A case study exploring the definition and application of the concept of woman centred care in a pre-registration midwifery education programme

Green, Sarah

Abstract

Woman centred care is a concept frequently promoted as a core aspect of midwifery practice, policy and education. However, woman centred care often remains ill-defined and an elusive feature of clinical practice. The impact of woman centred care as part of pre-registration midwifery education is underreported and has largely only been investigated as a theoretical concept. Consequently, there is limited evidence of how pre-registration midwifery education not only understands woman centred care but how the concept is contextualised into clinical practice environments.

A case study methodology, according to Yin’s deductive framework (Yin, 2014) was utilised to investigate student midwives, midwifery lecturers, Heads of Midwifery and the Lead Midwife for Education perceptions and experiences of woman centred care as part of a pre-registration midwifery programme. The single case study was based on a UK based university that typified pre-registration midwifery programmes. The case study methodology identified pre-ordained theoretical propositions and related variables that guided the entire research design. The case study also aligned to a critical realism ontology with a belief that there was an objective reality to be discovered.
The sampling strategy involved programme documents, semi structured telephone interviews and a focus group. Collectively these were analysed using Yin’s (2014) pattern matching and explanation building data analysis strategy. This strategy identified the extent to which the findings aligned to pre-ordained theoretical propositions alongside the identification of rival explanations that could not be explained through the data.

The case study found that the theoretical concepts of choice, control, mutual collaboration, continuity of care and individualised care were indicative of a pre-registration midwifery programme promoting woman centred care. However, there was differentiation in the understanding and experiences of these concepts that impacted on the ability for woman centred care to be contextualised in clinical practice. The differentiation was influenced by the powerful tendencies of professional identity, type of clinical context, ideologies, the profile of a woman and organisational aspects such as time constraints and policies. As a result, the student midwives were caught between often competing expectations between the university and the clinical practice context.
The study contends that woman centred care needs to be reconceptualised so able to integrate often currently competing ideologies and therefore, able to meet the changing future needs of woman centred care. New models for a critical realist framework and a programme planning tool for a contextual application have been developed as part of new understanding for woman centred care in pre-registration midwifery education.

Citation

Green, S. A case study exploring the definition and application of the concept of woman centred care in a pre-registration midwifery education programme. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/1490789

• Thesis Type: Thesis
• Publicly Available Date: Nov 26, 2019
• Keywords: woman centred care, midwifery education , case study
• Public URL: https://uwe-repository.worktribe.com/output/1490789
• Award Date: Nov 26, 2019