Celia Woolf ¹ & Adele Hamilton ²

1. Celia Woolf¹ & Adele Hamilton² ¹Institute of Health Sciences Education, Queen Mary University of London ²School of Community & Health Sciences, City University London _______________________________________________________________________________ C. Student Focus Groups • We piloted interprofessional peer-learning for fourth year medical and final year midwifery students on practice placement in the maternity unit of a busy London teaching hospital. • Aims • Enhance understanding of professional roles • Challenge negative stereotypes • Create opportunities for interprofessional team working in practice • Rationale • Good communication and collaboration between doctors and • midwives improves women’s experience of labour and birth • Poor interprofessional teamwork contributes to serious failures in • care of mothers and babies(e.g. Lewis, 2005) • Interprofessional education aims to improve collaboration and the • quality of care (Barr, 2005) • Peer learning benefits students as teachers and learners. • References: • Barr, H (2005) Interprofessional education: today, yesterday and tomorrow: a review. London, UK : Higher Education Academy, Health Sciences and Practice Network. • Lewis G (Editor) (2005) The Confidential Enquiry into Maternal and Child Health (CEMACH). Why Mothers Die 2000-2002. London: RCOG Press • The qualitative data from group feedback was analysed using the Framework approach (Ritchie and Spencer, 1994). • 1. Involvement • Medical students in the peer learning group found that working with midwifery students helped them get more involved in practice: • “Made me more part of the team” • “Able to get into labour ward more easily” • This contrasted with the experience of some students in the control group: • “I always feel in the way as a medical student – I don’t like to push – I don’t like to be underfoot”. • “In most …. ways I cause more trouble than help – makes me feel like I am wasting my time … Everyone’s so busy. I feel like I’m imposing” • 2. Role Clarification • Students in the peer learning group learnt about each other’s roles and perspectives: • “We have common ground” • “Was good to get midwives view of doctors, sticking people on IV drugs”. • “Because we all have a better understanding of each other’s roles and have more respect for each other, will work better together in multidisciplinary team” • 3. Learning • Students in the peer learning group felt that the interprofessional exchange of knowledge enhanced their learning: • “Was useful to see that midwives and medical students asked different questions and have different perspectives”. • “I am learning from midwifery students, for example how to assess the placenta. Midwives can also learn from medics… was good” • “By teaching it to someone else it affirms it in your own mind” • 4. Interprofessional experience • Students in the peer learning group valued the interprofessional contact • “Much better than other IPE experiences” • “joint teaching sessions really good, much better than any teaching we have had” • Students in the control group would have liked more opportunities to learn interprofessionally: • “It would be useful to have student doctors and student midwives meeting together” A. Role Perception Questionnaire (McKay, 2004) Pre-training : students held preconceptions about both professions, including some negative stereotypes • Post-training some of these preconceptions changed and some differences emerged between students in the peer learning and control groups. • For instance: • medical students in both groups showed increased awareness of medical • aspects of the midwifery role. • midwifery students in the peer learning group felt that the professional • role of doctors became more transparent , while those in the control • group rated it as less transparent. • medical students in the peer learning group perceived both professions • as working more autonomously than before training. • medical students in the control group strengthened their view that • midwives work less effectively in teams than doctors. This negative • stereotype did not increased among the peer learning students. • Participants • Student volunteers gave informed consent to take part. • Peer learning group n = 38 • Control group n = 26 • Peer learning programme • Practice-based reciprocal peer teaching between medical and • midwifery students • Students explored medical and midwifery roles in antenatal • care, normal labour and complicated labour through • joint clinical observations • working together to care for women on labour ward • interviewing woman about experience of maternity care • and consequences of teamwork • researching information together • Peer-learning handbook gave guidance • Students gave case presentations focusing on • interprofessional teamwork in maternity care. • Students also attended joint weekly facilitated seminars on: • normal labour • pregnancy induced hypertension • diabetes in pregnancy • complicated labour and assisted birth • 4 weeks duration x 3 student cohorts B. Student Feedback Questionnaires Medical and midwifery students valued the peer learning experience equally: Students deepened their understanding of the role of other health professionals: Students believed that they learned to collaborate more effectively with other team members: • Peer learning between medical and midwifery students had additional benefits beyond those gained through opportunistic interprofessional contact in practice. Peer learning: • was valued and enjoyed by students • helped clarify professional roles • developed understanding of how doctors and midwives collaborate • in practice • helped medical students get greater experience of involvement • with women during labour and childbirth • broke down barriers between the professions. • The peer learning model has potential for extending to other practice areas. • Evaluation • Role Perception Questionnaire pre and post • Student feedback questionnaires • Student focus groups • Control data from students on the same maternity unit allowed between-group comparisons to explore whether the peer learning experience enhanced learning compared with opportunistic interprofessional contact. ____________________________________________________________________________________________________________________ www.city.ac.uk www.qmul.ac.uk