Mechanisms of impact of a person-centred care model and simulation-based learning in midwifery education in Central Africa: A qualitative study

Abstract

Aim: To identify the mechanisms having an impact on the implementation of two profiles in a midwifery education programme in the Democratic Republic of Congo (DRC): i) a person-centred care model and ii) strengthened simulation-based learning - both on campus and in clinical practice.

Background: Midwives play a crucial role in advancing maternal and neonatal health. Therefore, it is important for midwifery education programmes to be of high quality.

Design: A qualitative process evaluation with an exploratory design was conducted. Interviews were conducted with 29 midwifery students across four focus groups.

Methods: Data analysis employed deductive and inductive content analysis, guided by an evaluation framework focusing on mechanisms having an impact on the intervention. Registered as ISRCTN10049855.

Results: The implementation of the two profiles created synergistic reinforcement, as simulation-based learning, on campus and in clinical practice, enhanced the implementation of person-centred care through practical case scenarios. Implementing person-centred care was facilitated by increased awareness of women involvement, enhanced communication and skilled faculty, but faced challenges due to cultural norms. Simulation-based learning was supported by adequate material, continuous capacity building and ensuring team safety, though hierarchical barriers in clinical settings limited implementation.

Conclusion: This study identifies the mechanisms impacting the implementation of person-centred care and the strengthened use of simulation-based learning in midwifery education. It highlights that using both profiles in campus-based education and in clinical practice creates synergy and contributes to an enhanced quality of care. The results may offer insights that could be helpful when designing and implementing a midwifery education programme in similar contexts.

Keywords: Childbirth; Implementation science; Midwifery education; Person-centred care; Simulation-based learning.