An exploration of clinical decision-making among students and newly qualified midwives

Young, Nicki

doi:10.1016/j.midw.2011.09.012

Cited by 20 publications

(14 citation statements)

References 19 publications

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“…Some openly verbalize that they are not even interested in working in the labour ward they are just complying with the placement policy.' (Experienced midwife, participant 3, TR hospital) Young (2012) revealed that newly graduated midwives find it difficult to make independent decisions and high levels of responsibility and accountability lead to anxiety, which negatively affect their commitment regarding performance of care to patients. Jordan et al (2013) concurred when they reported that newly qualified midwives demonstrated a very low level of commitment to provision of care.…”

Section: Sub-theme 13: Commitment To and Competence Versus Incompetence In Patient Carementioning

confidence: 99%

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

Netshisaulu

Maputle

2018

Health SA Gesondheid

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BackgroundThe implementation of community service for nurses commenced in January 2008 (Department of Health 2007) and was regulated by the South African Nursing Council (SANC) Regulation 765 of 24 August 2007 (SANC 2010). All nurses completed the 4-year nursing diploma or degree for registration as a nurse (General Community and Psychiatry) and as a midwife to 'practice a profession in a prescribed category' and to carry out 1 year of remunerated compulsory community service (Department of Health 2006). When placed in clinical environments, new midwifery graduates are expected to work autonomously and cope with increasingly high acuity patient workloads and major advances in technology (Morrow 2009). According to the SANC, community service must be performed for a period of 12 months. The aim of the community service strategy of the National Department of Health was to retain professional nurses through community service, with graduates obtaining clinical experience under the supervision of experienced professional nurses (Department of Health 2011). During this period, the new graduates must apply their learning from the academic setting into the clinical environment immediately upon entry into practice (Hickey 2009; Meechan, Jones & Valler-Jones 2011).The hospital managers and experienced midwives expect new midwife graduates to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions (Nursing and Midwifery Board of Australia 2006;Romyn et al. 2009; Wolff, Pesut & Regan 2010a). Although newly Background: Community service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions. Aim:The study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition. Setting:The study was conducted at the training hospitals of the five districts in Limpopo province. Method:The researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch's eight-step process was used to analyse data.Results: Results revealed that newly graduated midwives failed to meet the perceived expectations by experienced midw...

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Section: Sub-theme 13: Commitment To and Competence Versus Incompetence In Patient Carementioning

confidence: 99%

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

Netshisaulu

Maputle

2018

Health SA Gesondheid

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“…Learn how to make clinical decisions (factors that favor/ encourage or discourage/disfavor; conditions in which learning occurs) (23) 1 -1…”

Section: -1mentioning

confidence: 99%

“…In the analyzed studies, the contexts of critical thinking development were classroom and clinical settings (obstetrics and psychiatry) (23)(24)(25)(26) . Students were investigated: in their decision making, and the factors that help or interfere in this process were analyzed (23) ; in the available evidence on the development of nursing students' critical thinking through problem-based learning (24) ; in the understanding that they develop cognitive skills from their experiences (25) and in identifying critical thinking contexts during clinical practice in psychiatry units (26) .…”

Section: The Experience Of Developing Critical Thinking/ Clinical Reamentioning

confidence: 99%

“…Students were investigated: in their decision making, and the factors that help or interfere in this process were analyzed (23) ; in the available evidence on the development of nursing students' critical thinking through problem-based learning (24) ; in the understanding that they develop cognitive skills from their experiences (25) and in identifying critical thinking contexts during clinical practice in psychiatry units (26) . The findings of the studies indicated that to improve the learning environment in the classroom, the participation of nursing mentors and tutoring support in the clinical practice fields (23)(24) , the students' understanding of the importance of cognitive skills in their own training (25) , thus promoting reflection by the students about themselves, their actions, personal feelings and student-patient relationships (26) are necessary conditions for developing the process of decisionmaking in nursing education. The development of critical thinking in the context of problem-based learning is still controversial (24) .…”

Section: The Experience Of Developing Critical Thinking/ Clinical Reamentioning

confidence: 99%

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Clinical reasoning in undergraduate nursing education: a scoping review

Menezes

Corrêa

Silva

et al. 2015

Rev. esc. enferm. USP

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Objective:This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. Methods: A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. Results: From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decisionmaking process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. Conclusion: The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

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“…However, debriefing can assist students in understanding the situation and may also help them in decision-making. [33,34] In this study, some participants experienced feelings of guilt, particularly in acute situations. The feelings of guilt were most common among participants who had expected to master the situation better.…”

Section: Discussionmentioning

confidence: 89%

How midwifery students experience learning conditions in labor wards

Brunstad

Giske²,

Hjälmhult

2016

JNEP

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Midwives are responsible for the well-being of women and babies during labor and birth. Learning midwifery is complex and challenging, and how students are welcomed into the labor wards affects learning. This study aimed to identify and explain the conditions that affected midwifery students' learning in labor wards and their consequences. We used classical grounded theory to analyze longitudinal data from 15 individual and three focus group interviews of 10 postgraduate midwifery students in Norway. The key conditions identified that affect the learning outcomes of midwifery students were related to the students' relationships with midwives, the students themselves and the learning arena. Tailored assignments from midwives enhanced students' learning and apprehensive relationships with midwives inhibited learning. Midwives played a key role in facilitating students' learning by tailoring their learning opportunities and debriefing after challenging incidents and thus smoothed how students' emotions affect their self-esteem and learning process.

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An exploration of clinical decision-making among students and newly qualified midwives

Cited by 20 publications

References 19 publications

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

Clinical reasoning in undergraduate nursing education: a scoping review

How midwifery students experience learning conditions in labor wards

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