Assessing Application-Based Breastfeeding Education for Physicians and Nurses: A Scoping Review

Abstract

Background: Physicians and nurses are expected to support breastfeeding mothers. However, there is a lack of standardized lactation education throughout training programs and hospitals. As a result, providers lack the necessary confidence and skills to guide mothers throughout the breastfeeding experience. The hands-on nature of breastfeeding management demands the implementation of application-based learning tools to improve skills retention and patient breastfeeding outcomes. Research aim: In this scoping review, we aimed to critically assess the types of application-based breastfeeding management learning tools reported within medical and nursing professions and the evaluation methods of learner and patient outcomes. Methods: The authors searched the literature to identify peer-reviewed articles published between 2000 and 2018 with medical or nursing students, residents, or professionals as the target learner group in an application-based educational intervention. Both authors independently assessed the content in the resulting articles, with specific focus on teaching methods, curricular development, and the learning outcomes reported within each study. Results: Ten articles matched the inclusion criteria and were included in the final review, including five studies from the medical field and five from the field of nursing. Use of real patients was a common method for application-based skills training, followed by role playing and use of standardized patients. Teaching and evaluation methods varied widely across the studies. Conclusion: The results align with existing literature in finding a dearth of high-quality studies assessing breastfeeding education among physicians and nurses. The variability in teaching and evaluation methods indicates a lack of standardization in breastfeeding education between institutions.

Are the doctors of the future ready to support breastfeeding? A cross-sectional study in the UK

“…A recent scoping review of application-based breastfeeding education for nurses and physicians demonstrated a variety of teaching methods using real patients and roleplay, but found no standardised method of educational intervention or evaluation [38]. Several teaching methods have been suggested to provide an integrated breastfeeding education for the undergraduate medical student.…”

Development and evaluation of a high-fidelity lactation simulation model for health professional breastfeeding education

“…Low maternal breastfeeding self-efficacy and inadequate lactation support from healthcare providers are key reasons for premature breastfeeding cessation [1][2][3]. Insufficient clinical education in lactation support is a longstanding problem across healthcare specialties, professions, and levels of training [4][5][6][7][8][9][10][11]. Most physicians and nurses do not feel confident in their ability to support families with breastfeeding initiation or maintenance [6][7][8][9][10].…”

“…The World Health Organization strongly recommends the use of "high-fidelity" (realistic) simulation for health professional education because it leads to greater acquisition, retention, and transfer of technical and non-technical skills [17]. Low-fidelity commercially-available or handmade cloth breast models are frequently used in breastfeeding education, but the approach is not standardized and learning and patient outcomes are rarely assessed [5,11,12]. We propose that high-fidelity simulation is the ideal learning modality for breastfeeding education for three reasons: 1) Lactation support requires deliberate practice and confidence in examining, touching, and moving breast tissue.…”

“…Since breasts are an intimate body part, a safe learning environment could facilitate the development of core breastfeeding skills. Hand expression of breastmilk, breast examination, breast massage, and newborn positioning and attachment at the breast all require confidence in using ones' hands to touch and move breast tissue [5,16,18,19]. 2) The postpartum period is a vulnerable time for new mothers [20].…”

Methods and Success Factors of Induced Lactation: A Scoping Review

“…These new family structures have increased in recent years, thereby increasing rates of breastfeeding due to lactation being induced (Schnell, 2015), although women who adopt a child, who have a child through surrogacy, or who are the non-pregnant partners in a lesbian couple, may be able to breastfeed. However, it has been reported that many of these new family structures have found a lack of support during the process from nurses and physicians (Chuisano & Anderson, 2019).…”