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Background: The NMSF (2009) survey reported that bereavement midwife care was inadequate in a number of UK NHS Trusts. Using a small grant from the Scottish government, 3 experienced midwifery lecturers designed an interactive workbook called "Shaping bereavement care for midwives in clinical practice" for the purpose of improving delivery of bereavement education to student midwives. An instrument called the Understanding Bereavement Evaluation Tool (UBET) was designed to measure effectiveness of the workbook at equipping students with essential knowledge., Aim: To assess validity and reliability of the UBET at measuring midwives' self-perceptions of knowledge surrounding delivery of bereavement care to childbearing women, partners and families who have experienced childbirth related bereavement., Method: An evaluative audit using the UBET was undertaken to explore student midwives' (n=179) self perceived knowledge levels before and after the workbook intervention. Validity tests have shown that the UBET, (6-item version), could be considered a psychometrically robust instrument for assessing students' knowledge gain. PCA identified that the UBET comprised two sub-scales (theoretical knowledge base - Q 1, 2 & 3 and psychosocial elements of care delivery - Q 4, 5 & 6)., Discussion: Data has shown that the easy to administer and short 6-item UBET is a valid and reliable tool for educators to measure success at delivering education using the "Shaping bereavement care for midwives in clinical practice" work book., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Aims and Objectives: This element of the larger Scottish evaluation aimed to explore differences between access routes, cohorts and higher education institutes (HEI) (universities and colleges) in levels of self-efficacy, student support and self-reported competence in a nationally representative sample of student nurses and midwives., Background: This paper reports findings from the National Review of Pre-Registration Nursing and Midwifery Programmes in Scotland. Fitness for practice curricula have been the heart of many recent developments in nurse and midwifery education. Fitness for practice set out to map out the future direction of preregistration nursing and midwifery education with the aim of ensuring fitness for practice based on healthcare need. There have been no national evaluations of the effectiveness of this strategic objective. Previous major evaluations in the 1990s suggested that students may not have had the skills needed to be fit for practice., Design: The study design was a cross-sectional survey of a stratified random sample of student nurses and midwives (n = 777). Data collected included demographic information, generalised perceived self-efficacy, student support and self-reported competency., Results: Students reported high levels of self-reported competency. There were no significant differences between two cohorts or between students with different access routes. Students rated support from family and friends highest and support from HEI lowest. There was a significant difference in support levels between HEI. Self-efficacy scores were similar to other population means and showed small-moderate correlations with self-report competence. Similarly, self-reported competency appears to be at the higher end of the spectrum, although older students may have a more realistic perception of their competence. However, support from HEI was seen as less satisfactory and varied from one institution to another., Conclusions: This study portrays a relatively positive picture of preregistration fitness for practice curricula. Questions are raised about the relative value students place on support from educationalists and mentors and whether support from family and friends and from peers needs to feature more prominently in curricula. The study provides modest support for social cognitive theory., Relevance to Clinical Practice: The major drivers for changes in preregistration curricula stemmed from fears about the competence of students. This study did not provide support for this viewpoint, and students' self-reports suggest that curricula are, in this respect, meeting their objectives. Nevertheless support from mentors and from educational institutes may need to be improved.

This article presents findings from a survey of 186 first year nursing and midwifery students that relate to their smoking and alcohol consumption. Of the students sampled, 28% were cigarette smokers. This is higher than the smoking rate of 25% for the adult population in the UK. The majority of the students who smoked said that they would like to stop smoking. Most of the students (86.5%) reported having drunk alcohol on at least one occasion during the previous week, with 26.5% having had a drink on three or four days. The amount consumed over the week ranged from no drinks to 90, with the mean being 13.72.Worryingly, 74% had exceeded the daily benchmarks for low-risk drinking on at least one occasion during the week for which consumption was reported, and 55% were drinking at binge levels. The findings raise concerns for the future health of many of our students and for their roles as health promoters.

Objective: The primary aim of the study was to evaluate the effectiveness of two approaches to increase research awareness among midwives and nurses., Design: Quasi-experimental with the attitudes of staff in the two groups being measured at two points (January and October 1997)., Sample: All midwives and nurses working in four clinical areas in an acute NHS Trust. The intervention arm of the study involved all midwives and nurses in the Clinical Directorate of Obstetrics and Gynaecology, while the control arm involved all nurses working in a specialist oncology and haematology unit and in the children's directorate., Ethics: The Joint Ethics Committee considered approval unnecessary because the study involved staff and not patients., Data Collection: Data were collected by self-complete questionnaires., Interventions: A programme of education with policy and practice interventions targeted at ward sisters., Outcome Measures: Staff attitudes to, knowledge of, and level of involvement in, research., Results: The study demonstrated a significant increase in both knowledge and use of research resources. Following the programme of education, staff in the intervention group were significantly more likely to use resources associated with research utilization and to report that they had read a research paper within the last month., Study Limitations: The time scale of the intervention was restricted by the funding available; a significant Hawthorne effect was evident with both groups showing an increase in knowledge; the pragmatic nature of the study meant that it was not possible to randomize the study groups; the scale of the study did not permit an economic evaluation., Conclusions: The introduction of clinical governance challenges healthcare providers to improve the care they deliver. There are huge opportunities for Trusts to invest in developing staff knowledge and use of research. However, staff will only seize these opportunities if there is an appropriate, enabling environment--an environment that delivers intensive interventions and is sensitive to the wider structural factors in the NHS affecting staff morale and commitment. In the absence of this environment, what may be seen as opportunities to managers may be regarded as just another burden by staff.

Aim: To develop a research-based conceptual model of midwifery practice., Design: Qualitative using grounded theory., Setting: Midwifery practice in New Zealand and Scotland., Participants: 250 midwives and 219 clients from the two countries., Findings: Data from the participants provided the contextual background as well as the major categories. Forming the background were the concepts of: beliefs, colleagues, culture, experience, expertise, education, environment, friends, families, intuition, knowledge and professionalism. The major categories of the model which emerged from the data were: attending and presencing, supplementing and complementing, reflection and reflexivity. These are discussed as pairs while the basic social process (core category) of reciprocity embraces the whole midwife-client relationship., Conclusions: This model offers the beginnings of documentary evidence of the essence of the midwife-client relationship and may go some way towards the creation of a written body of midwifery knowledge. It has potential applicability for both midwifery education and practice.

Concern continues to exist about the lack of integration of research into clinical practice. One of the reasons which has been suggested for this, is that practitioners may either not know about, or understand, the research findings. The availability of a database which contains systematic reviews of research such as the Cochrane Pregnancy and Childbirth Database, should go some way to overcome such obstacles associated with the implementation of research into practice. As part of a national audit on Caesarean section, a computer with the Cochrane Database was installed in the labour ward of each consultant maternity unit in Scotland. The purpose of this study was to determine if midwives working in labour wards make use of this accessible source of research findings to inform their practice. Anecdotal evidence suggested that although midwives were keen to use the databases, they did not have the requisite computer skills to do so. This study examined the computer literacy of midwives and their perceived educational needs. A questionnaire was distributed to all labour ward midwives in 22 consultant maternity hospitals in Scotland (n = 850). This questionnaire considered issues such as the preparation of midwives to use computers, midwives' perceptions and use of computers and their perceived educational needs. The response rate was 74%. Following analysis of the questionnaire labour ward managers were interviewed by telephone to ascertain their views regarding the Cochrane Database and their perception of its effectiveness. The results highlighted that only 27% of midwives claimed to use the Cochrane Database on a regular basis. Overall midwives had a positive attitude towards information technology but claimed they did not have the requisite computer skills to use these tools. Managers agreed that there was a need for further instruction and support for midwives. The findings of this study have important implications for the future professional preparation and continuing education of midwives.

This paper describes aspects of the introduction an adult branch programme of a Diploma of Higher Education in Nursing course in a Scottish college of nursing and midwifery. It is argued that the Diploma of Higher Education in Nursing course represents a move from a so-called apprenticeship approach, that is the Scottish 1982 Modular Scheme of General Training, to a so-called academic approach under the auspices of the Project 2000 proposals which have been described as the most major development in the preparation of nurses in the UK for many years (UKCC 1986). This paper will discuss the challenges and difficulties encountered when designing the theoretical aspects of the course with respect to the nursing component. The implications of some of the major changes within the scheme of preparation for the clinical areas where the students gain experience will also be discussed. It will be suggested that practice supervision, a development of apprenticeship, is the way ahead.

A research project was undertaken to evaluate the extension of midwifery training in Scotland. The evaluative criterion used was the new midwives' employment decisions. The data on students' valuation of their training suggest that they regard their time as having been well spent and other data show that socialization into midwifery increased with the longer training. Confidence in midwifery skills did not change markedly in association with the extension of training. Certain benefits of the longer course anticipated among midwives, are shown by these data not to have happened.