Preparing midwives for practice in Ireland: midwifery students and preceptor midwives’ experiences of the assessment of clinical practice

Background: Clinical placement is a critical component of midwifery programmes, where students develop competence in the care of women and their babies under the supervision of preceptor midwives. Preceptors are responsible for the assessment of competence of these students, whilst simultaneously managing the care of women and babies.

Aim: To explore midwifery students and preceptor midwives’ experiences of assessment within clinical practice in a university in the Midwest of Ireland, at a time of significant change in midwifery education and practice.

Methods: A qualitative descriptive design was used to interview students (n=32) and preceptors (n=29), with the data analysed using content analysis.

Findings: Within an overarching theme of the context of assessment in practice, students and preceptors reported some commonalities. A clear process of assessment was valued by preceptors and students, but lack of continuity of preceptor and resource deficits, such as inadequate staffing levels affected this process. All the students and preceptors were challenged with the language of assessment. The importance of support for clinical assessment was highlighted by preceptors and students.

Preceptors played a central role in students’ experiences from both a positive and a negative perspective, with unacceptable behaviours perpetrated by a minority of preceptors having a disproportionate effect on students. Students’ vulnerabilities were evident in their reluctance to report these behaviours.

Benefits of preceptorship professionally and for the organisation were identified by the preceptors. They felt, however, that their role was unvalued by management, substantiated by inadequate resourcing and the volume and complexity of their caseload. Failing students was challenging, but safety of practice was the key factor underpinning preceptors’ ability to fail students when necessary.

Conclusion:

The findings highlight the cruciality of the context of the practice environment on these stakeholders’ experiences, with the future safety of practice reliant on robust assessment of students. A model of preceptorship is proposed to address the challenges identified, requiring a collaborative approach from universities and associated healthcare providers. Establishment and maintenance of this model will contribute to enriching the experiences of stakeholders, encourage recruitment and retention and enhance the quality of maternity care for women and their families.