Personal costs of the continuity of care experiences

Introduction: Midwifery education standards in Australia require students to undertake Continuity of Care Experiences (COCE). The COCE afford an ongoing relationship between a midwifery student and a woman for student learning, from initial contact in the early antenatal period, through pregnancy, birth and postnatal period. When exploring student learning in the COCE, we found incidental findings of significant personal cost to students undertaking COCE.

Aim: To identify and measure these personals costs involved for students participating in the COCE.

Methods: A mixed method study was undertaken over a 12 month period. A total of 72 midwifery students across all three years of Bachelor of Midwifery programs at two universities participated through an online survey, and diary records of their time, costs and personal concerns for each individual COCE they participated in across one year. Two focus groups were held at the conclusion of the 12 months of diary collection to discuss the findings and gain a deeper insight into the student experience.

Results: Of particular interest is the personal time taken to complete the COCE and the financial costs including travelling and parking to health services, and childcare. Significant non-clinical time of travelling and being with women for extended periods in clinic waiting to see the healthcare practitioners will be detailed. Furthermore, personal safety issues, concerns about their professional relationships with staff and the impact of the COCE on their personal/private relationships will be presented.

Conclusion: When developing educational interventions it is important to consider the impact on all stakeholders, including the student experience. These findings of the true costs of the COCE for students may influence the expectations placed on students and the support provided by both education and health service providers.