 Right, so before I hand over to our presenters, I'd like to tell you a bit about what we are going to tell us. Childbirth is a popular topic for mainstream factual television. Reality TV shows like One Born Every Minute and The Living Babies are trans-led audiences. But it was unclear how that might influence students' decision to study medri-free. The objectives were to investigate students' midwifes' experiences of viewing childbirth on mainstream factual television and to explore implications for career intentions and potential pedagogical uses of television except in midwifery education. Following four focus groups and sematic analysis, four main themes were agreed upon. One, change perspectives on televised childbirth through its representations of midwifes and social implications. The other is the representation of childbirth and social implications. Four is the role of television, televising childbirth in midwifery education. So in this session, our presenters, Hannah Slap and Bicis Bennett will discuss the research that was undertaken, the findings with explanations and conclusions that have followed from their research, including future recommendations. So I would hand over the presentation now to Hannah. Let her tell us more about her work. Thank you very much, Hannah and Bicis. Thank you, Jennifer. I hope everyone can hear me. So I just wanted to say hello and welcome, especially on today's International Day of the Midwife. So today, as we've said, we're talking about student midwives' views and experiences of birth on mainstream factual television. For those that don't know me, I'm Hannah and I will be presenting with Beatrice. We're both student midwives at the University of Nottingham and have been involved in this project through a cascade funded grant, which we'll talk a little bit more about towards the end. The last time we presented this, B actually unfortunately couldn't attend the conference due to being in isolation after returning from travels to Milan. So once again, this is another interesting platform to present purely online. We are very glad to be a part of the programme and to share our research with so many other great people from around the world. This project followed on from Julie Roberts's early work on televised childbirth and how this influences perceptions and expectations. Whilst it is unknown, whilst this is known, sorry, reality television shows like One Born Every Minute attract large audiences. It is unclear how this might influence perceptions on the midwifery profession, especially students. There is national and international concerns about this. However, up until this project, no student midwives have been involved, which is somewhat shocking as it has been suggested that reality television shows may influence the students' decisions to start midwifery. Hi, Beatrice. Sorry to interrupt you, but we can't hear you. Your line is breaking. It's not very clear at all. Hi, Beatrice. Sorry, Beatrice. Beatrice, your line is not clear. Beatrice, I wonder if I can call you instead and put you on loudspeaker. Or Beatrice, if you just log out of the audio and try and come back in, it often corrects itself. We can wait for a few minutes. Yes, thank you. Sorry, everyone. Thank you for joining us anyway. If anyone's got any questions so far. Hi, Beatrice. Your line is still not clear. We still cannot hear you. Hannah, is it possible to take over until you're able to spot Beatrice just found out? I can try and get around loudspeaker if she answers the phone. See if we can do it that way. Hi, Beatrice. Can people hear things this way or no? Hannah, is it possible to take over? Yeah, let me just get some notes up. Can you guys hear me this way? No, no. There's a lot of feedback if you can take over please. Yeah, let me get some notes up. So our current literature has been talked about a little bit. So as we've mentioned, this project builds upon previous work of Julie Roberts, who explored midwives' very critical views on televised childbirth, including concerns that birth were represented as risky and overmedicalised, and that midwives were not represented in a positive light. Nevertheless, the media have linked televised childbirth when increased applications to midwifery education at university. But there's been no published research on this. While there is considerable interest in the use of mainstream television clips in health sciences education, there's been much less published evidence on the acceptability of using television clips in midwifery education, where TV representations are controversial. So our main aims were to explore student midwives' views and experiences and perspectives on the way childbirth is represented on mainstream factual television. This was then split further into focused objectives which included views prior to training, representations of midwifery and childbirth, and then a focus specifically on education and the use of it at university level programs. We adopted a qualitative methodology approach to explore our research question. We recruited 24 student midwives from two universities, respectively based in the East Midlands and Yorkshire regions of England. Potential participants received an email inviting participation and contacted the researchers directly for more information. Focus groups took place at participants university base and each took roughly an hour and was audio recorded as well. We collected data through four focus groups which were recorded with informed consent. Participants were aware of the principles for focus groups including but not limited to confidentiality, mutual respect and avoiding overlapping speech to improve clarity of the recordings. A focus group topic guide was developed considering existing literature, existing evidence sorry and agreed by the research team. This was a semi-structured characterised by open-ended questions in order to encourage participants to share their perspectives on the study topic. Transcripts were read and reread to identify the relevant themes. We completed line by line manual thematic analysis across the entire data set. A first round of thematic analysis was conducted by the two co-researchers, myself and Bea, and then under the guidance of two senior researchers as well to identify emergent themes. The final coding was agreed with all the team members. Once thematic analysis was complete, four main themes were decided upon and these were further broken down into sub-themes. Through the methods mentioned already which we'll now discuss in more detail. Importantly, all team members were in agreement with the final themes. I actually don't have notes on these slides because these ones were mainly these so I'll do my best to talk over them but please forgive me if I don't go into them as quite as much detail as they deserve. So the first theme is change perspectives on televised childbirth and this was split into these four sub-themes. So before students started studying university a lot of them expressed that they did used to watch televised childbirth especially one born every minute but this changed as they started to study and learn more about midwifery. They discussed that it was seemed as a guilty pleasure and that they felt a little bit sneaky to watch them but they still enjoyed it just somewhat in secret. They expressed negative feelings towards the show because they found that with their increased knowledge base they were getting cross at what was shown on the TV and like I've said their knowledge base meant that they viewed it differently. They also found that talking to other midwives it wasn't the professional norm to watch it and interestingly some students were advised that if they mentioned it in their interviews they might actually be disadvantaged at the interview stage to get into the program. In terms of representations of midwives and social implications this was sort of how the students viewed the midwives as getting viewed on the television shows. So first of all they felt that it made midwives seem like obstetric nurses in that they weren't actually doing the job that the students were taught they were doing and it changed the expectations of the midwives roles. So it portrayed them negatively which students felt might make women and the public feel frightened of women when they come in. So they might have a negative portrayal of the midwifery profession. They also thought that the public would view them in not a way that they wanted to be viewed in that they might just be drinking tea and eating cake rather than actually doing the job that they're meant to be doing. And they also felt that it influenced the public on choosing midwifery so that some students may only get this is their only education and it might be seen as what am I trying to say? They see it as an easier job than what it really is which can contribute to the big burnout rate. Onto the third theme which was the ways in which childbirth is represented on television was recognised by participants to have potential social implications as well. Student midwives first responses were to describe representations of childbirth on factual television as unrealistic, over-edited, medicalised and highly dramatised. They felt that with their newfound knowledge of childbirth and the process that goes into interpartum care they could dissect that which was shown on television and realised it was not true to the care provided in reality. They went on to express concern over the consequences of these representations for the public including the possibility that women could come to fear labour. They felt this influenced what the women then anticipated and in a couple of focus groups the absence of the third stage of labour was brought up which as we know is very rarely shown. Having said this the students did recognise the limitations of televised childbirth and some were sympathetic to the directors and editors who had to make an engaging and entertaining show for the public. Participants were also able to identify examples when television shows both factual and fictional have broken the stigma around sensitive topics such as stillbirth, postpartum depression and postpartum psychosis. These shows were seen to have potential value in raising awareness reflecting people's experiences and even preparing the public for rare situations that could occur. They were also noted to be perhaps the only education women might get on these experiences due to the stigma associated with them. Our final theme involved directed questions regarding the potential use of television in midwifery education. It was initially met with scepticism but upon an example being given most students thought it could be useful. They felt if it was used alongside other resources it would be a good way to help with different learning styles. Some students remained unsure about their use and would instead prefer to use real life hands-on experience through placements. Some students remained hesitant about the potential value and felt that in any case they had better opportunities to learn in practice. Visual learners felt television excerpts could be a benefit to their learning style and that it would make lectures more interactive and engaging instead of being talked at for two hours. This theme was further developed as some experiences are not easily come into practice and television experts could be used to fill the gap. For example, obstetric emergencies. Plus one group explained the variation in student placement experience for some not attending Labour Suite in first year at all. Finally, although the focus group discussed factual television called the midwife and other non-factual shows did get briefly mentioned naturally. Students found the form particularly useful and commented that it would be beneficial to use this as a source of midwifery care from a historical perspective. It also identified appropriate care which was compassionate and involved a model of caseloading midwifery therefore providing an insight for students who do not get the opportunity to see this. So they were our four main themes and I think it is really valuable insight from what we gained. In terms of the strengths and weaknesses of this the strengths and limitations from the strengths perspective it was an innovative study area that hadn't been previously researched and the sample includes student midwives with a vast range of experiences both from previous prior to their studies but also vary throughout the year groups. It was a multi-site study which shows similar themes between the two areas and it also empowers student midwives to express their perspectives, opinions and concerns on televised childbirth. The educational purpose of the study was really unique and again we'll talk about a little bit more later on but it was also great that it contributed to a larger project and built upon previous work. The qualitative study enabled detailed and rich data and a fantastic opportunity to have student midwives involved as co-researchers as well. In terms of the limitations of research we were met with a disappointing number of individuals and focus groups. There was first of all a reduced number of students registered and then on the day some people didn't show up however this is somewhat expected and due to the nature of the research the small sample size is common but of course we've got lots of rich data. In some ways by involving students in the research it is hoped to raise the profile of research involvement in the future. Another related to the sheer size of the research team the number alongside other commitments they each had meant 14 meetups were rare although we had constant email communication and smaller teams met up regularly. As mentioned the involvement of student midwives has been a huge positive but the one slight negative of this meant that they knew some of the participants on a personal basis and although we did not lead the focus groups where this was applicable we were present which may have biased the results. So the qualitative research design enabled an exploration of this novel topic and detailed and rich data was collected as you've seen from our findings. Admissions advice that some students mentioned about not talking about the programs is somewhat concerning. It is felt by the research team it may exclude potential midwives who do not otherwise have access to this insider knowledge. Student midwives reflect and evaluate their relationships with the representation of their profession through television and the lack of realism and critique of the content reduced their enjoyment which may have been seen as a shame. There was also lots of concerns voiced around representations of childbirth from a public perspective and its implications and finally the role in midwifery education is a valuable one but needs careful consideration. For our recommendations for the future we discussed four key areas. It may be useful for students to have support during their training for students to reflect on their pre-existing attitudes and how to effectively support childbearing women whose views may have been influenced by watching births on television. Similarly several avenues need to be explored in developing an understanding of childbirth in the media. This is particularly important in the context of the rapidly expanding industry of birth photography and calls for midwives to become more media savvy in order to influence how childbirth and midwives are represented in the public. For future research it would be useful to investigate whether the media contributes to potential midwives forming unrealistic expectations of the role and how to mitigate this to prevent burnout and drop out rates plus explore the effectiveness of using television experts in specific aspects of midwifery education. Whilst this type of research is more common in medical and nursing education it could easily be replicated in the context of midwifery to inform educational practice. This project and the involvement of student midwives was actually funded by University of Nottingham Cascade grants at previous presentations. We have had comments on the actual funding behind the project and what the main project was so we just wanted to touch on that a little. These slides are actually taken from Sara Borrelli's previous presentation and four details of the project can be found in an upcoming publication in Midders in September. The code in the University of Nottingham both include research within them but currently the modules students partake and do not involve actually engaging in practical elements of research itself with the closest part being a research proposal. The project aimed to enhance the student experience by allowing a small selection of students to acquire first-hand experience of the research process and then evaluate this to see if it could be translated onto a larger scale. Students were split into two teams and were involved in all areas of the research activities following ethical approval stage so we didn't have to get involved from the very beginning but once the research properly started that's when we got involved. We got involved in post-do seminars and learning experiences. We presented at International Day of the Midwife last year as well as this year. We did workshops presented into our lecturers and also the rest of the division and recently one of the projects is presented at the Normal Childbirth Conference and this project was presented at the Royal College of Midwives Research Conference. In terms of the dissemination we've done poster presentations and oral presentations. We're hoping to have both projects having a published research paper and also the educational publication coming out in September. The presentation focus group came out with three things which you can hear about then. Again, these are supposed to be slides so I haven't looked into them too much but our overall project journey as a student was to first of all submit an application for involvement. This was a competitive process and out of the applications six students got selected and this was either students at the very end of their first year or the start of their second year. We then got introduced to the team so that we knew who we would be working with throughout and then we were split into our projects between us so two of the students were working on this project and four of the students on another. We began by discussing the research so we knew exactly what we were going to be doing and we got involved immediately in developing specific guides with a semi-structured basis of themes and topics. We then recruited students through emails from the faculties at both sites and facilitated the focus groups. So the first two focus groups were facilitated by one of the researchers and then the third and the fourth were each facilitated one by me and one by Beatrice and we got to facilitate them as well. Data was analysed as described and Beatrice and I did the main body of this to begin with and then discussed our findings with the rest of the research team and we have presented our findings at multiple different conferences and posters. We are hoping to submit our publication very soon and have loved being involved in it and reflecting on the project throughout our year. So what have we gained as students? We've gained an understanding of the value of evidence-based practice. So we're being able to apply the theory to practice and critique it. We've experienced the difficulties of research so as I've mentioned the recruitment stage was quite difficult but also for me personally I really struggled or not struggled but I found the hardest part of the data analysis just because it took so much time and every time we got together as a group it felt like we were starting from scrapped again and at some point you have to have an end to it because you could just constantly change the themes. We also developed other mid-release skills such as communication by working as a team but also developing those skills within the focus groups especially when we were facilitating them learning to actively listen and also manage people to prevent them from overlapping and personalities getting too big. Flexibility in our approaches resilience, confidence especially through presentation and organizing because we've done this alongside our full-time undergraduate studies. We've also had a great sense of achievement during all of this. It's great to be able to present our findings and it's really made it really worthwhile but also an insight into the role of the midwife as a researcher and some of us are considering it as a future career path. So overall we've loved being a part of it and excited to see how this will affect the future of the programme as well given our feedback. Thank you for listening and a quick note to say if there's any more questions we're more than happy to answer them. Well I'm more than happy to answer them. Thank you very much Hannah. That is an amazing piece of work you have done. So we now welcome questions to our speakers. If you have any questions you can ask Jane Marshall an excellent reflection. I hope your lecturer gave you a hundred percent. I agree with her. It wasn't actually involved. It didn't go towards our undergraduate programme so we weren't exactly marked on it. Yeah. Jackie Sert is so important to appreciate the difficulties of your work and research. Help us to be respectful to research of others. Definitely. I think it's definitely opened all our eyes to research and one of the students one of the students mentioned that it's made her more more considerate to others asking for people to be involved in their focus groups and I think we're all now going to be happy to be involved in them to help give it back. Awesome. Hannah, is this research that other students reading your cohort also benefited from or it was just new and Beatrice, you went through the experience. So Beatrice and I were the only ones involved in the actual research project but some of the it's hoped that following the findings of the focus group it may be that some sort of module or optional content will be involved in the future of the program so that it can be something more students can do in the future and it will contribute them to your undergraduate degree. Good. Thank you very much. So what would you recommend future students should watch to prepare for the reality of clinical practice? This is from Jane. Sorry, can you say that again? I missed the start. What would you recommend future students watch to prepare for the reality of clinical practice? Oh, you know, I kind of think that a lot of students don't get the opportunity to actually do clinical practice, well not students, before they become students they don't get the opportunity to go into hospitals all the time so sometimes the the factual television shows like one more in every minute although since we've done this research it has actually stopped being recorded but sometimes they're the best thing that we've got to give an example of how it works. I think some of the more modern programs are probably more consistent with what you actually experience in practice. I believe the Highland Midwife which is the Scottish one and then a lot of people in the focus groups mentioned Emma Willis delivering babies so although she's not actually acting as a midwife, she's a maternity support worker, it does follow some of the midwives and shows what they do as well in their jobs. Thank you, thank you. Laura says well done B and Hannah for carrying on despite the technical difficulty. Thank you. So this has been a practical activity so sadly no credit for this but you have gained so much more and inspired other students to engage in research and this project is a testament to the work ethic of these students going above and beyond their already busy curriculum. So thank you very much Hannah and Gage. It's great to see so much support from everyone especially some of our lecturers. Can you guess which ones they are? Yes, of course. And Sarah Matthew says very, very good presentation on the findings of the students research project saying again that future students currently are unable to gain any work experience due to COVID-19 so that was the reason behind her question. Yes, definitely, totally understand that and I think students do appreciate the insight that they can get. I just, I think what's come out of it is that a lot of students as they learn in the program realise that it's not quite true to value there needs to be something in place to help students realise that before it's sort of too late. Do you have any more questions, contributions, comments? Great work and presentation Hannah and B from Rachel. So thank you very much if we don't have any more questions or comments do we have any more? No, none for me.