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Midwifery in UK and areas that require improvement

Module Learning Outcomes

1. Identify and demonstrate critical understanding of the need to continually evaluate and improve practice.

2. Demonstrate the ability to conduct a comprehensive search for research and evidence to inform practice and the development of the midwifery profession

3. Discuss the contribution knowledge, research and evidence makes to service improvement and to the development of the midwifery profession.

4. Analyse how practice and women centred care can be developed through a range of tools such as service improvement, service evaluation methodologies and audit

5. Synthesise and appraise an extensive range of evidence to inform service improvement and/or the development of the midwifery profession.

6. Critically analyse ethical issues in the practice of research and service improvement/evaluation.

7. Make recommendations for practice improvement, identifying barriers and challenges of implementation

8. Critically reflect on own learning and the contribution of learning to professional development

2. Assignment Brief
Assessment Guidelines Outline
For your dissertation, you will be expected to identify an area of enquiry relating to Midwifery practice, undertake a critical literature review relating to your chosen topic, identify aspects of practice which require improvement, and develop a service improvement plan relating to one of these issues. The dissertation must demonstrate achievement of the learning outcomes above.
See below for more detailed guidance

Dissertation Guidance
What is a literature review?
A literature review is a comprehensive study and interpretation of the literature on a specific topic. Literature reviews make an important contribution to evidence based care. They do this by critically appraising evidence in a systematic way to identify what is known an aspect about of practice; they are also useful in revealing gaps in our knowledge and aspects of health care that need improvement.
What use are literature reviews?
As well as informing practice decisions, literature reviews are also used as a basis for health care policy and guidelines, for the development of service user/carer resources, as articles for publication and in applications for funding for research grants. On an individual level, undertaking a literature review will help you develop a range of useful skills, both practical and academic. These include; sourcing and handling large volumes of information, critically appraising evidence, expressing ideas clearly in writing and planning how to improve practice. Given the ever increasing volume of publications and research available, the ability to select and analyse high quality evidence in a time-efficient way will be a useful skill throughout your career and in many aspects of your practice as a health care professional.

What will I need to know?
This dissertation will draw on the knowledge and understanding of research and the intellectual skills you have built up during your programme, particularly through your studies of Evidence Based Practice. Timetabled sessions have been arranged during the dissertation module for you to refresh your skills, for example, in academic writing and critiquing skills.

What does the dissertation involve?
The dissertation offers a chance to explore in depth a specific aspect of practice that is of interest to you and that you believe requires improvement. The first step is to choose a subject to focus on of a contemporary midwifery practice issue. It is helpful if this is something you are interested in and will sustain your interest over a number of months. You will identify a specific question, then search, review and critique the literature on this topic. This will enable you to identify implications for practice and suggest recommendations. The final component is to develop a service improvement plan, outlining how one aspect of the topic you have reviewed could be put into practice.
What is service improvement?
Service improvement has been described as; “the combined and unceasing efforts of everyone… to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)”, (Batalden & Davidoff 2007). For the midwifery dissertation, the need for service improvement can be identified from the perspective of women and their families, the midwife or from wider policy and health drivers.

What support will I receive?
You will be allocated a supervisor from the Midwifery team who guide and support you whilst you are undertake your dissertation. This support will be arranged on an individual basis between you and the supervisor, based on an individual learning contract and action plan. It is good practice to contact your supervisor early in the module run in order to make the most of the time available. In addition to this individual support there are timetabled sessions with the Module Leader and other faculty staff.

Suggested Structure for the Dissertation
Word count 6,000 words
The 6000 word count begins at the start of Chapter 1 and ends at the end of chapter 4. There is no +/-10% leeway. The word count does not include: The title page, dedications or acknowledgements, list of contents, abstract, reference list, or appendices.

Title Page
ABSTRACT (200 words, not included in the word count)
● Include sections: Purpose, Method, Findings and Conclusions.
● References are not normally required here. Do not use abbreviations in the abstract.
● Identify up to 5 key words
● Include a summary box, at the end of the Abstract, summarising what is already known about the topic and what the review adds

Chapter 1: INTRODUCTION (approximately 500 words)
The purpose of this chapter is to outline the context in which your study was undertaken, it
● Sets the scene and gives reasons for the review and its relevance to practice.
● Outlines the controversies, debates and challenges in relation to the specific area of enquiry.
● Includes specific questions or areas to be addressed in the review
● Identifies at least one aspect from the literature review on which a service improvement plan will be developed
Remember, the choice of topic must have a midwifery practice focus.

Chapter 2: METHODS (approximately 500 words)
The purpose of this chapter is to outline and justify the methods used to source the evidence. The process must be rigorous and transparent
The chapter should present your search strategy, which should include the following:
● Key words and MeSH terms (Medical Subject Headings) or Subject Headings or Thesaurus Terms used.
● The databases used, with a rationale for their choice
● The inclusion and exclusion criteria used to refine your search.
● The results of your search. How you came to selecting the final choice of research papers must be clearly identified. This may be presented as a flow diagram and must be included in the appendices,
● Documents and other sources used, with a rationale, e.g. indexes, bibliographies.
● The critiquing framework you selected or developed, and the rationale for this.
● An acknowledgement of the limitations of the material you have accessed.
● The identification of the main themes to arise from the literature search. These themes will then be explored in Chapter three.

Note on using non-UK literature:
It may be necessary to include non-UK literature to ensure the most relevant evidence is captured. However, you must consider issues of transferability and generalisability of international evidence to the UK setting and your particular area of practice and give a justification for its inclusion.

Note on date of publication:
You should draw on evidence which has been published within the last 10 years. Older items may be included if these are seminal works or there is a lack of more recent evidence but justification must be provided.

Chapter 3: CRITICAL REVIEW of the literature (approximately 3000 words)
The purpose of this chapter is to provide a critical review of the available evidence on your selected topic. This will include an, in-depth review of primary research and reference to other sources of evidence if relevant which will help you answer your question or specific area of enquiry. You may wish to organise this chapter into sub-sections which reflect the main themes/findings to emerge from your review. In summary, this chapter should;
● Focus on the questions or specific area of enquiry identified in the introduction.
● Identify, compare and contrast the findings from the research evidence evidence. (You must choose between 4-6 primary research studies)
● Critically review the research and other sources of evidence if relevant.
● Show evidence of your ability to synthesise and evaluate information by making connections between what you have found from reviewing and critiquing the literature and applying this to midwifery practice.
● Draw out recommendations and identify areas for service improvement and select one of these to develop in chapter four.

Note on number of key papers:
To achieve the learning outcome ‘to critically analyse a range of evidence’ it is anticipated that you will need to critique between four and six key pieces of primary research evidence. Other types of evidence such as service evaluation, audits, guidelines and secondary research could be included but you do not need to critique these in detail. Please discuss this with your supervisor. You may find it helpful to prepare a summary table of the key evidence. You can refer to this as you are preparing the chapter and then include it in the appendices.

Chapter 4: PLAN TO IMPLEMENT SERVICE IMPROVEMENT (approximately 2000 words)
The purpose of this chapter is to focus on one aspect from the literature review where service improvement is required and develop a service improvement plan.

● Select one of your key findings from Chapter 3 where service improvement is required and provide a rationale for your choice. The rationale should link to the aim or specific question of your review that was identified in the Introduction.

● Present a service improvement plan outlining specific ways in which the change you are proposing could be implemented. Consider aspects of change management and barriers to practice/change.

● Suggest ways in which the service improvement could be evaluated

● Provide an overall conclusion to your dissertation. You may conclude with a brief reflection on your key personal learning.

Reference List
Formatted in UWE Harvard style, listed alphabetically.
This is optional: if including, it must be formatted in UWE Harvard style.
Please include the following:
● A flow diagram of your search strategy
● A summary table of the key papers reviewed in chapter three.
NB. Further detailed guidance is available on Blackboard in the learning materials section and also in the ‘Frequently asked Questions’ (FAQs) section.

The word limit is 6,000 words.
If you exceed the word count the marker will stop reading once the word limit has been reached and nothing further will be taken into account in the allocation of marks. The word count needs to be clearly and correctly stated on the title page of the assignment. Incorrectly understating the word count constitutes an assessment offence and may result in further action.


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