Examination of the Newborn (EXON) Pilot Project for under-graduate student midwives: an update.

In November last year I published a blog on the first pilot project I undertook with five under-graduate pre-registration midwifery students which was designed to enable them to qualify with the skills and competencies around examination of the newborn (EXON). The students were required to access and study the module with post-graduate midwives. Four of the students successfully completed the course in September 2014 with one student leaving early on in the project due to unforeseen family circumstances. The journey to completion was not smooth. The first hurdle was a clash of assessments. The EXON assessment (a presentation) fell in the same week as Complex Care (CC), a third year unit assessment where students are required to undergo a VIVA and manage two obstetric emergencies. It is a stressful experience and therefore three of the students requested an extension to their EXON presentation with only one choosing to present with her post-registration colleagues. As the EXON assessment took place on the Monday of that particular week and Complex Care assessments were running over three days, the student managed to negotiate to undertake her CC assessment on the Friday. The three students were re-scheduled to present later in the year with a number of other midwives who were on extensions or resits.  One of the advantages of choosing to present in January 2014 was that the student was able to choose a topic that she could use both for her learning around EXON and for her extended essay which was due to be completed somewhat later in the academic year. The student was successful in both endeavours as were all the others but at a later date.

Another hurdle students found themselves confronted with, was a lack of opportunity to undertake newborn examinations including a shortage of midwifery mentors who could support the training requirements of the project. Two of the students could not get any of the examinations done in their own trusts. Fortunately for them, the maternity unit and midwifery staff at Poole NHS Trust Hospital were extremely obliging and supported the students to work there which enabled them to complete the practical newborn checks. All four of the students have successfully qualified as midwives and have obtained midwifery posts in the local area. They remain committed EXON and have volunteered to be EXON ‘champions’ within their respective trusts. I am grateful to Jeanette Elliot, Luzie Schroter, Jenna Penhale and Bex Coleman-Moss for their hard work and dedication during the pilot and for their feedback and advice for the next intake.

Demand for places for the second pilot project remained high when the call was put out a short while ago. Unfortunately due to some of the barriers described above it was only feasible to recruit five students again and all of them based in the west. The students have commenced their studies and are enjoying the learning so far. The pilot projects are helping to inform what impact these barriers will have on the training needs for midwifery students within our local maternity units as this year we are introducing EXON theory to all midwifery students on our newly validated curriculum with the caveat that students will obtain the necessary theoretical knowledge but not all with qualify with the required skills. However by ‘fast-tracking’ students onto one of our twice yearly CPD EXON modules which has around 20+ midwives enrolled, by the time the students reach their third year there should be many more midwives qualified in EXON and in place to support our under-graduate students to gain the competencies around newborn examination.  If you require any further information please contact Luisa Cescutti-Butler on lcbutler@bournemouth.ac.uk