Assessment of midwifery practice skills in a distance based blended learning course

Introduction / Background

The learning contract, which is the focus of this post, is an assessment in the first year practice skills course in our undergraduate midwifery degree programme.  Although this three year degree has been running for around 16 years this is the first year on the new model of course delivery. I have described this course in detail in previous blog posts. The new undergraduate degree programme is very similar in content to the previous programme however the process of delivery has changed dramatically this year. In this post I discuss the learning contract and explain why we are using this as an assessment in this course I also explain how this assessment is presented to the students and how it is marked.

What assessment in being used in the practice skills course?

One of the main assessment tools that is being used in this course is  a learning contract. The students are required to identify a learning need around a midwifery practice skill. They have to identify the knowledge they already have about this and what it is that they need to learn. Students then explain how they will go about meeting these learning needs, what resources they will access and how they will improve their knowledge and/or experience with the skill. Students thenrecord what they have learned and what, if anything they still need to do to feel confident in their knowledge of the skill.  Finally the student prepares a reflective piece about their experience of undertaking this project. This assessment gives the student 50% of the  mark in the practice skills course.

Why is this assessment being used in this course?

This assessment forms part of the students Midwifery Practice Portfolio. The Portfolio is a structured document outlining all the practice experiences a student has during the three year degree programme. Students also reflect on their learning and experiences within the portfolio.  They maintain a record of the skills practiced and competence achieved with these skills.  The portfolio also provides a mechanism for reflection on midwifery practice and professional relationships with women and colleagues.  Portfolios have been identified as a useful tool to assess learning and competence amongst health professionals and are commonly used in nursing (Joyce, 2005; McMullan, Endacott et al, 2003; Scholes, Webb et al, 2004). The professional portfolio has been identified as a useful tool to develop critical thinking, promote adult learning and is geared to the individual needs of the learner (ibid). Portfolios are a required component of the recertification programme for midwives in New Zealand (http://www.midwiferycouncil.org.nz/main/Recertification/)

As a component of the portfolio, learning contracts also fit within the pedagogical framework of adult learning. Anderson and Boud (1996) suggest that learning contracts are useful assessment tools for flexible learning courses. Learning contracts support and encourage student autonomy and responsibility with regards to learning. Anderson and Boud recommend that  learning contracts should be used across the course and should not be a single isolated assessment tool within a course. Within the learning contract students  identify when, what, how and why they will learn a particular skill, they perform a self assessment of their own learning and provide evidence to corroborate this, they also identify their future learning goals.  This prepares the student well for the reality of midwifery practice where lifelong learning is essential (Boud, 2000). It will give the student a model to follow as they progress from undergraduate midwifery education to midwifery practice. It is an important aspect of practice, for students and midwives, to identify learning needs and how these learning needs can be met.

How this assessment is is being implemented

Students have been encouraged to use the learning contract process to identify their learning goals, learning activities and learning achievements within the portfolio and are being asked to identify one skill which they will submit for assessment and marking within the practice skills course. They have been given a table, within the portfolio, as a guide to help identify the process they need to follow to do this.  Students have been asked to keep their topic focused on the skills which they are learning  in the first year of the programme and will record their learning experience and reflections on this experience. The learning outcomes for the practice skills course are

  1. demonstrate an ability to use communication skills to develop effective professional relationships with their peers and colleagues.
  2. utilise an awareness of effective communication to enhance the quality of the childbearing experience for women and their families.
  3. safely perform a range of selected practice skills and be able to outline their underlying theories and rationale.
  4. accurately perform drug calculations and demonstrate skill of medication administration.

This assignment is designed to meet outcomes 1, 2, and 3.

In the course outline students have been asked to identify a situation in practice where a midwifery assessment has been carried out and write a reflective account of this experience. Students then develop a learning contract relating to this subject area. The student reviews her existing knowledge around the subject area and identifies her learning goals. She then reviews how these goals will be met and verify that they have achieved these goals. Students have also been given guidance within the portfolio to demonstrate how they can prepare and present this learning contract.

As the assignment date approaches students have been asking questions about this assignment. While I believe this is a good assignment technique in this course I am not sure that we have clearly articulated how this relates to the learning outcomes. I think this assessment will develop, change and grow for subsequent years.  I am interested to see how the students work with this assignment.

Is this assessment appropriate?

As described above there is a rationale for this assessment. Student are only now engaging with the process for submission of their learning contract. This may be because I am only getting my head around it too at the moment. I welcome your thoughts on this. If you are an educator of undergraduate health students do you think this would be a good way for your students to learn or be assessed? Are their any suggestions you have where this process could be better? I welcome any feedback on this. Please leave your comments in the comments tab below this post. Many thanks for coming to my blog and reading this post.

Conclusion

This post has outlined the learning contract which the most significant piece of assessment in the practice skills course in the first year of the undergraduate midwifery programme at Otago Polytechnic. Learning contract has been identified as a useful assessment tool for flexible learning, supports adult learners and gives the student skills which support lifelong learning. This is further described within the learning outcomes of the course, information in the course outline and within the portfolio document.

References

Anderson, G. & Boud, D. (1996). Introducing learning contracts: a flexible way to learn. Innovations in Education and Training International, 33, (4). 221-227.

Boud, D. (2000). Sustainable assessment: rethinking assessment for the learning society. Studies in Continuing Education, 22, (2). 151-167.

Joyce, P. (2005). A framework for portfolio development in postgraduate nursing practice. Journal of clinical nursing. 14, (4). 456-463

McMullan, M.,  Endacott, R.,  Gray, M. A.,  Jasper, M.,  Miller, C.,  Scholes, J.,  Webb, C. (2003). Portfolios and assessment of competence: a review of the literature. Journal of Advanced Nursing. 41, (3). 283-294

Scholes, J.  Webb, C.  Gray, M.  Endacott, R.  Miller, C. Jasper, M. McMullan, M. (2004). Making portfolios work in practice. Journal of advanced Nursing. 46, (6). 595-603

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6 Comments

  1. This is an spectacular entry. Thank you very much for the supreme post provided! I was looking for this entry for a long time, but I wasn’t able to find a authentic source.

    Reply
  2. thank you so much for this latest information i wonder if you can send me some of latest information regarding assessment of midwifery skills and other assessments of job availablity.

    i’am happy to hear you soon.
    thank you .

    Reply
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