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Medical students' experiences working with midwives on NHS labour wards: a qualitative study

02 February 2022
20 min read
Volume 30 · Issue 2

Abstract

Background

Multidisciplinary team collaboration has been identified as a key factor in optimising intrapartum care. The way future doctors feel about their undergraduate placements with midwives is worth considering, given that this might influence their behaviour in the long term. This study aimed to investigate the experience of medical students working with midwives on NHS labour wards.

Methods

Qualitative thematic analysis was done on transcripts of in-depth interviews with 10 medical students from across England. These students had clinical experiences with midwives or were seeking to work with midwives, and had experiences of training during or after 2010.

Results

Midwives were described as ‘gatekeepers’, with the power either to open or close the labour room door to medical students. Participants described mixed feelings about midwives; some reportedly provided pivotal learning experiences, particularly regarding physiological labour and birth. Others were perceived as unsupportive. The dynamic with midwives was often linked to wider multidisciplinary team culture.

Conclusions

Despite national calls to improve multidisciplinary team relations and undergraduate experiences, this sample of medical students shows that some still perceive tension with midwives. This may affect future obstetricians' exposure to physiological birth at an impressionable time and also influence their multidisciplinary team behaviour. Research into midwives' perspective is needed, given that collaboration is a key factor in providing safer, more personalised care.

Investigations into avoidable adverse events in intrapartum care have repeatedly found multidisciplinary teams fail to understand and appreciate each others' role (Kirkup, 2015; Royal College of Obstetricians and Gynaecologists (RCOG), 2017; Knight et al, 2019). Collaboration between midwives and obstetricians is central to current efforts to provide families with an experience of childbirth that is both safer and more personalised (NHS, 2020). Among the current generation of medical students are tomorrow's obstetricians. Their introduction to maternity multidisciplinary team culture is likely to influence how they collaborate – or not – in future (Zwarenstein et al, 2009; Downe et al, 2010). Therefore, it is important to consider how medical students perceive midwives after placements on NHS labour wards.

The RCOG (2009) undergraduate curriculum states, ‘witnessing the birth of a baby gives students exposure to a unique event, where they will learn the importance of patient-focused care, including communication skills, dealing with pain, team working and the importance of patient choice’.

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