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PROBLEM: Little is known about the educational impact of providing routine, online feedback from women on midwifery student learning and clinical practice. BACKGROUND: Feedback on students' clinical performance has historically been provided by lecturers and clinical supervisors. Women's feedback is not routinely collected or evaluated for impact on student learning. AIM: To evaluate the impact of women's feedback about continuity of care experiences with a midwifery student on learning and practice. DESIGN: Descriptive, exploratory qualitative study. METHODS: All second-and third-year Bachelor of Midwifery students undertaking clinical placement between February and June 2022 at one Australian university, submitted formative, guided written reflections on de-identified women's feedback they received through their ePortfolio. Data were analysed using reflexive thematic analysis. FINDINGS: Forty-four of the 69 eligible students (64%) submitted reflections on feedback received. Three themes emerged: 1) Confidence boosting, 2) Deeply integrating Midwifery Metavalues, and 3) Enhancing commitment to continuity. Three subthemes: connection, future practice and advocacy were identified. Women's feedback positively impacts student learning and places the woman in the educational feedback loop. CONCLUSION: This study is an international first evaluating the impact of feedback from women on midwifery students' learning. Students reported greater confidence in their clinical practice, a deeper understanding of their midwifery philosophy, and an intention to advocate for, and work in, midwifery continuity models after graduation. Routine feedback about women's experiences should be embedded into midwifery education programs.

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INTRODUCTION: ePortfolios are increasingly used in health professional clinical education. However, the nature of ePortfolios varies greatly amongst programs, as does the software, purpose, and institutional cost. OBJECTIVES: An integrative review of the literature was conducted to determine how ePortfolios are being used in pre-registration health programs to enhance clinical learning. DATA SOURCES: A systematic search of relevant databases (Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Center, Cochrane, Medline, ProQuest, PubMed, Turning Research Into Practice, and Web of Science) was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Retrieved papers were assessed using the Critical Appraisal Skills Programme tool and findings were analysed. REVIEW METHODS: A total of 272 records were identified. Thirty papers were assessed in detail. Five themes were identified by content analysis; feedback and communication; student-centred learning; experiences and competencies; access, attitudes, and digital literacy; and technological support. CONCLUSIONS: ePortfolios offer a range of pedagogical benefits. Clinical learning is enhanced by student-focused ePortfolio design which includes clear learning outcomes; development of relationships with peers and instructors via ongoing communication and feedback; use of templates; links to time-saving applications; and guided, assessed reflections. Poor technological support, negative attitudes by clinical supervisors, unreliable access, instructor-focused design, and excessive or repetitive documentation in ePortfolio design hindered clinical learning.

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BACKGROUND: Pre-registration midwifery students in Australia are required to engage in a minimum of ten continuity of care experiences (CoCE). Students recruit and gain consent of each woman to provide CoCE under direct supervision of a registered health professional, usually a midwife. Clinical outcomes for women who had CoCE with a midwifery student placed in a continuity of midwifery care (CMC) or fragmented models are rarely reported. AIMS: 1. analyse clinical outcomes for women experiencing CMC with CoCE by students; 2. analyse clinical outcomes for women in a fragmented care model with CoCE by students; and 3. compare clinical outcomes according to women's primary model of care. METHODS: Students undertaking a Bachelor of Midwifery program at one Australian university recorded clinical outcomes for women experiencing CoCE during pregnancy [n=5972] and labour and birth [n=3933] in an e-portfolio. A retrospective, cohort design compared student recorded maternal data with National Core Maternity Indicators and Queensland Perinatal Data. RESULTS: Midwifery students providing CoCE reported better or equal clinical outcomes for women compared to population data. Women receiving CoCE had reduced likelihood of tobacco smoking after 20 weeks of pregnancy, episiotomy, and third and fourth degree tears. CONCLUSIONS: Clinical outcomes for women in fragmented models of care and receiving CoCE by undergraduate, pre-registration midwifery students are equal to or better than State data across 12 variables. CoCE should be offered to all women early in their pregnancy to ensure optimal benefits. Acknowledging midwifery students' potential to make positive impacts on women's clinical outcomes may prompt more health services to reconceptualise and foster CoCE.

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AIM: This study describes a novel framework used to evaluate the feasibility of an online survey to routinely collect women's feedback about their continuity of care experiences with Bachelor of Midwifery students during the clinical practicum. BACKGROUND: The extent to which secure online platforms can efficiently distribute surveys and collect routine feedback from women receiving continuity of midwifery care experiences by Bachelor of Midwifery students needs to be effectively assessed and evaluated. METHODS: Using a co-design approach, the teaching team, program software developers, information technology and cybersecurity experts, students, consumers and clinical placement officers were consulted in development of survey content and processes. RESULTS: A novel framework for evaluating online surveys was developed with a focus on survey content, processes, web technology and outcomes. CONCLUSIONS: The online survey was found to be reliable, valid, reproducible, efficient and easy to access by women with a response rate of 56% achieved. Only 0.4% of surveys were opened and not completed. Accuracy of electronic addresses was increased by adding two text-match fields in the consent form and sending a confirmation email when first completed. Application of this novel framework is recommended when developing and evaluating online surveys for educational and research purposes.

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BACKGROUND: Pre-registration midwifery students in Australia undertake a minimum of ten continuity of care experiences with childbearing women. However, women are rarely asked to formally evaluate this care by students. AIM: To evaluate data from a routine, web-based survey of women about having a midwifery student provide a continuity of care experience. METHODS: All women (n=886) recruited by a midwifery student for a continuity of care experience during a 12 month period received an email inviting them to complete an online survey. The survey included personal details, experiences of care, and two scales on Respect and Satisfaction. RESULTS: A response rate of 57% (n=501) was achieved. On average students attended six antenatal visits (mean=5.83) and had six postnatal contacts with women. Most students attended labour and birth (92.6% n=464). Most women rated overall satisfaction with care by their student as 'better than they had hoped'. Positive correlations were found between number of antenatal visits and postnatal contact with students on both levels of satisfaction and respect felt by women. Women felt more satisfied when their midwifery student attended labour and birth. CONCLUSIONS: The online survey was feasible and provided valid and reliable feedback from women about their student during a continuity of care experience. Women valued having an ongoing relationship with a student during pregnancy, labour and birth, and postpartum. Pre-registration midwifery education programs should continue to privilege relationship-based care and national standards should support the effective integration of continuity of care experiences.

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