gms | German Medical Science

Background: Since 2020, there has been an ongoing structural transition from vocational to academic-based midwifery education. As part of this transition, the expertise of midwives, understood as practical implicit knowledge and a core aspect of professional identity, is intended to be preserved. The Hebammengesetz and the Studien- und Prüfungsverordnung für Hebammen require students to be capable of critically engaging with theoretical and practical knowledge.

Aim: Methods for imparting this expertise within midwifery education have not yet been sufficiently considered and developed. Therefore, the concept of the Key Situation Reflection Model from Social Work is used for the exploration of experienced situations in midwifery practice. Through the reflection of experienced situations, applied actions can be understood and internalized as reflective abilities.

Methods: In the midwifery program “Applied Midwifery Science B.Sc.” at the Faculty of Medicine, University of Cologne, a reflection seminar within the framework of practical guidance was implemented. Students draw from their experiences during an eight-week obstetric ward placement in the second semester. The 25 students are divided into four groups and are guided by a practical instructor for 90 minutes. Within this seminar, a student brings forward an experienced situation that has deeply affected her and remains incompletely understood. In the group, learners attempt to grasp the situation through dramatic reenactment on one hand and theoretical exploration of expertise on the other, leading to the juxtaposition of theory and practice.

In the dramatic enactment, the concept of reflection-in-action is introduced by the practical instructor. In this process, students can pause their actions in their roles and articulate the considerations and emotions they have. Subsequently, general standards from theory are compared with the practical example to find alternative actions for the case experienced.

Results: Student surveys show that real-life situations experienced by learners are essential for the development of expertise. The practical mentor can explicitly articulate the knowledge of the practice instructors as experts in midwifery, thereby making expertise accessible to the learners. Students reported that they were better able to categorize and understand the experienced situation through this method. The significance of the experienced cases for individual persons was also emphasized.

Relevancy: In academic education training for midwifery, methods for the transfer of theory to practice are essential for educating midwives as reflective experts.

Conclusion: Further research is needed with a larger number of students to evaluate whether the concept of the Reflection Seminar on Key Situations in midwifery education can sustainably generate reflective expertise among aspiring midwives.

Ethics and conflicts of interest: This abstract was written in the context of a master’s thesis. A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.