A Case Study Approach to a Process and Outcome Evaluation of a Midwifery Curriculum Using Enquiry Based Teaching and Learning Strategies.

This thesis examines the process and outcomes of a case study evaluation of a midwifery curriculum, which utilised an enquiry based learning (EBL) approach as one teaching and learning strategy. This new curriculum was written to address some of the educational recommendations made by the Fitness for Practice (UKCC 1999) publication in preparing students to be fit practitioners at the point of registration. A multiple data source approach to this case study of a midwifery curriculum evaluation was used in terms of method and participant groups over a three- year period. Both qualitative and quantitative methods were applied to analyse the data sets generated through student reflections as part of their portfolio assessments, questionnaires, interviews and field notes from observation. Participant groups included a total of 26 students on both a diploma and degree programme, 10 tutors, 26 mentors and 2 practice facilitators supporting these students, and were based at a university in the South East of England attached to five NHS trusts in the area. The research exploring the concept of effectiveness of an EBL approach was examined from five identified constructs of effectiveness which were inductively formulated from a sample of student reflections. These were further explored through yearly questionnaires followed up by interviews with 9 participants contributing to the evaluation. An EBL approach appears to have the ingredients to develop and enhance skills of confidence in learning and competence in practice. However the effectiveness of an EBL strategy requires preparation of both mentors in practice and tutors for academic support before implementation. Maturity and some life experience, before commencing the programme and personal attributes of motivation appear to be key elements in effective learning through an EBL strategy. In addition reflection plays a key role in developing the participant both from a personal and professional perspective as a lifelong learner. EBL is perceived as a tool through which participants are empowered to challenge and transform practice in terms of communication skills and perceived essential skills of intuition and empathy developed as a by-product of the process. Difficulties in assessing such skills have been discussed. In addition assessment processes in determining levels of critical thinking, reasoning and reflection and their competent application in practice, as a product of an EBL strategy, require further development