EXAMINATION OF THE NEWBORN FOR MIDWIVES - 2019/0

Module code: NUR3200

Module Overview

The module aims to develop skills for complex assessment of the newborn. These systems would include theoretical and practical knowledge of the central nervous system, respiratory system, cardiovascular system, gastrointestinal system, genitourinary system, skin, musculoskeletal system and the special senses. This will enable analysis of clinical cases to develop diagnostic skills focusing on neonatal problems for the above body systems. In addition analysis of current frameworks for assessment is developed to include critical analysis and reflection on the practitioner’s role and evidence of contribution to the development of the role. Evidence of autonomous and advanced practice and critical analysis of the evidence for practice is explored.

Module provider

School of Health Sciences

Module Leader

BROWN Anna (Health Sci.)

Number of Credits: 30

ECTS Credits: 15

Framework: FHEQ Level 6

Module cap (Maximum number of students): N/A

Overall student workload

Module Availability

Year long

Prerequisites / Co-requisites

Module content

Neurological development

embryology and fetal development of the neurological system

adaptation to extra-uterine life

the neurological abnormalities that can be detected on examination in relation to this system

the neurological common problems in relation to the well neonate

the explanations and information that is given to parents

the information from maternal history that is required to relate findings to management

choice of a specific neurological problem and outline the management and the short and long term care and prognosis for that neonate

exploration of the processes involved in integrating parental and professional model of care

Repeat as above for each of the systems below:

Cardiovascular system

Respiratory

Gastrointestinal

Urogenital/ chromosomal sexual differentiation

Musculo-skeletal

Sensory organs – including skin

Metabolic and Endocrine system

Immune system – infection

Genetics/Embryogenesis- dysmorphology

Assessment pattern

Assessment type	Unit of assessment	Weighting
Pass/Fail competencies	PORTFOLIO	Pass/Fail
Coursework	CASE STUDY	100

Alternative Assessment

N/A

Assessment Strategy

The assessment strategy is designed to provide students with the opportunity to demonstrate

development of skills in the examination of the newborn underpinned by a sound knowledge base to support clinical practice. Skills development is within the context of holistic care and therefore the emphasis is on recognition of the theory and practice to develop and expand these new skills, which are based on evidence based practice.

Thus, the summative assessment for this module consists of:

PRACTICE ASSESSMENT

Forty (40) newborn clinical assessments in placements (Pass/Fail)

THEORETICAL ASSESSMENT

CASE STUDY which will focus on the following elements and will require:

Critical analyses of the full physical examination of the newborn, including history and findings relating this to evidence based practice

Parent education as a teaching activity throughout the examination

Identification of professional implications for this extended role in midwifery practice

Theoretical marking grid at level 6

(100% of the module mark)

A workbook is provided to complement the theoretical component. Each student is expected to work through a series of questions in the workbook, designed to facilitate active learning. The midwife will develop appropriate levels of understanding in relation to both normal and abnormal physiology

5 Reading Logs expected and these must be well structured and adequately demonstrate how the content is relevant to practice. Good analysis must be demonstrated, identifying methodological issues etc.

Reflections must be sensitive, analytic and integrated to current practice. One or two are sufficient to demonstrate progression from the first examination of the newborn to the final assessment carried out. Identifying a reflective model on which to base the structure of this section must be included.

The above are submitted as part of the final portfolio and are awarded a Pass/Fail

Feedback

Through Surrey/ Learn

Module aims

The module aims to prepare midwives to undertake the complete physical examination of the healthy newborn, between 37-42 completed gestational weeks. This examination will replace that which has traditionally been undertaken by a paediatrician or a GP. The rationale for the neonatal examination conducted within the first 24 hours and days after delivery will be to detect any signs of acute illness or abnormalities, to allow prompt diagnosis and intervention without which many of the acute conditions which afflict newborn babies can lead to serious consequences.
The midwife as the lead professional is increasingly expected to manage a caseload, diagnose and refer appropriately and communicate effectively with a variety of other disciplines and the multidisciplinary team.
However, in the interest of clients, this constantly changing and expanding role requires midwives to develop new skills and competencies, which necessitate appropriate education. This module seeks to develop such skills, underpinned by a sound knowledge base to support clinical practice. Skills development is within the context of holistic care and therefore the emphasis is on recognition of the theory and practice to develop and expand these new skills, which are based on evidence based practice.
This new role undertaken will enhance independent and autonomous practice whilst improving continuity of care and facilitate more timely discharge of babies from the postnatal area, reducing paediatric workload. In addition such a role will enable birth at home to be easily facilitated where the GP has not been contracted to provide neonatal examination.

Learning outcomes

		Attributes Developed
001	Assess the physiological adaptation of each system in the fetus-neonate and relate these to a competent examination of the newborn and critically evaluate the relevant research studies to underpin best practice in the care of the newborn and demonstrate systematic newborn assessment and physical examinations within clinical settings.	KP
002	Critically evaluate the evidence and research base of new approaches to judgement and decision-making in relation to risk factors in the care of the newborn, applying skills of systematic and holistic assessment of undifferentiated newborn problems to make accurate diagnoses, safe management plans and appropriate referrals.	CT
003	Analyse and evaluate contemporary issues in the field of neonatology using appropriate evidence to determine the involvement of the multidisciplinary team, through referral to a paediatrician and the need for any urgent intervention through locally agreed channels.	CP
004	Consider critically the ethical, legal and moral dilemmas parents may encounter when faced with a deviation from the normal in the newborn and to improve skills of the midwife in breaking bad news using effective communication skills.	CP
005	Critically evaluate and reflect on own learning and practice as a means of improving care for newborn babies, acting autonomously, using skills acquired, within guidelines of supervision.	CP
006	Demonstrate systematic newborn assessment and physical examinations within clinical settings	P
007	Apply complex skills of systematic and holistic assessment of undifferentiated newborn problems to make accurate differential diagnoses, safe management plans and appropriate referrals	PT
008	Act autonomously, using skills acquired, within guidelines of supervision.	PT

Attributes Developed

C - Cognitive/analytical

K - Subject knowledge

T - Transferable skills

P - Professional/Practical skills

Methods of Teaching / Learning

Study Days

7 study days in theory on the following: assessment strategy, history taking, and peer evaluation, accountability in advanced practice, clinical reasoning and diagnosis in certain conditions of a number of body systems as applicable to the newborn eg heart sounds, hip assessment and respiratory conditions

Delivery of the module:

Teaching will be by interactive lectures/discussions/seminar presentations and practical experience.

Students will be enrolled through VLE Surrey learn for blended learning using e-learning technology. Academic component of the assignment will be submitted on line. Practice component of the assignment will be submitted as paper copies.

For legal and professional implications, it is important that all examinations of the new born undertaken throughout this module should also be examined by a suitably qualified practitioner (paediatrician or midwife with the qualification of examination of the newborn). A practice assessment document should be used to record all findings on each examination. For those examinations which midwives will undertake without supervision it may be useful to compare notes with the results of the examinations of the same babies conducted by the paediatrician? This will give them “practical” feedback regarding the adequacy of their own examination and interpretations of the findings. It is the midwife’s responsibility to seek further experience if certain routine conditions have not been encountered by the completion of the required number of examinations.

Self-directed study

Self directed study will be the primary process of learning with students taking responsibility for their own educational development. Students are expected to develop skills in reflection and negotiate appropriate clinical experience to achieve specific skills required to expand this role. A workbook is provided to complement the theoretical component.

Indicated Lecture Hours (which may also include seminars, tutorials, workshops and other contact time) are approximate and may include in-class tests where one or more of these are an assessment on the module. In-class tests are scheduled/organised separately to taught content and will be published on to student personal timetables, where they apply to taken modules, as soon as they are finalised by central administration. This will usually be after the initial publication of the teaching timetable for the relevant semester.

Reading list

https://readinglists.surrey.ac.uk
Upon accessing the reading list, please search for the module using the module code: NUR3200

Please note that the information detailed within this record is accurate at the time of publishing and may be subject to change. This record contains information for the most up to date version of the programme / module for the 2019/0 academic year.