A forward thinking Midwifery Department at City, University of London has been using Patients Know Best (PKB) since 2017 to support their first year midwifery students undertaking the Midwifery BSc (Hons) Undergraduate degree. They wanted to use PKB as the Personal Health Record (PHR) during one of their modules which explores professional issues in midwifery practice. In this module, students learn about the ethical and legal framework which underpins midwifery practice (based on the Nursing and Midwifery code of practice) and develop an understanding on how caring and accountability shape the expectations and responsibilities of a modern midwife.
In their most recent use this Spring, PKB was used to help with the interactive storytelling element of the module. This allowed the students to get an opportunity to use technology in their communications with their patients and enhance the students' understanding of the holistic care of a patient. It also enabled the expectant parents to have a digital maternity care plan, which allowed the midwife full access to the symptoms/measurements and feelings of the patient.
Students were divided into different storytelling groups and worked together to play different characters in the story - a midwife or a patient. Roles were swapped halfway through the module when a new patient character was introduced - this allowed students to get experience of both roles.
Two students in each group played the role of a midwife and two students played the role of a patient, all using PKB to simulate a real life experience. The ‘patient’ students logged their symptoms, filled in journal entries and sent messages to the ‘midwife’ student all in real time.
Understanding the ‘lived experience’ of pregnancy is one of the key learning outcomes for students in this module. Students were given the opportunity to fully utilise a working personal health record giving them the chance to experience something that they will encounter when they graduate and go to work in NHS Trusts.
The Midwifery team were able to create scenarios, whereby the students would have to consider issues such as safeguarding and ethical or legal problems, they may come across in real life and be able to make decisions in a controlled learning way. Such scenarios included a patient who may be a victim of human trafficking or domestic voilence. The team wanted to see if the students picked up on indicators of this and how they dealt with it.
Programme Director at City University, Dr Mandie Scamell commented on the success of introducing PKB: “This has allowed the students to get an opportunity to use technology in their communications with their patients and to enhance the students' understanding of the holistic care of a patient. The students get to put themselves ‘in the shoes of the patient’ and start to practise compassionate care”.
Care plans were developed jointly with the City University Midwifery team and made available on their PKB platform so all of the midwives could go through them with their patients. The care plans were designed to help them assess their patients - with symptom trackers and the ability to input measurements, from fetal heart rate to patient’s alcohol intake. Experience of shared care planning and co-production was a direct learning outcome identified for the students during this module.
Students need to learn about the importance of record keeping, as the responsibility of the midwife. It gives the students the opportunity to see how important information is for the expectant parent, so they can self manage their pregnancy, what they need to look out for and when to get in touch with their midwife. For example, if they have an increase in itching, this is a symptom they should always tell their midwives about and be able to track. Maternity notes are typically kept in hard copy but using PKB these could be digitised as care plans. This enables the expectant parents to have access to their notes anytime, anywhere and allows them to share them with whomever they wish to.
Care Plans were also designed to be informational for the patients, providing support for the patient between appointments and after the child’s birth with signposts to support groups and online resources.
The use of PKB has certainly helped City University midwifery students to achieve a more varied learning experience as they attain the key module learning outcome of simulating patient and professional interactions.
Federica Andreoni, Education Project Administrator at Patients Know Best, added: “We’re delighted to continue our work with City University Midwifery course. Through the PKB platform, students work together in pairs to effect good care for their patient, making sure they respond in appropriate time frames, enter correct and justified information into the record, and follow up on areas of concern. Collaborative team working is key for students as it will help them in their future career as midwives.
For PKB, the concept of privacy by design and by default is intrinsic to our DNA, and using the software allows students to think not only about confidentiality in relation to their or their patient’s record, but also informed consent - making sure patients have an understanding of what is being done with them, not to them”.
City University Midwifery is a great example of how PKB can be used by educational partners to achieve different learning outcomes. While some education partners may find that PKB works seamlessly with one or multiple year groups for case based learning, other sites will choose to use PKB in one specific module with particular learning objectives in mind.