A, McConaughey E, Salstrom J, Schelling K, Seger S. Midwives in medical student and resident education and the development of the medical education caucus toolkit. J Midwifery Womens Health. 2015; 60:(3)304-312 https://doi.org/10.1111/jmwh.12329

Rahimi M, Haghani F, Kohan S, Shirani M. The clinical learning environment of a maternity ward: A qualitative study. Women and Birth. 2019; 32:(6)e523-e529 https://doi.org/10.1016/j.wombi.2019.01.002

Reiger K, Lane K. Working together: collaboration between midwives and doctors in public hospitals. Australian Health Review. 2009; 33:(2)315-324 https://doi.org/10.1071/ah090315

Renfrew MJ, Homer CSE, Downe S Midwifery: an executive summary for the Lancet's series. Lancet. 2014; 384:(1)

Ritchie J, Spencer L. Chapter 14 Framework thematic analysis. In: Bryman A, Burgess B (eds). London: Routledge; 1994

The RCM standards for midwifery services in the UK.London: Royal College of Midwives; 2016

Labour ward leaders: working together for safe care (pilot programmes evaluation report).London: Royal College of Midwives; 2017

National undergraduate curriculum in obstetrics and gynaecology.London: Royal College of Obstetricians and Gynaecologists; 2009

Each baby counts: 2015 summary report.London: Royal College of Obstetricians and Gynaecologists; 2017

The clinical learning environment and recruitment: report of a joint working party.London: Royal College of Obstetricians and Gynaecologists Press; 2008

Joint statement on undermining and bullying in the workplace.London: Royal College of Midwives; 2015

Simpson KR, James DC, Knox GE. Nurse-physician communication during labor and birth: Implications for patient safety. J Obstet Gynecol Neonat Nurs. 2006; 35:(4)547-556

Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science. 1974; 185:(4157)1124-1131

Visser G, Ayres-de-Campos D, Barnea E FIGO position paper: how to stop the caesarean section epidemic. The Lancet. 2018; 392 https://doi.org/10.1016/s0140-6736(18)32113-5

Whitten S, Higham J. Recruitment and retention into obstetrics and gynaecology. Br J Hosp Med. 2007; 68:42-6

Evaluation report of the WHO safe childbirth checklist collaboration.Geneva: World Health Organization; 2017

Yearley C. Pre-registration student midwives: ‘fitting in’. Br J Midwifery. 1999; 7:(10)627-631

Ziebland S, McPherson A. Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness). Med Educ. 2006; 40:(5)405-414 https://doi.org/10.1111/j.1365-2929.2006.02467.x

Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2009; (3) https://doi.org/10.1002/14651858.cd000072.pub2

Medical students' experiences working with midwives on NHS labour wards: a qualitative study

02 February 2022
Volume 30 · Issue 2

Abstract

Background

Multidisciplinary team collaboration has been identified as a key factor in optimising intrapartum care. The way future doctors feel about their undergraduate placements with midwives is worth considering, given that this might influence their behaviour in the long term. This study aimed to investigate the experience of medical students working with midwives on NHS labour wards.

Methods

Qualitative thematic analysis was done on transcripts of in-depth interviews with 10 medical students from across England. These students had clinical experiences with midwives or were seeking to work with midwives, and had experiences of training during or after 2010.

Results

Midwives were described as ‘gatekeepers’, with the power either to open or close the labour room door to medical students. Participants described mixed feelings about midwives; some reportedly provided pivotal learning experiences, particularly regarding physiological labour and birth. Others were perceived as unsupportive. The dynamic with midwives was often linked to wider multidisciplinary team culture.

Conclusions

Despite national calls to improve multidisciplinary team relations and undergraduate experiences, this sample of medical students shows that some still perceive tension with midwives. This may affect future obstetricians' exposure to physiological birth at an impressionable time and also influence their multidisciplinary team behaviour. Research into midwives' perspective is needed, given that collaboration is a key factor in providing safer, more personalised care.

Investigations into avoidable adverse events in intrapartum care have repeatedly found multidisciplinary teams fail to understand and appreciate each others' role (Kirkup, 2015; Royal College of Obstetricians and Gynaecologists (RCOG), 2017; Knight et al, 2019). Collaboration between midwives and obstetricians is central to current efforts to provide families with an experience of childbirth that is both safer and more personalised (NHS, 2020). Among the current generation of medical students are tomorrow's obstetricians. Their introduction to maternity multidisciplinary team culture is likely to influence how they collaborate – or not – in future (Zwarenstein et al, 2009; Downe et al, 2010). Therefore, it is important to consider how medical students perceive midwives after placements on NHS labour wards.

The RCOG (2009) undergraduate curriculum states, ‘witnessing the birth of a baby gives students exposure to a unique event, where they will learn the importance of patient-focused care, including communication skills, dealing with pain, team working and the importance of patient choice’.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month