A previous article considered the relevance of Hunter and Warren's (2013) findings to pre-registration midwifery education, and whether student midwives were adequately prepared to deal with the ever more complex demands of their chosen profession (Power, 2016). It is estimated that approximately 20% of students who commence the pre-registration midwifery programme will not qualify to become a midwife (Centre for Workforce Intelligence, 2012). This is compounded by the fact that the increasingly complex demands of midwifery practice lead some midwives to leave the profession, with the top five reasons being: dissatisfaction with staffing levels; dissatisfaction with the quality of care they were able to give; excessive workload; lack of managerial support; and poor working conditions (Royal College of Midwives (RCM), 2016). Given the current ‘retirement time bomb’ the profession is facing (RCM, 2015: 2), it is more important than ever that student midwives are supported to successfully complete their programme of study to join the depleting workforce. Students leave the programme for many reasons such as deciding midwifery is the wrong career choice, financial difficulties and family circumstances (Galloway, 2015); however, academic failure is not usually cited as a key reason for leaving the course. The experiences of those students who have failed and retaken a module are the focus of this article, as their narratives give an insight into their character traits and motivations.
Louise's story
‘Unfortunately, at the end of Year 1, I failed a module, which meant I would have to step off the course in order to repeat that module. Initially this was upsetting; midwifery was my dream and at the time I felt like it was slipping away. It crossed my mind that if I had failed Year 1, how would I be able to pass Years 2 and 3?
‘Looking back now, I see it as a blessing. I had been out of education for a long time, other than the credits I needed to get onto the course and repeating my GCSE science, so I was not prepared for the academic demands of the programme. I was also juggling being a single mum to a very young child. After university, clinical placements and being a mum, the only time to study was the evenings, which I found exhausting.
‘During my year out, I ensured I made the most of it. I continued to work at my Trust as a health care assistant, mainly in A&E, which was the closest area to midwifery I could think of owing to the fast pace and multidisciplinary working. I found that it not only helped me to maintain my basic skills, but gave me confidence when working with the multidisciplinary team, such as doctors. During quieter moments, I would ask the nurses questions that I felt would benefit my training, on topics such as medicines management. I sought further help for academic assessments from the university's learning and development department, to ensure this side was also developed during my year out.
‘Being back on the course, I feel much more equipped to succeed. I am not naturally academic, but my passion for midwifery keeps me focused to ensure that I do succeed.’
Charlotte's story
‘My experience of repeating a module has been a rollercoaster of emotions. At first it was a big shock—and a panic—as I didn't really know what it meant and what I was going to do next. I felt like I had let my family and myself down. However, once I got over the initial shock and disappointment, I started to look at the bigger picture. I realised I am 20 years old, with a lifelong career in midwifery ahead of me, and that another year at university was not the end of the world.
‘I spoke to my lecturers to get advice on how to move forward, and they helped me plan for the future. Although it has been very disheartening and hard not to be on placement while my friends continued without me, it was never an option for me to give up. I have always dreamt of being a midwife, and one setback won't stop me from pursuing my dream career. It has made me more determined than ever to do well and better myself.
‘I have passed my first assessment of the module, and I've recently been offered a job as a bank health care assistant, which will allow me to earn money while choosing my hours to fit in with university. Now I am focusing on revision for my upcoming exams.
‘My tips for success for anyone else in this position are:
Liz's story
‘You open your university results page, and what you see is a second fail grade. The shock is numbing, and the thoughts about how you were planning on celebrating are gone instantly. The initial days are the hardest, but it does get better and you will find your strength again. But in order to get there, you must be kind to yourself. Maybe what I am about to say will sound a bit over the top, but to me it felt like a bereavement; I went through the five stages of grief identified by Elisabeth Kübler Ross of denial, anger, bargaining, depression and finally acceptance.
‘In the first few days of hearing the news you begin to tell others from the cohort, work, family and friends that you need to retake a module. Constantly repeating the story becomes akin to picking the scab off a freshly healing wound. If you are in placement, you need to let your mentor know; if they are worth their salt they will be understanding and supportive. At times you may feel in limbo: you are no longer in your original cohort, but with a new group of students. Emotional support will help you keep strong: friends who make you laugh and bring you into the light are much needed. Some friends disappear while others can shine their brightest in your hour of need; these are the friends you need right now. However, you may also need friends who will not allow you to stay in your onesie all day and eat ice cream at 9am. There is the day that comes when you need to wash your hair and say, “Hello world, I am fabulous and I will be a midwife!”
‘If you feel that you don't have the right support, make use of the student support services through the university. They will be able to signpost you to academic support and counselling services if you feel you need them. I found that mindfulness worked for me—something I hadn't explored previously, which could be applied to stressful situations I will come across once I qualify.
Be kind to yourself. We can all be our own worst critics, and berate ourselves for our situations, but that is not helpful in building your strength back up. Knowing other students who have been in a similar situation may help you feel less isolated and stay positive
‘Getting feedback on the areas that you didn't pass is going to be valuable for your next attempt. However, timing is important—if you are still feeling angry you could be defensive in the meeting and miss the points that are highlighted. When you are in the “acceptance” phase, this will be more conducive to using feedback to move forward and improve.
‘The next challenge to conquer is your income. The sooner you speak to your HR department to see what you can do, the better. Some Trusts may offer you a maternity care assistant position, either under a contract or bank shifts. If you are not comfortable with this choice, care work in another area of health might be an option. Alternatively, you could take a break and use the time to reflect. If you work in the Trust you want to work in once qualified, you can stay up to date with current policies, which will be to your advantage when it comes to re-entering practice as a student or applying for a midwifery position.
‘Be kind to yourself. We can all be our own worst critics, and berate ourselves for our situations, but that is not helpful in building your strength back up. Talk to midwives in practice and other students who have been through this themselves. Knowing others who have been in a similar situation may help you feel less isolated and offer you some suggestions to stay positive. One great idea someone gave me was to look into something to add to my practice, such as hypnobirthing. By having additional training before qualification, I will have an extra string to my bow and maybe the edge on other applicants. By picking yourself up and carrying on, you are demonstrating commitment, resilience and courage.’
Alice's top tips
Conclusion
The stories shared here are not remarkable: students fail modules, that's a fact. What is remarkable is that these students, along with others in their position, have demonstrated courage, commitment and resilience to pick themselves up and keep striving for their dream.
In the current climate of an increasing birth rate accompanied by growing social, economic and clinical challenges, exacerbated by high levels of attrition and staff shortages (RCM, 2016), such students are displaying the character traits of highly motivated individuals. These traits are important if they are to successfully deal with the demands of contemporary midwifery practice and provide women and their families with the high-quality care they deserve. All ‘retakers’ should be commended for their tenacity, and wished the best of luck with their ongoing studies.