Discovering the invisible: Transformative learning experiences of midwifery students to support physiological birth during continuity of care placements in Québec's freestanding birth centres
Bibliographic record
Abstract
BACKGROUND: Despite international consensus advocating a physiological approach to childbirth, there are inconsistent opinions on how to acquire the competencies needed to successfully carry out this approach. While continuity of care experiences (CoCE) within placements is a valued educational strategy, there are limited studies that focus on the learning experiences to support physiological birth. AIM: To describe and understand the learning experiences related to physiological birth, as well as the transformations required to become a midwife who supports physiological birth, during the CoCE placement process in a birth centre. METHODS: An interpretive description study design was adopted. Data were collected through audio diaries (n=126) with midwifery students and preceptors (n=14) across four level of placements in birth centres, in Québec, Canada, and discussion groups with students who kept the audio diaries. RESULTS: Three main themes were identified: 1) appropriating culture: relational autonomy; 2) developing competencies: acknowledging attitude, enabling behaviours and narrative skills; 3) constructing identity: coherence and resistance. DISCUSSION: The findings demonstrated the importance of CoCE, along with the continuity of preceptorship and a low-tech environment as optimal educational strategies for the acquisition of a culture and competencies that promote physiological childbirth. Resistance is part of identity transformation and represents an opportunity for critical questioning and safe feedback. CONCLUSION: This study contributes to the understanding of the nature of the competencies developed and the transformations experienced to support physiological childbirth. It recognises the primacy of CoCE within extended placements, embedded in a workplace culture and environment that support relational autonomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.014 | 0.008 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.001 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".