Research Electives in a Preregistration Honors Degree Program for Paramedics: Innovative Practice or Just Another Gimmick?

The principles of ethnography were used to map the development of decision-making skills in student midwives during training and after qualification in the United Kingdom. The 49 participants were a combination of students, midwives who had been qualified for less than a year, and midwifery mentors. The data collection methods consisted of focus groups, observations of practice, and individual semistructured interviews. Data analysis followed the principles of coding data, category, theme, and metatheme formation described by Garner (1991) and Ely et al. (1997). The classification of the nature of professional knowledge and typology of nonformal learning created by Eraut (2000) was used to identify where explicit and implicit learning occurred. Very little knowledge related to decision-making was gained from formal teaching sessions in the classroom. The personal knowledge or “know-how ” surrounding decision-making was acquired by the student working alongside the mentor in practice. Consequently, the relationship between learner and mentor and the quality of mentoring itself became strong influences. Findings suggest that study participants use a number of strategies to learn the skill of decision-making. These strategies include seeing the outcome of care, predicting and anticipating events, pattern recognition, self and group reflection and the use of heuristics. Other factors that helped or hindered decision-making were evident, such as confidence and emotion management, getting to know the woman, and contextual and environmental influences. Vignettes were created to represent composites of the findings; these were presented to study participants in a focus group as a means to achieve respondent validation