Midwifery education in practice
Teaching evidence based practice and research through blended learning to undergraduate midwifery students from a practice based perspective

https://doi.org/10.1016/j.nepr.2013.10.001Get rights and content

Abstract

The international world of higher education is changing with universities now offering students flexible delivery options that allow them to study away from campus and at a time convenient to them. Some students prefer on line learning while others prefer face to face contact offered through a traditional lecture and tutorial delivery modes. The response by many universities is to offer a blend of both. While online and blended mode of delivery may be suitable for some subjects there is little knowledge of the efficacy of blended learning models to teach evidence based practice and research (EBPR) to undergraduate midwifery students. EBPR is a challenging, threshold level subject upon which deeper knowledge and skills are built. This paper describes the design, delivery, and evaluation of an undergraduate EBPR course delivered in blended mode to first year midwifery students. Components of the blended learning innovation included: novel teaching strategies, engaging practical activities, role play, and e-learning strategies to maintain engagement. University-based course evaluation outcomes revealed very positive scores and the course was rated within the top ten percent of all courses offered within the Health Group at the host University.

Introduction

Increasingly, universities are offering students flexible delivery options allowing them to study online, away from campus, and at a time convenient to them (Tanner, 2011).

Evidence across international settings demonstrate that online material supported by podcasts results in greater student engagement and overall knowledge acquisition when compared with a traditional lecture, without a loss of satisfaction with teaching (Bhatti et al., 2011, Rabe-Hemp et al., 2009). Students irrespective of background have variable opinions about the efficacy of on line learning with some preferring face to face contact offered through a traditional lecture and tutorial delivery modes (Farley et al., 2011). The response by many universities is to offer a blend of both. While online and blended mode delivery may be suitable for some subjects there is little knowledge of the efficacy of this model to teach evidence based practice and research (EBPR) to undergraduate midwifery students.

It is well acknowledged that student nurses and midwives find EBPR a challenging subject (Newton et al., 2010, Peckover and Winterburn, 2003). Whilst there is a paucity of literature on teaching this subject to student midwives it can be assumed that issues are similar. EBPR is a threshold level subject upon which deeper knowledge and skills are built to enable midwives to enter the workforce as critical thinkers and reflective practitioners. The disconnect between research active staff and the teaching of undergraduate students that is currently evident in some universities has been cited as problematic, with many students taught by lecturers who are not currently engaged in research, or employed in teaching intensive roles (Strickland et al., 2012). Another challenge includes the lack of engagement with research by clinical staff (Forsman et al., 2009). Student midwives spend up to 50% of their program hours within the clinical environment where program based learning should be embedded through interaction and engagement with clinicians. This interaction across education and practice can be facilitated by the use of e-learning technology which enables the student to be situated in the practice environment, but access learning materials at a time convenient to them (Stewart et al., 2012). The use of e technology also enables research active staff to be more readily involved in student teaching. This paper describes the design, delivery and evaluation of an undergraduate evidence based practice and research blended learning course undertaken by students in the first year of their Bachelor of Midwifery program. The paper proposes the benefits of a blended learning environment, but also highlights a number of other important ingredients as seemingly necessary to underpin successful delivery and positive student evaluation.

Section snippets

Designing the program

The course ‘Research, Evidence and Clinical Practice’ was developed for delivery within a blended learning environment. In designing the course the belief was that the approach to teaching evidence based practice and research (EBPR) within the midwifery programme should be laid down early in the programme and then interwoven and built upon throughout the programme. An understanding of EBPR is important to facilitate the provision of evidence based care (McCurry and Martins, 2010). Hence, the

Program delivery

In line with “blended mode” delivery, students attended two workshop days on campus at the beginning of the semester where they were introduced to the core themes and topics of the course. The aim of the workshops was to motivate and engage students and develop a passion for the subject. This was achieved through the use of a blend of practical activities, role play and engagement with research active faculty.

Conclusion

Evidence highlights that students traditionally find EBPR courses challenging and fail to engage effectively. This can have a number of negative consequences beyond academic outcome, including a failure to appreciate the necessity to practise within an evidence based framework to assure safe, high quality care and fulfil the legal and professional obligations of a midwife.

The positive student evaluations and outcomes of this course demonstrate that it is possible to effectively engage students

References (32)

  • K. Clark et al.

    Teaching undergraduate nursing research: a collaborative approach

    Nurse Educ.

    (2009)
  • A. Farley et al.

    Blended learning in finance: comparing student perceptions of lectures, tutorials and online learning environments across different year levels

    Econ. Pap.

    (2011)
  • R. Force et al.

    The dreaded “R” word.... or is it? Our journey as student midwives into the world of research via the BELIEF study

  • H. Forsman et al.

    Research use in clinical practice – extent and patterns among nurses one and three years postgraduation

    J. Adv. Nurs.

    (2009)
  • H. Fry et al.

    Understanding Student Learning

    (2003)
  • V. Hodgson

    Lectures and the Experience of Relevance: the Expereience of Learning: Implications for Teaching and Studying in Higher Education

    (1997)
  • Cited by (31)

    • Online learning and teaching approaches used in midwifery programs: A scoping review

      2021, Nurse Education Today
      Citation Excerpt :

      Despite online role play offering a positive and authentic educational experience, which helped to develop skills in clinical reasoning, there were limitations in the evaluation of quality and frequency of contact by academics which was not well evaluated. Ten papers located in this scoping review evaluated or investigated the use of BL (Balasubramaniam et al., 2018; Sidebotham et al., 2014; Geraghty and Godwin, 2016; O'Flaherty and Timms, 2015; Patterson et al., 2015; Kensington et al., 2017; Zolfaghari et al., 2013; Di Marco et al., 2017; Milne et al., 2014; Geraghty et al., 2019). BL incorporates a combination of learning and teaching activities together, often combining face-to-face with online learning activities.

    • Identifying the priorities for midwifery education across Australia and New Zealand: A Delphi study

      2021, Women and Birth
      Citation Excerpt :

      This issue while identified within round one of the Delphi did not reach consensus as a concern in this research. This could be because the adoption of digital technology and models of blended learning are already well established within both countries with a good track record of midwifery led research in these areas [35–40]. The priorities in relation to reviewing content and delivery were more conceptually focussed including the need to ensure a holistic approach was adopted and core skills including communication, and critical thinking were emphasised.

    • Using simulation to teach undergraduate nursing and midwifery students research design

      2020, Nurse Education in Practice
      Citation Excerpt :

      Linking theory to clinical practice as a teaching pedagogy in nursing and midwifery has been proven to enhance students understanding and critical thinking (Chong et al., 2016). Methods to teach EBP have been reported from larger course based approaches including blended learning (Sidebotham et al., 2014), and can involve small numbers of students in research projects undertaking supervised data collection and analysis (Newton et al., 2010). Other novel methods of teaching EBP include the use of crossword puzzles (Beck, 1986) and board games (Lever, 2005), and more recently the use of ‘gaming’ as a teaching activity (Davidson and Candy, 2016)

    • In what ways does online teaching create a positive attitude towards research in nursing students studying a first year evidence-based practice undergraduate subject online?

      2020, Nurse Education in Practice
      Citation Excerpt :

      Findings of Halabi and Hamdan-Mansour (2012) and Strickland et al. (2012) suggest for students there is a link between motivation, attitude and satisfaction and the likelihood of future engagement with research, and that educators planning nursing research teaching delivery should not merely concentrate purely on the content. When this is viewed against the backdrop of the pre-semester anxiety towards research, it becomes clear that the literature was suggesting that attitude and knowledge were both very important factors in helping students to view nursing research more positively (Hart et al., 2008: Sidebotham et al., 2014). Although the Strickland et al. (2012) study had a special focus on the use of enhanced teaching strategies in teaching research, their findings suggested a proportional relationship between motivation to learn, satisfaction, and the perceived clinical relevance of their research studies.

    View all citing articles on Scopus
    1

    Tel.: +44 (0)1482 464618; fax: +44 (0)1482 464588.

    2

    Tel.: +61 (0)7 33821083; fax: +61 (0)7 338 21277.

    View full text