Integrating threshold concepts: exploring innovations in the redesign of a problem-based learning curriculum

Abstract

An innovative new midwifery programme leading to midwifery registration with the Nursing and Midwifery Council (NMC) developing potential registrants at both BSc and MSc levels commenced in September 2016. The programme is delivered utilising problem-based learning (PBL) as both a content delivery method and a philosophical approach, underpinning student learning at the UK's University of Bradford, School of Midwifery. A requirement for NMC revalidation at a five-year juncture and institutional programme reapproval acted as a catalyst for change. The programme team embraced a new curriculum framework which emphasised a move to reviewing stage and programme outcomes rather than concentrating on the minutiae of module outcomes. This new approach suited the holistic nature of PBL ensuring an intellectually challenging and inclusive method of teaching and learning for midwifery practice. A further progression for the programme team was to develop an understanding of, and to integrate, ‘threshold concepts’ or ‘troublesome knowledge’. These are defined as knowledge, principles or components which students find difficult to understand and therefore to utilise to improve practice and deliver high-quality care. This article explores the integration of threshold concepts into a problem-based midwifery curriculum.