Action research to improve the pre-registration midwifery curriculum Part 2: case study evaluation in seven sites in England

Objective: to identify factors which facilitate and inhibit the effectivene ss of current pre-registration midwifery programmes. Design: the case study part of an action research project. Setting: seven case study institutions in England. Participants: student midwives, midwives, midwifery managers/supervisors of midwives, midwife teachers, collaborators in the study. Findings: it emerged, following a synthesis of all data, that the pre-regis tration midwifery curriculum should have five key outcomes: students should feel confident and competent as midwives; students must have achieved the statutory requirements for registration; students should be committed to un dertaking the whole role and responsibilities of a midwife; students must b e equipped to take responsibility and accept accountability for their actio ns; students must recognise the need for career long learning. Whilst overa ll these new programmes were considered to be effective in preparing studen ts for their role as midwives, there was variability in the degree to which these five key outcomes were achieved by the case study students. Implications for practice: there needs to be agreement as to what constitut es fitness for practice at the point of registration; assessment schemes, p articularly those relating to practice capabilities, need to be valid, reli able and robust with the benefit of the doubt being given in favour of chil dbearing women when students are 'borderline'; fitness for purpose requires clarification to avoid employers having unreal expectations of new qualifi ers which may result in attrition due to excessive stress; review of curric ula should take account of the importance of personal qualities and learnin g strategies which enable students to cope with complexity, uncertainty, de cision making and 'being a midwife' before course completion. (C) 2000 Harc ourt Publishers Ltd.