‘ Asking the hard questions ’: Improving midwifery students’ confidence with domestic violence screening in pregnancy

Abstract

Domestic violence is a global public health issue. Midwives are ideally placed to screen for, and respond to, disclosure of domestic violence. Qualified midwives and midwifery students report a lack of preparedness and low levels of confidence in working with women who disclose domestic violence. This paper reports the findings from an education intervention designed to increase midwifery students' confidence in working with pregnant women who disclose domestic violence. An authentic practice video and associated interactive workshop was developed to bring the 'woman' into the classroom and to provide role-modelling of exemplary midwifery practice in screening for and responding to disclosure of domestic violence. The findings demonstrated that students' confidence increased in a number of target areas, such as responding appropriately to disclosure and assisting women with access to support. Students' confidence increased in areas where responses needed to be individualised as opposed to being able to be scripted. Students appreciated visual demonstration (video of authentic practice) and having the opportunity to practise responding to disclosures through experiential learning. Given the general lack of confidence reported by both midwives and students of midwifery in this area of practice, this strategy may be useful in supporting midwives, students and other health professionals in increasing confidence in working with women who are experiencing domestic violence.

Which Violence Against Women Educational Strategies Are Effective for Prequalifying Health-Care Students?: A Systematic Review

“…Of the four studies that collected qualitative data, two explored results thematically (Helton & Evans, 2001; Pomeroy et al, 2011) and two used open-ended questions to collect students’ feedback and opinions regarding the intervention (Cerulli, Nichols-Hadeed, Raimondi, Stone, & Cerulli, 2015; Smith, Wight, & Homer, 2017). The studies each describe the effects of a GBV-related education intervention, and the majority reported a significant improvement (where applicable) in the measured outcomes postintervention.…”

“…Educational interventions included brief (≤3 hours) single-session lectures or seminars (Cerulli et al, 2015; Ernst, Houry, Nick, & Weiss, 1998; Ernst, Houry, Weiss, & Szerlip, 2000; Everett et al, 2012; Heron, Hassani, Houry, Quest, & Ander, 2010; Kennedy, Vellinga, Bonner, Stewart, & McGrath, 2013), one-time computer-based tutorials (Danley, Gansky, Chow, & Gerbert, 2004; McAndrew, Pierre, & Kojanis, 2014), standardized patient (SP) interactions (Edwardsen, Morse, & Frankel, 2006; Elman, Hooks, Tabak, Regehr, & Freeman, 2004; Heron et al, 2010; Jonassen et al, 1999; Milone, Burg, Duerson, Hagen, & Pauly, 2010), peer education and theater (Pomeroy et al, 2011), and a full-day interactive workshop covering theory and practice (Smith et al, 2017). Multiple studies included or compared two or more of the above educational strategies.…”

“…Four studies (Edwardsen et al, 2006; Elman et al, 2004; Heron et al, 2010; Jonassen et al, 1999) included a practical assessment for measuring outcomes (e.g., objective structured clinical examination [OSCE]). Four studies (Cerulli et al, 2015; Edwardsen et al, 2006; Jonassen et al, 1999; Smith et al, 2017) collected students’ feedback on the format and content of the educational intervention(s) being tested. Full details of all educational interventions and measured outcomes are listed in Table 1.…”

“…One study which did not conform to this theme was that of Smith, Wight, and Homer (2017), which saw midwifery students give feedback following an all-day workshop. Despite commenting that both didactic and interactive activities had been useful, the aspect of the workshop cited as “most useful” was an authentic practice video (44% of 102 students), which had no interactive component.…”

“…b Two-month follow-up survey was part of a previous study by the authors. c Approximately 60% of the students in Smith et al’s (2017) study were registered nurses completing a 12-month preregistration midwifery program. Although this group was already registered in a health-care profession, they were yet to qualify in the profession being studied by this research (midwifery), and so the paper was not excluded.…”