DREAM: Empowering Preclinical Medical Students With Labor Support

Abstract

IntroductionDelivery Resources, Experiences, and Advocacy for Moms (DREAM) is an interprofessional service-learning program that empowers preclinical medical students by training them to provide labor support. Boston Medical Center is a safety-net hospital featuring an in-house doula service with limited coverage capacity. Consequently, many patients do not receive continuous labor support, although evidence shows that continuous labor support improves outcomes and may help reduce birth-outcome health disparities. We present a pragmatic approach to integrating preclinical students as labor-support staff and outline the methods and content of the training process as well as the evaluations used to assess program effectiveness.MethodsStudents were trained by doulas (Birth Sisters) and midwives to provide prenatal, labor, and postpartum support. Students completed an orientation and training workshop and then partnered with a Birth Sister for one prenatal visit, labor, and postpartum visit prior to working independently. Student leaders provided structure, mentoring, and support for preclinical students. Pre- and postsurveys assessed student confidence and obstetric knowledge acquisition. Budget, logistics, and program evaluation process are reviewed.ResultsStudents demonstrated increased knowledge, as well as confidence in communication, advocacy, and support. Although balancing DREAM with academics was stressful, students continued to meet academic standards and felt their participation was gratifying and worthwhile. Student reflections and patient statements on their experience show the program was mutually beneficial.DiscussionPreclinical students need gratifying clinical opportunities to develop confidence in communication and advocacy skills. Partnering them with underserved women to provide labor support is a pragmatic and clinically valuable intervention.

The NICU Cuddler Curriculum: A Service-Learning Curriculum for Preclinical Medical Students in the Neonatal Intensive Care Unit

“…Service-learning curricula have been shown to improve student preparedness for clinical duties and help students understand barriers to health care access, illuminate disparities in health care, improve cultural competency, and develop professionalism. 6 , 7 These were all achieved within an effective service-learning curriculum by Shakartzi et al 8 which empowered preclinical students with the ability to offer labor support to pregnant women in underserved communities.…”

Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-St

“…Students´awareness of the main obstacles for a humanized childbirth (L1), is a critical point to start taking into account values such as woman's emotional state, beliefs, sense of dignity and autonomy in their future professional practice, in order to achieve the goal of promoting a positive childbirth experience (Behruzi, Hatem, Fraser, et al, 2010a;Wagner, 2001). A number of studies have been published in the last decade that explore incorporating specific competencies or pedagogical interventions in medical, nursing or midwifery study programs (Arzuaga & Cummings, 2016;Cooksey, 2010;Cummings et al, 2015;Daboval et al, 2014Daboval et al, , 2019Drake, 2016;Garbarino et al, 2019;Hall & Mitchell, 2016;Persson et al, 2018;Pilkenton et al, 2015;Shakartzi et al, 2018;Thompson et al, 2019;Yin et al, 2018). Most of these studies are surveys conducted among education experts and program directors, with particular attention to training needs in relation to dignity, respect (Hall & Mitchell, 2016;Yin et al, 2018) and perinatal mental health (Garbarino et al, 2019).…”

The Students' Attitudes Towards Women'S Childbirth Experience - Development and Validation of a Questionnaire for Health Sciences Students (Cave-St)

“…A number of studies have been published in the last decade that explore incorporating speci c competencies or pedagogical interventions in medical, nursing or midwifery study programs to improve the quality of woman-professional interactions during the perinatal period (18,19,(28)(29)(30)(20)(21)(22)(23)(24)(25)(26)(27). Most of these studies are surveys conducted among education experts and programme directors, with particular attention to training needs in relation to dignity, respect (27,30) and perinatal mental health (20).…”

“…Most of these studies are surveys conducted among education experts and programme directors, with particular attention to training needs in relation to dignity, respect (27,30) and perinatal mental health (20). Regarding undergraduate students, some authors have proposed interprofessional education initiatives, involving midwives and nurses as teachers to develop communication and support skills (18,29). These studies involved training rst-year medical students that provided clinical and non-clinical care to pregnant women, and the training covered issues such as paying attention to women instead of the electronic instruments in the delivery room, speaking in an appropriate tone, attending to women's needs, and providing emotional or physical support (20, 23).…”