In our final #InnovationMonth blog post, Jemma Walker explores the implementation and benefits of Interprofessional Education (IPE) in obstetric training, specifically focusing on the Undergraduate Practical Obstetric Multi-Professional Training (PROMPT) programme for student midwives. Jemma Walker is a Senior Lecturer in Midwifery at the University of the West of England, Bristol.
Interprofessional education
Interprofessional education (IPE) involves two or more professions learning with, from, and about each other; within healthcare education, it is acknowledged to improve working relationships and care provision. The WHO (2010) Framework for Action on Interprofessional Education and Collaborative Practice and NHS England National Maternity Services review recommend that multi-professional learning should be a “core” part of all undergraduate training for midwives and obstetricians, nurturing understanding and respect for each other’s skills sets and perspectives. Recent reports from Ockenden (2022) and Kirkup (2022) highlight how poor interprofessional teamwork and communication can negatively impact standards of safe compassionate care and lead to devastating outcomes for families; recommending staff that work together, should train together. Furthermore, they highlight professional behaviour begins to establish at undergraduate level; recommending opportunities for interprofessional experiences at the pre-registration level to contribute to effective teamwork that extends into autonomous practice.
Undergraduate Practical Obstetric Multi-Professional Training (PROMPT)
Since 2019, University of the West of England and the University of Bristol through partnership launched undergraduate PROMPT training for 2nd and 3rd year student midwives and 4th year medical students with the help of the PROMPT Maternity Foundation. PROMPT is a well-established and evidence-based training approach, using the ethos of “those that work together, should train together” to improve clinical outcomes within maternity services, its annual training is mandated by a variety of national bodies. The PROMPT Maternity Foundation approach, ethos, and resources allows students to work on developing their communication and teamwork skills by navigating through obstetric emergency scenarios in a safe learning environment.
The Undergraduate PROMPT days run six times a year and have a range of 90 – 120 students attending each day. Students are provided with a pre-reading electronic booklet, that includes the clinical algorithms that they will be encouraged to use during their simulated sessions. The students are allocated into small interprofessional groups at the start of the day with an introduction session where the importance of teamwork and communication is the focus. All groups are provided with short lectures covering each emergency scenario in preparation for the simulated sessions, where they work within their interprofessional groups to recognise and manage the scenarios. The scenarios use standardised patients and are facilitated by both clinicians and academics. Each scenario ends with a debrief covering the main key learning points and feedback on the experience of teamworking and the development of confidence and competence within their scope of clinical practice.
Student testimonials
The use of IPE within obstetric emergency simulation training is valuable for both midwifery and medical students, further supported by Edwards et al, (2015) who undertook a pilot study at University of the West of England. The Undergraduate PROMPT training team are undertaking further research to assess the effect of such IPE on interprofessional attitudes and working among students attending the undergraduate PROMPT training.
Here are examples of student experiences extracted from feedback following attendance to Undergraduate PROMPT training:
“The session was an amazing tool for learning and helped me with my confidence in practice going forward.”
“Working in an interprofessional team and approaching simulation scenarios with a number of people made it more like a real-world scenario.”
“Understanding when to call for help and knowing each other’s role within an emergency matters.”
“I was unsure of the benefit of working with medical students but found it really helpful to understand our different specialties and challenges. The group I worked with was really respectful of each other’s skills.”
How can Undergraduate PROMPT training address challenges in the maternity workforce?
The provision of undergraduate PROMPT training for midwifery and medical students is a positive example of IPE which brings together students to learn together through a simulated practice learning day. It improves interprofessional attitudes and relationships between professionals providing maternity services, who to provide the safest possible care need to be able to work together effectively. It provides an opportunity for emerging health professionals to work alongside one another without perceived hierarchy, breaking down some of the common stereotypes that can exist within healthcare. This is particularly important given the recommendations from recent national reports to improve maternity care and safety, by addressing poor workplace cultures. Furthermore, it has the potential to protect the future workforce who are particularly vulnerable upon registration, by developing their confidence and competence and embedding a culture of effective teamworking.
Reference list
Edwards, S.E. et al. (2015) Effective interprofessional simulation training for medical and midwifery students. BMJ Simulation and Technology Enhanced Learning [online]. 1 (3). Available from: https://stel.bmj.com/content/1/3/87.
Kirkup, B. (2022) Reading the Signals Maternity and Neonatal Services in East Kent -the Report of the Independent Investigation [online]. Available from: https://assets.publishing.service.gov.uk/media/634fb083e90e0731a5423408/reading-the-signals-maternity-and-neonatal-services-in-east-kent_the-report-of-the-independent-investigation_print-ready.pdf.
NHS England (2016) NHS England National Maternity Review England.nhs.uk. 2016 [online]. Available from: https://www.england.nhs.uk/mat-transformation/implementing-better-births/mat-review/.
Ockenden, D. (2022) Final report of the Ockenden review GOV.UK. 2022 [online]. Available from: https://www.gov.uk/government/publications/final-report-of-the-ockenden-review.
World Health Organization (2010) Framework for Action on Interprofessional Education & Collaborative Practice World Health Organization. 2010 [online]. Available from: https://www.who.int/publications/i/item/framework-for-action-on-interprofessional