The Influence of the Working Environment on Midwifery Staff and Students in Relation to the Newborn and Infant Physical Examination (NIPE)

Abstract

This qualitative study explores the experiences of practitioners and students in relation to the ‘newborn and infant physical examination’ (NIPE). Previous research relating to the NIPE has given some insight into practice issues, including why midwives may have refrained from undertaking these examinations and whether it was appropriate to include the NIPE within pre-registration midwifery curricula. This study examines the views of different practitioner groups including consultant neonatologists, midwifery managers, midwives, practice education midwives and student midwives. The purpose was to gain a detailed perspective of practitioners’ experiences; highlighting and comparing themes that were similar and those that were specific to the different participant groups. Data were collected through student-midwife focus groups and semi-structured interviews with doctors and midwifery staff. The participants self-volunteered across three large NHS Trust sites that were linked to a local university within the South of England. The main findings indicate that environmental culture and interprofessional collaboration has a major impact on practitioners’ experiences and those of the student midwives. There was a notable disparity regarding consistency of training, supervision and assessment processes between junior doctors and midwives. There was a link between this inconsistency and the need for strong managerial leadership and effective collaboration between different professional disciplines. Effective and pro-active leadership was also associated with the provision of equipment, referral guidelines, usefulness of NIPE clinics, knowledge and skill updates and the unnecessary re-assessment of newly qualified NIPE practitioners. Recommendations for NIPE education, practice and future research are provided in relation to both local and national policies and practices. A key recommendation is to build interdisciplinary respect and collaboration into everyday practice, as this has a significant effect on the quality of NIPE provision.