‘No offence, it's just that research is boring’: The trials and tribulations of the midwifery research educator
Research has not always been a focal point of midwifery work and education; however, since the 1980s, evidence-based practice and research have become the norm. Ensuring that new generations of midwives have an understanding of the research process; an ability to critique it; and a view that research is attainable and necessary to midwifery, is a crucial role of the midwife educator. This article will discuss how the relationship between research and midwifery developed, and how research is now an established part of midwifery undergraduate programmes. It will also suggest meaningful ways of challenging negative attitudes and engaging student midwives to learn about research. The aim is to prepare students for practice by ensuring that the reasoning behind their clinical skills is understood, evaluated and safe, thereby enhancing the care of women and their families and shaping the future of midwifery.
The argument that ‘research is boring’ is one that greets me most days when trying to introduce research to undergraduate student midwives. The role of research in midwifery has become well established and, as a lecturer, I believe that it is important for student midwives to appreciate the importance of research, and to be able to understand and analyse it. However, determining how to achieve this, when student midwives do not always immediately see its value, has not been an easy journey. This article will discuss how research has become embedded in midwifery practice and education, and how midwifery educators can begin to engage student midwives in research and evidence.
Research has not always played a role in midwifery care and education. Memories of common midwifery practices that were not evidence-based, such as routine shavings, enemas and episiotomies, remain vivid in the memories of both midwives and women (Steen and Roberts, 2011). During the 1980s, however, the concept of evidence-based practice began to emerge in medicine, through the work of David Sackett at McMaster University in Canada (Spiby and Munro, 2010). Medical professionals were encouraged to act on available research, and eradicate care that was based purely on a health professional's personal preference and tradition (Rees, 2012). This same ethos was transferred into midwifery care through the work of the National Perinatal Epidemiology Unit (NPEU) in Oxford, which was established in 1978 and comprised researchers from various backgrounds, including midwifery. The NPEU was led by Iain Chalmers and was developed after Archie Cochrane, a leading British epidemiologist, made disparaging remarks about the lack of evidence in the care of pregnant women (Renfrew, 1997). The following years saw the development of research within midwifery; in 1985, the Midwives Information and Resources Service (MIDIRS) was created, a journal dedicated to the dissemination of midwifery knowledge (Anderson, 2006), and research by NPEU led to the publication of Effective Care in Pregnancy and Childbirth (Chalmers et al, 1989) and a subsequent guide (Enkin et al, 1989). This is one of the first examples of evidence in childbirth being collated and synthesised for use in midwifery care (Renfrew, 1997). It was also at this time that midwives began to undertake research themselves, and Clark (2000) highlights revolutionary midwifery research into shaving (Romney, 1980), enemas (Romney and Gorden, 1981) and routine episiotomies (Sleep et al, 1984). The Cochrane Pregnancy and Childbirth Database, a collection of the latest research and evidence, followed in 1993 (Chandler et al, 2017), and for the first time, provided every midwife with easy access to the latest research and evidence-based knowledge (Renfrew, 1997). Research was also introduced into the midwifery curriculum in the 1980s (Macdonald, 2004). When midwifery education was assimilated into higher education institutions in the 1990s, it cemented the concept of midwifery as an evidence-based profession (Clark, 2000).
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