Perfect Preceptorship? - Maternity & Midwifery Forum · interactive practice. British Journal of...
Transcript of Perfect Preceptorship? - Maternity & Midwifery Forum · interactive practice. British Journal of...
Perfect Preceptorship?
Jean Mason Mitchell, June 2018
MSc, PGCHER, RM,RGN
Lecturer Midwifery UoS
Lecturer practitioner, 2003–2011development and implementation of preceptorship programme
MSc Midwifery – evaluation of programme
Preceptoship Publications – 2009, 2013, 2016
NET Conference - 2015
• A period of structured transition for the newly
qualified practitioner
• Develop confidence as an autonomous
professional, refine skills, values and behaviours
• NOT a way to meet any shortfall in pre-
registration education(DH 2010:11).
Definition (DH 2010.11)
Barriers
And
Challenges
Lack of consensus between
regulatory and professional
bodies Skills & attitudes to
promote normal birth are focus of midwifery
education(NMC 2007)
NQM not fully conversant with skills to care for
women with complex needs
NMC - 2009 development
needed AFTER registration to
acquire skills to be lead carer for these
women
–“quality” of preceptor
pivotal to NQM development (Finnerty et al
2006)
No need for additional “course” or review & no
recognition for preceptor role
GAPS
MIND THE GAP
preceptorship variable -
months or up to 2 years – NHS Trust dependent
Hughes and Fraser (2011) differing skills & abilities of
NQMs on qualification
not recognized
SINK OR SWIM – culture / bullying
NOT JUST ABOUT CLINICAL
SKILLS
EVALUATION AND REVIEW
REQUIRED
EVIDENCE / POLICY
CHANGING WORKFORCE
• WHY?
• ? Lack of robust, formalized systems for development implementation & audit
↓ evidence of real growth despite being↑ on policy agenda – remains local responsibility
• WHY?
• ? Lack of quantitative evidence
• Qualitative studies don’t demonstrate cost or quality of care
Difficult to convince budget holders of value / need to fund provision & evaluation
Structured / evaluated / revised
Personalised and flexible – evidence based, content and
delivery, length, rotation
Supportive
Develop confidence & competence
NQM’s report feeling safe, able to achieve specific skills and
evidence their development
Mason, JM Davies, SE (2009,2013, 2016) / Hughes and Fraser (2011), Hughes AJ; Fraser DM (2011) / Currie,L.Watts, C (2012)
/ Hobbs, J. (2012), Currie,L.Watts, C (2012) / Feltham (2014), Power A, Ewing, K (2016) Irwin C, Bliss, J, Poole, K (2018)
Jones,K, Warren,A, Davies A,(2015) Mind the gap, Summary report from Birmingham and Solihull Local Education and
Training Council, Every Student Counts
Rankine,J, Symeonaki, M. (2018) Developing future midwifery, Empowering Preceptees
Qualitative evidence - effective
programmes need to be
• need to facilitate
supportive working
environment for NQM’s. Hobbs (2011) Mason Davies
(2013) / Good relationship
= reciprocal benefits - (Kirkham, 2007)
• Peers important in
learning (Rogers 2010) &
support helps address
emotional issues
surrounding transition
from student NQM (Ferguson and Day 2007).
Are we always supportive?
• A midwife is a midwife is a midwife….
shes paid as much as me…..soon
knock that out of her…
• ‘Stones can make people docile’:
reflections on how the hospital
environment makes us ‘good girls’
(Bosanquet 2002) / Bullying and
Horizontal violence – Curtis, Ball and
Kirkham (2013)
• Do we encourage peer support groups
within preceptorship programmes or
simply in day to day practice?
Provide supportive relationships
• “Mind the gap” – are we adapting / responding?
• Simulation in a supportive environment
• “…made such a difference when learning new skills ...
holding the instruments ....playing with the FSE, attaching it
through a torso to a grapefruit... mad but it so helped…”
• NB -utilize MDT for support
• How do we support development of leadership / decision
making etc - Practice based education & support facilitates development of decision
making expertise more effectively than traditional teaching (Kitson Reynolds 2009).
Develop confidence and competence
in our NQM’s
YOUR ACTION
BIG IMPACT
WHAT YOU CAN DO
Be that supportive colleague-
Coach / facilitate
recognize time
pressures of colleagues undertaking preceptor
role
Have a voice in
trust meetings
Demand local
evaluations of current provision
Lobby NMC – listening
events forums etc
RESPOND TO
CHANGE
Perfect preceptorship?
• Probably not in my lifetime!
• We can all be more effective in
supporting NQM’s at local level and
lobbying for effective change at national
level
• Thank you for listening!
• Currie,L.Watts, C (2012) Preceptorship and pre-registration nurse
educationhttp://www.williscommission.org.uk/__data/assets/pdf_file/00
11/479936/Preceptorship_and_pre-registration
• Department of Health (2004) Agenda For Change: Final Agreement.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicat
ionsPolicyAndGuidance/DH_4095943
• Department of Health (2008) A High Quality Workforce. NHS Next
Stage Review.
• Department of Health (2010) Preceptorship Framework for Newly
Registered Nurses, Midwives and Allied Health Professionals.
• Feltham,C (2014) The Value of Preceptorship for Newly Qualified
Midwives, British Journal of Midwifery 22(6);427-431
• Ferguson, L Day, R. (2007) Challenges for new nurses in evidence-
based practice. Journal of Nursing Management 15: 107 - 113
References
• Hobbs, J. (2012) Newly qualified midwives’ transition to qualified
status and role: Assimilating the ‘habitus’ or reshaping it? Midwifery
28:391–399
• Hughes AJ; Fraser DM (2011) 'SINK or SWIM': the experience of newly
qualified midwives in England. Midwifery 27(3):382-386
• Irwin C, Bliss, J, Poole, K (2018) Does Preceptorship improve
confidence and competence in Newly Qualified Nurses: A systematic
literature review, Nurse Education Today (60), 35 – 46.
• Jones, K. Warrren, A. Davies, A. Mind the Gap, (2015) Exploring the
needs of early career nurses and midwives in the workplace, Summary
report from Birmingham and Solihull Local Education and Training
Council Every Student Counts Project
• Kirkham, M. (2007) Retention and return in the NHS in England.
Midwives, the official journal of the Royal College of Midwives 10 (5):
224- 226
References
• Kitson- Reynolds, E. (2009) Developing decision making for students using
interactive practice. British Journal of Midwifery, vol 17 (4) p 238 -243
• Mason,J. Davies,S.(2009) Preceptorship, Time for a Change? British Journal of
Midwifery, 17(12),804 – 805
• Mason,J. Davies,S.(2013) A qualitative evaluation of a preceptorship programme
to support newly qualified midwives. Evidence based Midwifery, September 2013
• Mitchell, JMM and Davies, S (2016) Implementation of a structured
• programme of preceptorship for Newly Qualified Practitioners (Midwives) in one
North West England Maternity Unit, Nursing management
• Nursing and Midwifery Council (2007) Review of pre registration midwifery
education – decisions made by the Midwifery Committee. Circular 14 12/5/2007
• Nursing and Midwifery Council (2009) Standards for pre-registration midwifery
education
• Power A, Ewing, K (2016) Midwifery preceptorship: The next chapter . British
Journal of Midwifery, August 2016. https://doi.org/10.12968/bjom.2016.24.8.582
• Rankine,J, Symeonaki, M. (2018) Developing future midwifery, Empowering
Preceptees
References