Early hands-on experience in clinical practice

Background and challenges

In Norway, one must first qualify as a nurse and gain two years of nursing experience before starting a two-year midwifery program. The program combines theory and clinical practice, similar to many other countries. At the University of South-Eastern Norway (USN), the goal is to prepare students as thoroughly as possible before they enter clinical practice, helping them maximize their hands-on experience and graduate as confident midwives. One challenge has been teaching clinical midwifery skills within a limited timeframe before students begin their clinical rotations. To address this, USN has implemented GynZone as a systematic part of student preparation just before clinical placement.

Implementation

USN has purchased suturing kits for the classes to be used at the university in combination with their GynZone license. Additionally, USN recommends that students purchase their own suture starter kits to complement GynZone’s e-learning content. These kits are used during four hands-on workshops at the university, where students use GynZone e-learning content in preparation for the workshops. The workshops are scheduled for the final week before students begin their clinical rotations, after which they have completed their exams and assignments and can fully focus on both the e-learning and the workshops. Furthermore, the training remains fresh in their memory when they enter the delivery rooms.

During the workshops, the educators focus on diagnostics, anesthesia and pain management before diagnosing and suturing, basic surgical skills, and suturing first- and second-degree tears.

USN and GynZone have today been working together on simulation training and e-learning since 2015.

The impact

• All students sutures at least a first- or second-degree tear within the first two weeks of clinical practice—some also repaires episiotomies
• Early mastery of knot-tying and suturing skills boosts confidence in the clinic
• Improved focus on pain management and greater confidence in advocating for better anesthesia during suturing

Conclusion

The University of South-Eastern Norway and its educators have received evaluations from hospitals and their clinical supervisors reporting that the students’ competencies in diagnostics and suturing are very strong. Clinical supervisors have shared that they feel confident allowing students to take an active role early on. They have been reassured by the students’ knot-tying skills, thanks to the GynZone e-learning content and the workshops held at the university.

Through early hands-on experience in clinical practice, the students become confident and competent in perineal repair, which not only enhances their ability to focus on other clinical midwifery competencies but also boosts their confidence as graduate midwives.