Review of midwifery education and training and newly qualified experience: thematic analysis

Context: Between November 2022 and February 2023, Health Education England (HEE) conducted the first nationally co-ordinated quality review of pre-registration midwifery education and training. Prior to this, independent reviews by Ockenden and Kirkup highlighted the significant failings of maternity services, which can impact on the experiences of midwifery students and the quality of their clinical placements. Therefore, the purpose of HEE’s quality review was to explore the experiences of student midwives and newly qualified midwives, across England, in order to inform the development of a Student Charter. In March 2023, Health and Society Knowledge Exchange (HASKE) was commissioned by NHS England (formerly HEE), to undertake a thematic analysis of the data collected through their review of midwifery training and newly qualified experience. Methodology: HEE’s national quality and maternity teams were supported by the regional quality teams and regional maternity leads to undertake the data collection for this project, which involved: • 152 focus groups across England with maternity students from all years of study; • 10 focus groups with newly qualified midwives across England; • A national online survey of newly qualified midwives who were unable to attend the focus groups; • 10 focus groups with multi-professional students from the South West of England; • 9 focus groups with newly qualified multi-professionals from the South West of England; • An online survey of newly qualified multi-professionals, from the South West of England, who were unable to attend the focus groups; and • Slido Polls distributed during the focus groups. The questions posed in the focus groups and online surveys were positively orientated to capture ‘what good looks like’ in order to inform the development of a Student Charter, with a focus on midwifery students in the first instance. The questions were structured around the following key themes: overall quality; safe learning and training; client and learner safety; induction; practice supervision; receiving feedback; practice assessment; university support; health and wellbeing; facilities (education, support, clinical, wider working environment); educational opportunities; respect and value in the placement environment; and supporting future careers. Findings: Across all of the regions, a clear set of themes emerged regarding the overall quality of educational experience in midwifery. - It is essential for students to feel valued as part of a midwifery team, who can fulfil their caring role well. Students should be based in interested, motivated and supportive environments in practice and at university, with clear communication of expectations and support in achieving learning outcomes. - Staff who have time to role model excellent care and teaching in a positive work environment are crucial to a quality experience. Supervisors should be consistent (and potentially continuous), motivated, trained in pedagogical methods, proactive and engaged in student learning and development, and supportive of their individual needs and interests. - It is important to ensure ample opportunity to develop skills and develop knowledge with the ability to reinforce this over time and across practice, including the chance to practice a range of skills regularly in order to embed learning (through real life practice and simulations). - Sufficient time and dedicated spaces are needed to discuss and reflect on a varied practice, in order to learn. - Staff levels should remain safe, and staff-student ratios and workloads should allow for good teaching to occur, ensuring that students can feel safe and confident on placement and in their work. - Flexibility in shifts can allow for learning opportunities. These themes were largely reproduced in the data collected from NQMs, multi-professional learners and newly qualified multi-professionals