Supervision of midwives what makes it special

The practical aspect include 20 normal deliveries, 10 abnormal deliveries, 10 Information, Education and Communication IEC , 10 domiciliary visits, 10 long palpations, 40 short palpations, 10 special family planning cases, 10 ordinary family planning cases and 1 case study. Thus the clinical supervisor facilitates the integration of theory into practice and adequate transfer of the newly acquired clinical skills though this may be influenced by some factors. Studies have revealed a number of factors influencing clinical supervision of student midwives such as supervisory relationship [8].

A study by in CHAM nursing college in Malawi on factors affecting acquisition of psychomotor clinical skills by students nurses and midwives found that student motivation, lack of resources, learning environment, knowledge gap between the qualified nurses and Tutors and role modeling [9].

Other factors include availability of expertise, educational preparation and positive attitude of supervisor [10]. The main objective of the study is therefore to determine factors influencing clinical supervision of student Midwives in order to ensure the integration of theory to practice and adequate transference of newly acquired skills.

Clinical supervision of student midwives is a critical factor for skills acquisition, patient care and safety [11]. However, supervision of students at Lusaka School of midwifery is not adequately achieved due to a shortage of the teaching staff and midwives in the clinical areas. Lusaka school of midwifery currently has two Clinical Instructors and six Tutors and on average there are 5 to 8 Midwives on duty per shift in labour ward and these are expected to work with and supervise student Midwives including student Nurses on duty.

The staffing levels per shift in both labour ward and NICU according to the records is 5 - 8 Nurses or midwives to work with a group of more than 40 students. The ever increasing student population makes it difficult for the Midwives to monitor students and patients effectively. Furthermore, most of the clinical staff are not trained in student clinical supervision. There also has been a public outcry on the caliber of the newly qualified midwives graduating from midwifery schools.

It is against this background that this research study will be conducted with the purpose of exploring factors influencing clinical supervision of student midwives at Lusaka school of Midwifery. Having a good number of trained Clinical Preceptors and Registered Midwives in a clinical site promote good and effective training of students. Shortage of staff in most of the clinical sites and increased population of students has contributed to limited supervision as per guidelines.

There is limited published data on the topic in the country. The study aims to determine if available structure, skills of staff and attitudes contribute to effective supervision. It is hoped that the study findings will open a way for other scholars and researchers to look at this problem and further influence policy direction towards helping the Student Nurse Midwives acquire competencies to enable them practice as expert reflective practitioners and thus improving the quality of the midwifery profession.

The main aim of the study was to determine factors influencing clinical supervision of Student Midwives in Lusaka Urban District. The specific objectives were to assess level of knowledge of supervisor on clinical supervision of student midwives, determine attitudes of supervisors towards student midwives, identify competences of the supervisor of student midwives and assess the student midwives learning environment. A cross-sectional study to determine factors influencing Clinical Supervision of Student Midwives in Lusaka urban was used as little was known about the topic.

The researcher employed both quantitative and qualitative methods to collect data. The quantitative method helped quantify the factors influencing clinical supervision of student midwives in Lusaka urban by use of self-administered questionnaires to study participants. The qualitative approach was used to uncover trends in thought and opinions, and dive deeper into the problem of clinical supervision. Qualitative data collection methods vary but this study used focus group discussions.

The quantitative data collection tool was also exploratory in order to gain an insight into factors that influence clinical supervision of Student Midwives in Lusaka urban. The study setting was in Lusaka at the University Teaching Hospital, a tertiary hospital with a bed capacity of ; and the five health facilities in Lusaka Chipata, Chawama, Chilenje, and Matero first level district Hospitals and Kalingalinga Health Center ; where the Student Nurse Midwives practice from as this was the natural location for study participants.

The study population included the Nursing and Midwifery Staff who work in the facilities where student Midwives practice from in Lusaka Urban. These are the ones who are likely to be involved in clinical supervision of Student Midwives as they work with them. The purposive sampling method was used to select the study sample since the study population was limited. All the facilities and Registered Midwives where Student Midwives are practicing from in Lusaka were part of the study to enable the Research collect data from a representative sample.

Nurses and Midwives with at least 1 year working experience who were working in clinical sites where Student Midwives do their Midwifery practice and were willing to give informed consent were recruited to participate in the study. These were resident employees of the study areas as part time Staff may not have been regularly in contact with Students. The sample size was calculated using the proportion of Nursing and Midwifery staff who work with Student Nurse Midwives as follows:.

Data were collected from the respondents using a questionnaire. A questionnaire and focus group guide were used to collect data because all the respondents were literate and able to write in English language, which is the formal language of communication in the country. Questionnaires were given to participants for them to read and answer the questions. The questionnaire had five 5 sections covering demographic data of the respondents, knowledge, attitude, competences and skills for clinical supervisors.

The questionnaire had both closed and open ended questions to enable the Researcher collect specific data and this allowed for free expression of participants on issues where they wanted to add more information that could have been missed out in closed ended questions. Focus group discussion guide were used during the FGDs to help guide participants on the topic under discussion.

Validity was measured by ensuring that the same questions were asked to each respondent in the same sequence during the focus group discussions. To ensure validity, questions were constructed in a simple, clear and precise way in order giving respondents an opportunity to give clear and precise answers on factors influencing clinical supervision of Student midwives.

The Questionnaires had same questions that were clearly constructed to avoid ambiguity. Reliability was ensured by standardizing the instrument by testing the research tools before the main study was conducted using a pilot study in an environment with similar characteristics.

To ensure reliability, a variety of open ended questions were used in the questionnaire to allow for spontaneous responses that gave more valid answers. A pilot study was carried out to check whether the instruments were able to bring out consistent information about factors influencing clinical supervision of Student Midwives. The questionnaires were distributed to the respondents at their working places.

The completed questionnaires were collected by the researcher within 48 hours after distribution. Participants were thanked after receiving the completed questionnaires. Prior to the main study, a pilot study was conducted at Kabwe General Hospital and School of Nursing and Midwifery located in Kabwe town which is kilometers from Lusaka City.

The purpose of piloting the instrument was to obtain clarity, find out its appropriateness and obtain direction to the main study. Participants, participated in the study voluntarily and were informed of the right to withdraw at any time without negative implication. Written consent was obtained from all participants before they participated. Consideration was made to those who were not in a state of participating due to time and fatigue related to their work. The information that was collected was kept confidential under lock and key.

No names were indicated, however, the questionnaires and FGD guides had serial numbers for the purpose of data entry. Data were collected using questionnaires and focus group discussion guides. After data collection, the questionnaires that were used were counted and checked for completeness, legibility, accuracy and consistency.

Answers from closed ended questions were coded and entered on the computer using SPSS version Answers from open ended questions were read through, and answers that belonged together were grouped, a process known as categorization [12]. Numerical codes 1, 2, 3 and so on were then assigned to each group and the data were entered on the computer using SPSS version Chi-square and linear regression was used to test for associations between dependent and independent variables.

After each focus group discussion, the recorded information from the voice recorder was played to the participants to check for consistency of the information recorded and study participants were asked to clarify any points which were not clear. Data were read through to get the key points and general ideas expressed.

Content analysis, which involved classifying words in a text into a few categories chosen because of their theoretical importance [13] was used to analyse data. Answers from the three 3 groups of students were compared. The findings revealed that In terms of academic qualifications, most respondents Though most of the respondents had medium knowledge level on clinical supervision, a high percentage of them However, most of the respondents had positive attitudes towards clinical supervision.

Figure 1. Clinical supervision skill. Table 1. Table 2. The main objective of the study was to determine factors influencing clinical supervision of Student Midwives in Lusaka Urban District.

They were more respondents aged between 35 and 44 years, perhaps indicating that younger midwives and nurses were not being employed due to the economic recession the country is experiencing or it could also be due to an increase in post basic qualifications being offered in the country like Advanced Diploma in Paediatric Nursing and Child Health, Critical Care Nursing, Clinical Instructor Program and Bachelor of Science in Nursing at universities. The study findings on gender showed that the majority of the respondents were female, constituting There were more female midwives and Nurses because previously Nursing and Midwifery were regarded female careers and hence more females were trained as Nurses and midwives.

In addition, culturally women are considered to be care givers and the ones expected to attend to pregnant women. On the academic qualifications of those involved in clinical supervision, most respondents There were more midwives with a certificate in midwifery supervising students because these are specialized professionals mainly employed in the midwifery section in the health sector.

These findings are contrary to a study conducted in Tanzania which showed that non-qualified individuals were involved in provision of clinical supervision of student midwives [5] [14]. All the respondents who participated in this study were involved in clinical supervision of student midwives and most of them have been supervising student midwives for 1 to 3 years This suggests that most of the clinical supervisors lacked experience in terms of supervision of students. On whether the Clinical Supervisors had been trained in clinical supervision of student midwives, the majority of the respondents This could be attributed to lack of clinical Instructor training in the country hence the need for the relevant authorities to look into matter; the school of Nursing in Lusaka trains Clinical Instructors but the enrollment numbers are low as institutions only think of those working in schools as instructors to be the ones eligible for training; Schools also have few staff working as instructors making it a challenge to release them to go for training.

Trained staff in clinical field has the responsibility to teach although few have formal training in supervision. In fulfilling this role, Supervisors are independent of their employers. Instead, the decision will likely be taken by a clinical director, or be mandated by a policy or procedure which the specific organisation has in place, for example, to investigate all elective surgery deaths.

In response to the learning from events at Morecambe Bay and other failings of care, it revised its Midwives rules and standards in In particular, a new rule strengthened the requirements on the LSA for investigating, reporting and information sharing about adverse incidents and complaints. The purpose of supervision of midwives is to protect women and babies by actively promoting a safe standard of midwifery practice. Midwifery supervision and regulation: recommendations for change.

Statutory supervision For midwifery, supervision is a statutory responsibility which provides a mechanism for support and guidance to every midwife practising in the UK.

The LSA The functions of the LSA include: providing a framework of support for supervisory and midwifery practice; receiving intention to practise data for every midwife practising in that LSA; ensuring that each midwife meets the statutory requirements for practice; assessing initial and continuing education and training for Supervisors; leading the development of standards and audit of supervision; determining whether to suspend a midwife from practice; being available to women if they wish to discuss any aspect of their midwifery care that they do not feel has been addressed through other channels; and investigating cases of alleged misconduct or lack of competence.

Supervisor of Midwives Supervisor The Supervisor provides support and advice to midwives to ensure their practice is consistent with the regulatory framework. How supervision works following a serious untoward incident The role of the Supervisor is to monitor and support the practice of each midwife for whom they are responsible, including development needs, whilst at the same time discharging their own duties as practising midwives. You may, however, draw upon and refer to material contained in the Contribution in preparing articles for publication in scholarly or professional journals, in contributions to symposia, in a single chapter in a book, for teaching purposes and may use and make copies of excerpts from the Contribution for this purpose , and for presentations or lectures at professional meetings, provided that the Publisher and the Work are appropriately identified.

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