Evaluation of strategies designed to enhance student engagement and success of indigenous midwifery students in an Away-From-Base Bachelor of Midwifery Program in Australia: A qualitative research study.

BACKGROUND: A strategy to close the gap in relation to Indigenous health is the employment of more Indigenous health professionals. However, despite government reviews, research studies and educational initiatives, Indigenous students' retention and completion rates of tertiary education remains below those of non-Indigenous Australians. OBJECTIVE: To evaluate two enhancements to an Away-from-Base Bachelor of Midwifery program for Indigenous students, namely the appointment of an Indigenous Academic Liaison Midwife to provide academic and cultural support and an additional clinical placement in a high-volume tertiary hospital. METHOD: In this qualitative study, 10 Indigenous students enrolled in the Away-from-Base Bachelor of Midwifery program participated in one of two focus groups. Focus group transcriptions were subjected to a manual thematic analysis, and key themes were identified and explored. FINDINGS: The role of the Indigenous Academic Liaison Midwife was highly valued as students had access to a resource who provided cultural and academic support, and who encouraged and advocated for them. Regular contact with the Indigenous Academic Liaison Midwife enabled students to stay connected with and focussed on their study. Students were overwhelmingly positive about the opportunity to undertake the additional clinical placement, as it exposed them to complex clinical cases they may not have seen in their home communities. CONCLUSIONS: The introduction of an Indigenous Academic Liaison Midwife and an additional clinical placement in a high-volume tertiary hospital were perceived as valuable additions to the range of support mechanisms already in place for Indigenous Away-from-Base Bachelor of Midwifery students. These interventions have had a direct impact on retention, course progression and completion rates for Indigenous students. Students expressed enhanced clinical learning and knowledge retention as a result of the additional clinical placement, and the Indigenous Academic Liaison Midwife provided culturally sensitive support for students undertaking remote learning, and during on-campus intensive sessions.

Women's perceptions of social support during labour: development, reliability and validity of the Birth Companion Support Questionnaire.

OBJECTIVE: to develop and test the reliability and validity of a research instrument to measure women's perceptions of social support provided during labour by at least one lay birth companion. DESIGN: a cross-sectional study was carried out from April 2009 to February 2010. SETTING: non-tertiary hospital in the outer western region of Brisbane, Australia. PARTICIPANTS: six registered midwives and 10 postnatal women reviewed the instrument. The instrument was then completed by 293 inpatient women who had experienced a vaginal birth. MEASUREMENTS AND FINDINGS: the Birth Companion Support Questionnaire (BCSQ) was developed and its reliability and validity were evaluated in this study. An exploratory factor analysis was performed on the final instrument using principal component analysis with an oblique (Promax) rotation. This process suggested two subscales: emotional support and tangible support. The questionnaire was found to be reliable and valid for use in midwifery research. KEY CONCLUSIONS: the BCSQ is an appropriate instrument to measure women's perceptions of lay birth companion support during labour. IMPLICATIONS FOR PRACTICE: this is the first rigorous study to develop and test a measure of social support in labour which is critical at a time when policy makers and health planners need to consider the needs of birthing women and their network of support friends and family.