gms | German Medical Science

Background: Critical reflectivity is a core competency for midwives and is enshrined as a study objective in the German Midwifery Act. It facilitates the integration of theory and practice and is associated with enhanced professional identity and greater job satisfaction. However, models of reflection used in midwifery education are often borrowed from other disciplines and have not been evaluated for use with midwifery students. The holistic reflection model developed in Australia by Bass has not yet been utilized in German-speaking countries.

Aim/research question: What adjustments are necessary to implement the Bass model in an undergraduate midwifery program to promote students’ reflective abilities effectively?

Methods: A working group of the institute plans the step-by-step adaptation of the model for implementation in the study program after the translation of the model guideline. The following aspects were discussed: 1) cultural alignment, 2) alignment with the curriculum, and 3) alignment with the structure of practice in the study program.

Results: The basic structure of the Bass model was assessed as universally relevant to the profession and was adopted without modification. Reflection is depicted as a holistic process that occurs both individually and collectively and encompasses all levels of knowledge. The model is divided into six interdependent phases within a reflective cycle and aims to develop skills for a holistic reflection practice in students.

Adjustments were made in the following areas: 1) Cultural alignment: The Bass model incorporates the concept of cultural safety, which is closely linked to the history and society of a colonized country like Australia. Instead, the concept of intercultural competence was used. 2) Curricular and 3) practice alignment: The Bass model encompasses a complex structure of different applications, formats, and forms of feedback (including reflective writing/conversations; feedback by peers, supervised women, and lecturers). Implemented were written practice reflection reports starting from the second practical module with feedback from faculty, as well as reflection by students in structured discussion groups (student support circles) to reflect on practice experiences.

Relevancy: The Bass model is based on a woman-centered and holistic approach to midwifery. Validation studies from Australia indicate that working with the Bass model leads to an improvement in written reflective capability, and that midwifery students rate working with the model as beneficial to their own professional and personal development.

Recommendations/conclusion: Experiences in the practice phases are challenging for midwifery students. Reflecting on these experiences helps to train critical thinking and a constructive approach to the theory-practice gap. The next step should be to evaluate, in collaboration with the authors of the Bass model to what extent the adaptations made have an impact on the effectiveness of the model.

Ethics and conflicts of interest: A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.