School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia; Women and Babies Department, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia.
Women Birth. 2024 Jul;37(4):101627. doi: 10.1016/j.wombi.2024.101627. Epub 2024 May 29.
Midwifery students are seldom afforded experiences of perinatal loss care, potentially depriving them the confidence and competence to provide effective and supportive care in such circumstances.
Perinatal loss care is predominantly provided by midwives. Students depend on midwives to provide clinical learning experiences of perinatal loss, preparing them for registered independent practice. The reasons behind midwives' decisions regarding the provision of clinical experiences to students remains unexplored.
To identify the contextual factors identified by midwives as influencing the involvement of student midwives in clinical experiences of perinatal loss.
A qualitative interview study, using semi-structured interviews with 20 senior midwives in New South Wales, Australia.
Four themes describing the contextual factors were identified: 1) it's not in their book, 2) unwritten rules, 3) activity, acuity, and 'the numbers', and 4) teaching the teachers.
The contextual factors influencing decisions of midwives around this issue are complex and interrelated. Commonly held beliefs within the workplace, and hesitancy to challenge the status quo, are complicated by lack of confidence in 'what to do' with a student in the space of perinatal loss. Lack of direction from governing bodies regarding requirements of students in this space, and pressures on staffing, also play key roles.
Midwives need support, guidance, mentorship, and supervision in what is for many, a new practice. Our findings suggest systems-level changes are needed, to allow midwives the time and space to learn and reflect on this new skill.
助产士学生很少有机会获得围产期丧失护理的经验，这可能使他们缺乏在这种情况下提供有效和支持性护理的信心和能力。
围产期丧失护理主要由助产士提供。学生依赖助产士提供围产期丧失的临床学习经验，为他们注册独立执业做准备。助产士在提供临床经验给学生方面的决策背后的原因仍未得到探索。
确定助产士认为影响学生助产士参与围产期丧失临床经验的背景因素。
采用半结构式访谈对澳大利亚新南威尔士州的 20 名资深助产士进行定性访谈研究。
确定了四个描述背景因素的主题：1）这不在他们的书中，2）不成文的规定，3）活动、敏锐度和“数量”，4）教学的老师。
影响助产士在这个问题上决策的背景因素是复杂和相互关联的。在工作场所普遍存在的信念，以及不愿挑战现状，加上对学生在围产期丧失空间中“做什么”缺乏信心，使情况变得复杂。管理机构在学生在这个空间的要求方面缺乏指导，以及人员配备的压力，也起着关键作用。
对于许多人来说，这是一种新的实践，助产士需要支持、指导、指导和监督。我们的研究结果表明，需要进行系统层面的变革，以使助产士有时间和空间学习和反思这一新技能。
