Course Syllabus ©National College of Midwifery 2014
03/2014
Course Title: MSM MW570- Midwifery Research Methodologies
Course Credit: 4 Credits
Course Description: This course is an introduction to scientific research methods as
they apply to midwifery and health sciences. The course gives a detailed description of
the key concepts of both qualitative and quantitative approaches to research. All of the
core concepts for designing a research proposal are covered in this course. This course
requires the student to apply an understanding of research methods and create a poster
project that should be presented in a MCH conference venue.
Course Objectives: After completing this course the student will:
 Understand the importance of research to midwifery practice
 Be familiar with the process of writing a research proposal
 Understand the ethical and legal considerations for undertaking research
 Understand the power dynamics that are at play between researchers and their
subjects
 Understand a variety of different approaches to qualitative and quantitative
research design
 Understand the principles of mixed methods research
 Understand the principles of population selection and sampling
 Understand data collection approaches to qualitative and quantitative research
 Understand data analysis techniques for qualitative and quantitative research
 Understand the principles of disseminating research
Learning Activities:
(See Course Assignments)
1. Student reads appropriate sections from the Learning Materials/Resources.
2. Student practices the process of writing research proposals, as well as various
legal/ethical issues regarding research.
3. Student practices using statistical methods required for evaluating research.
4. Student answers questions.
5. Student writes papers.
6. Student conducts interviews.
7. Student creates survey using SurveyMonkey.com
8. Student creates Poster presentation
9. Student present poster presentation at midwifery conference
Learning Materials / Resources:
Please use textbooks less than 5 years old or most recent edition.
1. (Textbook) Jirojwong, S et al. Research Methods in Nursing and Midwifery:
Pathways to evidence-based practice. Oxford University Press. 2011
Course Syllabus ©National College of Midwifery 2014
03/2014
2. (File Downloadable from NCM Website) Green, J. M. (2012), Integrating
Women's Views into Maternity Care Research and Practice. Birth, 39: 291–295.
doi: 10.1111/birt.12003
3. (Online Resource) SUNY DOWNSTATE MEDICAL CENTER EVIDENCE
BASED MEDICINE TUTORIAL. Suny Downstate Medical Center. 2004.
http://library.downstate.edu/EBM2/contents.htm
4. (File Downloadable from NCM website)Tutorial: How to Form an Answerable
Clinical Question. Cincinnati Children’s Hospital Clinical effectiveness specialist.
2004.
A note about the textbook:
As is made obvious by the title of the main text used for this course, it is based in a
perspective of hospital-based midwifery and references the field of nurse extensively.
Unfortunately, the field of direct-entry midwifery research in the US is still in the early
stages of development, therefore we have no academic texts that reflect the principles
and values of our own profession within the field of research. This text was chosen
because it is accessible, and written for teachers and learners. Please bear in mind that
although it may not always speak directly to midwifery practice the concepts provided
can, in most cases, be applied to research in the field of midwifery.
Evaluation Tools / Methods:
Minimum passing grade for all courses is a cumulative 80% / B-. Students and
preceptors are encouraged to work together until the student masters 100% of the
information.
Evaluation is based on demonstration of comprehension of concepts and completion of
written assignments. The preceptor will evaluate the written activities for each lesson for
completeness, comprehension, and professional presentation. Answers should be
referenced when appropriate and written work should be typed and well organized. This
course is graded on a pass/fail scale. The student must achieve a grade of at least 80%
to pass. The difference between undergraduate and graduate credits is not one of
quantity, but of quality, as assessed by the preceptor.
Course credit:
One Academic credit equals approximately 15 hours of formal time plus 30 hours of
additional study or homework. Formal time is defined as the amount of time taken to
answer the Learning Objectives to the level of 80% and to complete any learning
activities to the preceptor's satisfaction, including any time spent face to face with the
Course Syllabus ©National College of Midwifery 2014
03/2014
preceptor. Informal time includes any time spent actively reading relevant sources and
textbook/s, researching Learning Objectives, and studying for examinations.
Course Assignments:
Reading and writing assignments are to be complete by the student with supervision of
the preceptor. Read each chapter and take notes before answering the questions for
each lesson. Focus on learning the key concepts and terminology of each lesson before
answering the questions provided. We encourage students to spend time reviewing
these concepts with the preceptor to insure that each is well understood. These
concepts are the foundation of this course as well as Evidence Based Midwifery
Practice.
Lesson 1: Read Integrating women’s views into maternity care research and practice
by Green
1. Write a reflection paper on how you think “women’s views” might be integrated
into midwifery practice through advances in research about out-of-hospital birth.
Address the following question in your discussion:
a. Would listening to “women’s views” significantly change the way midwifery
is provided in the US?
b. How important do you think “women’s views” are to the work that
midwives do?
c. To what extent to you think “women’s views” are incorporated into current
research in maternity care?
Lesson 2: Read Chapter 1: The importance of Research in Nursing and Midwifery
1. Write a two-page reflection based on your personal experiences. List three major
changes in direct-entry midwifery as a profession over the last 10 years. To what
extent have education and research made an impact on or motivated these
changes?
Lesson 3: Read Chapter 2: Introducing the research process
1. Create an outline for a research proposal. List all of the steps necessary to
complete the proposal.
2. Discuss the ways in which many practitioners develop a research topic or
problem.
3. Discuss the importance of a literature review in understanding a perspective
research topic.
4. Discuss how a frame of reference is developed within a research study.
5. What does ‘defining the significance and outcomes of research’ mean? Why is
this important when identifying a research topic?
Course Syllabus ©National College of Midwifery 2014
03/2014
6. Discuss some important questions that the midwife-researcher must ask in order
to generate a research question that is suitable for research.
7. Create a budget for the research proposal outline in question 1.
8. Create a timeline for the research proposal outline in question 1.
9. Access your local library or online database and select a research article that
you find interesting and easy to understand.
a. Write down the headings used in the article and compare them with those
used in the chapter. How are they similar? How are they different?
b. Identify the purpose of the study.
c. Identify the hypothesis or research question being studied.
d. Discuss if the hypothesis is directional, non-directional or null.
10. Read the proposals at the end of the chapter and apply b-d of question 9.
Lesson 4: Read Chapter 3: Ethical and legal considerations in research practice
1. Discuss a historical event that has lead to the ethical evaluation of human
subjects research.
2. What role does a human research ethics committee (HREC) play in evaluating a
research proposal?
3. Explain the difference between confidentiality and anonymity.
4. Discuss why data management is important to the quality of a research project.
5. Describe the power relationship between researcher and participant. What
influence might this have on research outcomes?
6. Discuss how recruitment of clients within a midwife’s own practice might pose an
ethical issue.
7. Discuss the principles of informed consent and how they apply to midwifery and
midwifery research.
8. Discuss why a plain language statement is necessary
9. Review the MANAstats informed consent document. Does it use plain language?
Does it fully explain what is being requested of the participant? Are there ways
that this informed consent could be improved?
Lesson 5: Read Chapter 4: Vulnerable groups as research participants
1. As a midwifery student you are interested in carrying out a small community
health project. Discuss the populations that comprise your community, are any of
these populations “vulnerable” as discussed in the chapter. What important
issues might need to be considered before commencing your research? Write a
1-2 page reflection paper on your answer.
2. What is the meaning of vulnerable in the context of midwifery research?
3. Under what circumstances, as a midwife, would you most often encounter a
“vulnerable” population?
4. What type of research will elicit the most accurate information about the lives and
needs of these populations?
5. Discuss compensation and incentives in recruitment of research populations.
Course Syllabus ©National College of Midwifery 2014
03/2014
Lesson 6: Read Chapter 5: Qualitative research design
1. Discuss how grounded theory could be a useful research method for
investigating the following areas of midwifery practice:
a. Performing aseptic technique
b. Clinical decision-making
c. Providing culturally safe (appropriate) care
2. Discuss the central concepts that underpin ethnographic research.
3. In what ways could ethnography be used in midwifery research?
4. Find an ethnographic study that explores the culture of midwifery, read it and
share it with your preceptor.
5. What aspect of midwifery could benefit from using a critical social theory or
feminist research approach?
6. Formulate a research question and rationale based on your answer to #5.
7. What are some issues of inequality that face midwives today in the United
States?
8. Discuss an area of midwifery that could benefit from an action research
project.
9. Describe two areas in which action research might be an appropriate tool for
initiating change in your practice setting.
10. Discuss what is meant by “qualitative research”
11. What are the main features of qualitative research?
12. What type of questions would be best suited to a qualitative research design?
13. What do you see as the relationship between qualitative research and
midwifery practice?
Lesson 7: Read chapter 6: Quantitative Research Design
1. Read through the chapter summary and “implications for evidence based
nursing and midwifery”.
2. What are the characteristics of quantitative research?
3. Discuss the placebo effect. How might this effect a quantitative research
study?
4. Discuss the concept of causality as it relates to quantitative research.
5. Discuss the difference between quasi-experimental and experimental
research design.
6. Perform Problem Solving 6.1 on page 160.
7. From the following list, which is likely to be the most precise measure of hand
washing?
a. Direct Observation
b. Self-reporting of hand washing
c. Measuring hand-washing product usage
8. Identify a research design from the following research objectives or questions:
Course Syllabus ©National College of Midwifery 2014
03/2014
a. Will increasing the number of home visits by a midwife to women who
are experiencing postpartum depression increase self-confidence in
their ability to parent?
b. Will clients with gestational diabetes who receive health education from
peers control their blood sugars better then clients who receive health
education from routine sources?
c. Two groups of women, women with preterm infants and women with
term infants, were asked about smoking and stress during their
pregnancies. Researchers want to find out if cigarette smoking and
stress during pregnancy is correlated with preterm birth.
9. Discuss how important you think quantitative research is for the development
of midwifery practice in the US today.
Lesson 8: Read chapter 7: Mixed Method Research
1. Discuss the purpose of conducting mixed methods research.
2. What are some of the differences between qualitative and quantitative
research?
3. What are some of the strengths and weaknesses of qualitative research?
4. What are some of the strengths and weaknesses of quantitative research?
5. What are the characteristics of mixed-methods research design?
6. How is sampling performed in mixed-methods research?
7. What are some of the validity issues associated with mixed-methods research
design?
8. A midwife-researcher wants to explore identity and self-perception among
direct-entry midwives in the United States. The researcher investigated the
social, cultural, political and legal environment in which direct-entry midwives
live and practice. Mixed-methods research was used to collect quantitative
and qualitative data from 250 midwives. They took part in a group discussion
and complete a short questionnaire. Based on this information, what type of
mixed method design was implemented?
Lesson 9: Read chapter 8: Populations and sampling
1. Why is sampling important to a research design?
2. Describe the difference between probability sampling and non-probability
sampling.
3. Explain how probability sampling is related to generalizability.
4. Discuss some of the probability sampling approaches used in a quantitative
study.
5. Give an example of a research design that might use cluster random sampling.
6. Discuss simple random sampling vs. systematic random sampling. What are the
pros and cons of each method of sampling?
7. Discuss the aspects of sampling that are important for surveys.
Course Syllabus ©National College of Midwifery 2014
03/2014
8. Briefly describe the difference between random allocation and random selection
in experimental studies.
9. Discuss some of the non-probability sampling approaches used in quantitative
studies.
10. Give examples of the type of qualitative study designs that might utilize each of
the following sampling methods:
a. Convenience sampling
b. Intensity sampling
c. Maximum variation sampling
d. Opportunistic sampling
e. Quota sampling
f. Typical case sampling
11. Discuss the sampling approaches that might be used in a mixed methods
research study.
12. How can a researcher make reliable estimates about population characteristics
within a given sample?
13. What information does a researcher need to calculate a sample size for a study
that is seeking to measure the effect of an intervention on difference groups?
14. What are some situations in which a larger sample size is often indicate? Why?
15. A midwife-led gestational diabetes risk assessment tool is being trialed in a large
birth center practice. Pregnant women (200 in a treatment group and 200 in a
control group) will be randomly allocated to the treatment group or the control
group. The treatment group will receive a face-to-face dietary and lifestyle
screening assessment upon entry to care and a visit with a dietary counselor.
The control group will receive a gestational diabetes prevention brochure on
entry to care and follow-up glucose testing at 28 weeks. Answer the following:
a. What type of sampling is used?
b. Was the approach appropriate for the study? Why or why not?
c. Will the findings of this study be generalizable to the target population? To
other populations not included in the study?
16. A purposive study of 20 women with endometriosis was chosen based on the
number of years of experiencing the disease, the range of medications taken
including complementary medicines, and the use of other healing modalities.
Typical and maximum variation cases were included to provide rich data. Answer
the following:
a. What type of sampling is used?
b. Was the approach appropriate for the study? Why or why not?
c. Will the findings of this study be generalizable to the target population? To
other populations not included in the study?
Lesson 10: Read chapter 9: Data collection: Qualitative research
1. Describe how a literature review is important to selecting an appropriate method
of data collection for qualitative research.
2. Compare and contrast the unstructured interview and the phenomenological
interview approaches.
Course Syllabus ©National College of Midwifery 2014
03/2014
a. What are the characteristics of each?
b. When would each approach be most appropriate?
c. What are the advantages of each?
d. What are the drawbacks?
3. Give an example of the kind of question that might be asked in a dialogical
engagement approach.
4. Discuss the use of a structured interview. When is this approach most
appropriate?
5. Discuss how a focus group interview is facilitated. What are some of the benefits
and challenges of this approach to data collection?
6. Discuss what is meant by emic and etic views.
7. Discuss the benefits and drawbacks to overt vs. covert observation.
8. Discuss what constitutes the case study method of data collection.
9. What is the rationale behind using triangulation in data collection?
10. Describe three forms of triangulation used in qualitative research.
11. Discuss what is meant by “rigor” in data collection approaches.
12. What are the factors that affect the trustworthiness of data collection in qualitative
research?
13. Give an example of a research question that would suitable for each of the
following methods of data collection:
a. Unstructured interview
b. Structured interview
c. Focus group
Lesson 11: Read chapter 10: Data collection: Quantitative research
1. Describe the data that is best collected with a questionnaire.
2. Give an example of each of the following types of questions:
a. Fixed response, closed-ended question
b. Open ended question
c. Checklist
d. Rating scale
e. Visual analogue scale
3. Discuss some of the “best practices” when writing questions.
4. Discuss some of the “best practices” when formatting a questionnaire.
5. Discuss the purpose of pilot-testing your questionnaire.
6. Discuss the advantages and disadvantages of a postal questionnaire.
7. Describe the ways that the Internet can be utilized for collecting quantitative data.
8. What are some of the principles that guide internet-based survey design?
9. What are the advantages and disadvantages of utilizing the Internet for collecting
quantitative data?
10. How can structured interview be used to collect quantitative data?
11. How can structured observation be used to collect quantitative data?
12. What are the advantages and disadvantages of using structured observation in
quantitative research?
13. Discuss the rationale behind using an existing tool to collect data.
Course Syllabus ©National College of Midwifery 2014
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14. Discuss the qualities of an existing tool that must be considered before selecting
that tool for use in data collection.
15. Discuss what is meant by the validity of an existing data collection tool.
16. Create a surveymonkey survey:
a. Go to www.surveymonkey.com and create a free account.
b. Plan what you would like to ask your respondents and list the variables.
c. Design a survey with 10 questions. The first 5 questions should collect
information about your participants, the second 5 should explore a topic of
interest to you.
d. Send the survey to at least 5 colleagues.
e. Organize the responses you receive into a visual display that explains the
results of your survey.
Lesson 12: Read Chapter 11: Qualitative data analysis
1. Discuss the three broad approaches to qualitative data analysis and the stages
of the analysis process.
2. Discuss the process of thematic analysis and how it is undertaken.
3. Discuss the process of data analysis for grounded theory research. What stages
are undertaken and how is the analysis unique to this type of research
approach?
4. Discuss the most commonly used approach to analyzing data in a
phenomenological study.
5. Discuss data analysis for ethnographic studies. What are the common ways that
the outcomes of ethnographic research are presented?
6. What are two ways that visual data can be analyzed?
7. Describe the ways in which a researcher can build the trustworthiness of their
qualitative data analysis.
8. Discuss how computer software can be used to analyze qualitative data.
9. Many women experience postpartum depression after birth and have difficulty
managing the stress of life with a newborn. A researcher wishes to pose the
question “What factors influence parents’ ability to cope with stress and
depression postpartum?”
a. What data collection methods could be used to explore this question?
b. List 4 sources from which data could be collected.
c. List the ways in which this data would be best analyzed.
10. Conduct a research interview:
a. Find a willing participant to take part in an informal interview.
b. Choose a comfortable topic such as “how do you define good health?”
c. Conduct the interview for 10 minutes, using questions that relate to your
chosen topic.
d. Record the interview and transcribe it.
e. Write down your own reflections about the interview.
f. Review the information you have documented
g. Analyze your own interview style. What were your strengths and
weaknesses?
Course Syllabus ©National College of Midwifery 2014
03/2014
h. Highlight the recurring themes in your transcript and identify which topics
drove the conversation in answering your question.
Lesson 13: Read chapter 12: Quantitative Data analysis
1.
2.
3.
4.
5.
Why is statistics important to the analysis of quantitative research?
Describe the difference between categorical and numerical variables.
What is the purpose of using descriptive statistics to describe quantitative data?
Discuss the purpose of graphical displays for quantitative data.
Describe a scenario in which a scatter graph would be the most useful display of
data.
6. Describe the use of inferential statistics in health sciences data.
7. Discuss what is meant by a confidence interval.
8. Describe how statistics could be used to test a hypothesis in the midwifery.
9. Discuss how the appropriate bivariate test can be identified for analyzing
quantitative data.
10. Give an example of one and two-sided scientific questions.
11. What is the difference between a paired and unpaired test.
12. When is it necessary to use a multivariate statistical analysis?
13. Discuss the steps involved in a multivariate analysis.
14. A midwife-researcher is investigating the difference in perceived pain of
contractions during labor for women who use aquatherapy during labor and those
that use massage. Data is collected on the following characteristics: age,
ethnicity, body mass index, parity, pain score (0= no pain while 100=worst pain)
and perceived pain tolerance (low, moderate or high). Which group of bivariate
statistical tests would be appropriate for investigating relationships between the
following variables?
a. Pain score and type of pain relief
b. Pain score and BMI
c. Age and perceived pain tolerance
d. Parity and age
e. Parity and type of pain relief
f. Parity and pain score
Lesson 14: Lesson 6: Creating a PICO question
1. Read the tutorial How to form an answerable clinical question and take notes.
2. Generate three clinical scenarios from your own practice that have lead you to
question what advice or treatment you should give a client.
3. Create a chart for each of the clinical scenarios that answers the follow
questions:
a. What is your clinical question in PICO format?
b. What type of clinical question is it?
c. What is the best study design for answering this question?
Lesson 15: Read chapter 15: Disseminating Research
1. What is a poster presentation?
Course Syllabus ©National College of Midwifery 2014
03/2014
2. How is a poster presentation used to share results of research?
3. Discuss how peer review is used in journal publication?
4. What are some of the barriers faced by direct-entry midwives in the United States
to publishing?
5. Why is it important for midwives to engage in publishing research despite some
of the barriers?
6. Identify 2 journals that are relevant to midwifery practice. Answer the following
questions:
a. Are the instructions for authors clear?
b. What type of referencing style is required?
c. What are the format and word limit guidelines provided?
Lesson 16: Poster project
1.
Using one of your PICO questions perform a mini-review and present it as a
poster presentation following these guidelines:
a. State the Pico question and give a short description of problem and its
significance.
b. Perform a critical appraisal of 3-5 studies related directly to your PICO
question.
c. Present a synopsis of this critical appraisal in your poster including: article
citations, level of evidence of the study, conclusions drawn by the study,
relevance of the study to your PICO question, and any significant research
flaws in the study.
d. Synthesize recommendations for clinical practice that can be created
based on the studies that have been analyzed. Illustrate areas where
evidence is not conclusive for creating practice recommendations.
e. Organize the poster in a way that is professional, attractive and easy to
read. Provide drawings or pictures where necessary for clarification. (For
example of poster formatting you can reference the Natural Sciences
Guidelines for undergraduate research conference: guidelines for poster
presentations http://www.pitt.edu/~etbell/nsurg/PosterGuide.html or The
Vanderbilt University Medical Center Evidence Based Practice and
nursing research resources on poster presentations
www.mc.vanderbilt.edu/root/vumc.php?site=evidencebasedpractice&doc=
37886
f. Write a 350 word abstract for the poster that provides introductory
information on the research review and implications for clinical practice.
g. Present this poster project at a regional or national midwifery or maternal
child health venue. Document your participation in this event.