title: Action research to improve the pre-registration midwifery curriculum Part. 2: Case study evaluation in seven sites in England.
abstract: OBJECTIVE
  To identify factors which facilitate and inhibit the effectiveness of current pre-registration midwifery programmes.
  
  
  METHODS
  The case study part of an action research project.
  
  
  METHODS
  Seven case study institutions in England.
  
  
  METHODS
  Student midwives, midwives, midwifery managers/supervisors of midwives, midwife teachers, collaborators in the study.
  
  
  RESULTS
  It emerged, following a synthesis of all data, that the pre-registration 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 undertaking the whole role and responsibilities of a midwife; students must be equipped to take responsibility and accept accountability for their actions; students must recognise the need for career long learning. Whilst overall these new programmes were considered to be effective in preparing students for their role as midwives, there was variability in the degree to which these five key outcomes were achieved by the case study students.
  
  
  CONCLUSIONS
  There needs to be agreement as to what constitutes fitness for practice at the point of registration; assessment schemes, particularly those relating to practice capabilities, need to be valid, reliable and robust with the benefit of the doubt being given in favour of childbearing women when students are 'borderline'; fitness for purpose requires clarification to avoid employers having unreal expectations of new qualifiers which may result in attrition due to excessive stress; review of curricula should take account of the importance of personal qualities and learning strategies which enable students to cope with complexity, uncertainty, decision making and 'being a midwife' before course completion.
authors.affiliation: Academic Division of Midwifery, School of Human Development, University of Nottingham, A Floor, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK. diane.fraser@nottingham.ac.uk
authors.forename: D M
authors.initials: DM
authors.lastname: Fraser
mesh_terms: D003479:Curriculum / Q000592:standards*; D004739:England; D006801:Humans; D008008:Licensure, Nursing; D008880:Midwifery / Q000193:education* / Q000592:standards*; D016294:Models, Nursing; D015402:Nursing Education Research; D019982:Organizational Case Studies; D012107:Research Design; D013338:Students, Nursing