Exploring factors that may optimise learning from and working within continuity models of midwifery care

Background Maternity policy and guidelines increasingly recommend or stipulate the increased provision of midwifery continuity of carer as a priority model of care. The scale up and sustainability of this model will require that student midwives are confident and competent to provide continuity of carer at the point of qualification. Guidance relating to how to optimally prepare student midwives to work within continuity models is lacking. Aim To explore perspectives and experiences of the effectiveness of the pre-registration midwifery curriculum for optimal working within continuity models of care, and to prepare recommendations for effective working within and learning from this model of care. Methods This MRes project utilised an integrative literature review to identify barriers and facilitators to optimal working within continuity models of care, and online surveys, for student midwives and midwives, to explore perspectives and experiences of their preparation for and learning within continuity models of care. The results of the literature review and survey were analysed using reflexive thematic analysis and from a critical theory perspective. Findings The literature review emphasised the need to prepare students with regard to the intent and expectations of continuity within the curriculum and to establish a related philosophy across the programme and to practice. It also highlighted the need to prioritise continuity of mentor and to ensure students are supported through strategies to establish professional boundaries and strong education-practice partnerships. A continuity toolkit and continuity coordinator will be useful to complement these strategies. The surveys confirmed these findings and emphasised the need for organisational support for continuity models, which needs to be optimised to support working in a way that aligns with the philosophy of continuity of carer. Prioritising woman centred care as foundational to education and facilitating the critical deconstruction of dominant discourses that conflict with, and may prevent this form of practice, will ensure women are optimally supported regardless of model of care.