BACKGROUND: Meeting the safety needs of women and newborns is crucial in preventing harm in maternity care. Recent recommendations suggest that childbirth needs to be understood through a broader framework, since maternal and newborn mortality/morbidity remain a global challenge. The unique role of midwifery students in clinical environment can provide and contribute to such understanding. This paper explores aspects of maternity care services impacting patient safety as identified by midwifery students in five European countries. METHODS: A 2-stage qualitative design employed an interpretivist approach. Thirty-five midwifery students (Belgium, Czech Republic, Estonia, Norway, Slovakia) were recruited through purposive sampling to engage students with an Erasmus + experience. Stage 1 (2022-2023): Thirty-five written narratives were collected anonymously via an online 'Sharing LearnIng from Practice for Patient Safety' Learning Event Recording Tool. The dataset captured care in antenatal, maternity and postnatal wards. Stage 2 (2024): Three focus group discussions verified and added to the initial findings. Audio recordings were transcribed, NVivo software was utilised to assist reflexive thematic analysis in both stages. RESULTS: Three themes emerged from the analyses. 'Treat me well' theme captured the communication gaps and dehumanised assembly-line approach leading to compromised safety, obstetric violence and trauma. The second theme describes the paralysing impact of specific team members in 'Team dynamics and accountability', reducing a sense of agency among staff to advocate for patient safety. Theme 'Traumatised team-members' reveals the secondary trauma impact on emotional fatigue and defensive practices. CONCLUSIONS: Midwifery students emphasised the importance of individualised, well-communicated, and respectful care, with language barriers being addressed. Ensuring that patients feel safe seems equally relevant to physical safety. Collaborative teams prevent errors/hazards through interdisciplinary simulations, debriefings and students' continuous mentoring. By fostering a psychologically safe environment and implementing whistleblowing policies, the paralysing bystander effect among staff might be mitigated, and obstetric mistreatment, violence, and trauma could be addressed. Unresolved secondary trauma appears to increase unnecessary interventions and reduce the emotional availability of staff for patients in maternity care. Hence, effective recovery needs to be supported by management, and emotional resilience training should be incorporated into midwifery curricula to indirectly improve patient safety. CLINICAL TRIAL NUMBER: Not applicable.
- Klíčová slova
- Mentorship, Midwifery, Respectful care, Safety, Students, Trauma,
- Publikační typ
- časopisecké články MeSH
AIM: To explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events BACKGROUND: Clinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic. DESIGN: Two stage interpretivist qualitative study based in social constructionism METHODS: Convenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students' (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers. RESULTS: Three themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: 'Clinical and Emotional Companionship', 'Clinical and Emotional Abandonment' and 'Sense of agency - Professional and personal growth'. 'Companionship' reflected the students' feelings of being welcomed, respected, heard, trusted and supported. Conversely 'abandonment' emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and 'useless'. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students' learning journeys in a patient safety context. CONCLUSION: The findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students' emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients' safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to 'emotional safety for learning', promotes students' behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply blame mentors/supervisors, staff, or the students themselves- they are simply part of a much larger complex environment of professional education encompassing hidden curriculums, power dynamics and professional socialisation.
- Klíčová slova
- Clinical placements, Emotional safety, Emotions, Health sciences, Internship, Learning, Mentorship, Practical, Student,
- MeSH
- bezpečnost pacientů * MeSH
- dospělí MeSH
- klinické kompetence MeSH
- kvalitativní výzkum * MeSH
- lidé MeSH
- mentoring MeSH
- školitelé psychologie MeSH
- studenti ošetřovatelství * psychologie MeSH
- studenti zdravotnických povolání psychologie MeSH
- studium ošetřovatelství bakalářské MeSH
- učení MeSH
- zjišťování skupinových postojů * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
During the first wave of the COVID-19 pandemic in the spring of 2020, the government of the Czech Republic issued a nationwide ban on visitors to maternity wards. We studied whether the absence of a close person during labor due to this ban impacted perinatal indicators. This study was performed using an administrative observational questionnaire focused on absolute frequencies of events sent to maternity facilities across the Czech Republic. Completed answers were received from 33 facilities covering 4805 births during the study period in 2019 and 4514 births in 2020. The differences in individual parameters were tested using Pearson's chi-squared homogeneity test. There were no significant differences between the two periods in spontaneous pre-term births (p = 0.522) or in the number of cesarean sections (p = 0.536). No significant changes were seen in either local or systemic analgesia. Data showed a significantly shorter (p = 0.026) first stage of labor in 2020 compared to 2019, while there was no significant difference (p = 0.673) in the second stage of labor. There was no statistically significant difference found for newborn perinatal adaptation. There were also no significant differences in intrapartum maternal injuries. Overall, we found no significant differences in basic perinatal indicators during the first wave of COVID-19 in 2020 compared to 2019. Although the absence of a close person may cause stress for the laboring women, it does not impair objective clinical outcomes.
- Klíčová slova
- COVID-19, birth companion, childbirth experiences, continuous childbirth support, women’s health,
- MeSH
- COVID-19 * epidemiologie MeSH
- lidé MeSH
- novorozenec MeSH
- pandemie MeSH
- porod v termínu MeSH
- porodní děj * MeSH
- těhotenství MeSH
- vedení porodu MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
