"They hold your fate in their hands": Exploring the power dynamic in the midwifery student-preceptor relationship

Midwives views about preceptorship and peer-learning in a birth unit: A cross-sectional study

BACKGROUND

Practical training in a birthing unit is an important part of midwifery education. Previous research on the preceptor role predominantly consists of qualitative interview studies and have not explored pedagogical models like peer learning.

OBJECTIVES

The purpose of this study was to quantitatively describe midwives' experiences, conditions, and needs in their role as preceptors in a birthing unit, as well as their attitudes towards and experiences of peer-learning.

DESIGN

A cross-sectional study, using a web-survey.

SETTINGS

The survey was distributed to all midwives working in a birthing unit in Sweden.

PARTICIPANTS

A total of 573 valid responses were obtained.

METHODS

A questionnaire consisting of 22 questions, which included background questions, questions to be answered on a four-point Likert scale, and open-ended questions, was sent out from November 2022 to March 2023. The collected data were analysed using descriptive statistics, Chi-square, and Mann Whitney U test analyses. The open-ended responses were analysed using quantitative content analysis.

RESULTS

Midwives with ≤10 years of experience were more hesitant about taking on the preceptor role. They also described a lack of support and found it more challenging to integrate supervision into their working hours than midwives with >10 years of experience. Time for supervision and time for reflection with midwifery students were identified as areas that could improve the quality of supervision. Of the respondents, 42.8 % had experience of peer learning. "Students learn from each other" was identified as the most common advantage of peer learning.

CONCLUSIONS

Long-term experience as a midwife plays a crucial role in how midwives perceive their role as a preceptor and the conditions they experience. The midwives in this study had started supervising students earlier than they deemed advantageous. As the preceptor plays a critical role in the midwifery student's learning process, it is important to have experienced preceptors.

Navigating power dynamics between pharmacy preceptors and learners

Pharmacy preceptors are crucial in pharmacy experiential education. They help develop learners during didactic learning, experiential learning, and post-graduate training. Preceptors hold a position of authority over learners as they are responsible for providing feedback and ultimately completing evaluations that determine whether the student passes or does not pass the rotation. Preceptor status, behavior, and communication style may cause students to feel intimidated. Preceptors should be aware of this power differential and keep generational, gender, cultural, and other factors in mind when providing feedback. Preceptors should also receive training and be open to constructive feedback from learners to ensure the experience meets the needs of the learner and allow for adjustments on the experiential rotation. Students should be empowered to provide open and honest feedback to preceptors in a psychologically safe environment without fear of repercussions.

Navigating interprofessional boundaries: Midwifery students in Canada

The literature on professional socialization focuses on how students adopt and internalize professional identities and values, and assumes that boundary work is essential to learning how best to practice their profession. However, a focus on boundary work in the context of midwifery training - which is embedded in the gendered and hierarchical landscape of maternity care - is lacking. Thus, this article examines how Canadian student-midwives learn to navigate and negotiate interprofessional boundaries. Grounded in a symbolic interactionist approach, it draws on 31 semi-structured qualitative interviews from a mixed-methods national study on midwifery retention, explores how midwifery students make sense of the tensions among midwives, physicians, and nurses, and describes what strategies they utilize when navigating boundaries. Our analysis, based in constructivist grounded theory, revealed that participants learned about interprofessional tensions in clinical placement encounters via direct or indirect interactions with other healthcare professionals, and that strategies to navigate these tensions included educating others about midwifery training and adopting a learner identity. This article proposes that the process of professional socialization enables to reshape professional boundaries and that students are not only learners but also agents of change. These findings may yield practical applications in health education by highlighting opportunities for improving interprofessional collaborations.

Midwifery professional placement: Undergraduate students' experiences with novice and expert preceptors

BACKGROUND

In recent decades, increased midwifery university places have been offered to address midwifery workforce shortages. As a result, more graduate midwives entered the workforce, in turn leading to more midwifery students precepted by novice midwives when on professional placement. It is not known whether this more junior midwifery workforce impacts student experience.

AIMS

To explore undergraduate midwifery students' experiences with novice and expert midwifery preceptors, and to identify the benefits and challenges of working with novice and expert preceptors, from the perspective of undergraduate student midwives.

METHOD

This study used a qualitative descriptive approach. Nineteen third/fourth-year Bachelor of Nursing/Bachelor of Midwifery (Honours) students attended six focus groups (ranging from 2 to 5 participants). Data were analysed thematically.

RESULTS

Three overarching themes were identified: 'Building relationships'; 'Teaching and learning'; and 'Improvements to professional placement'. Benefits and challenges existed with both novice and expert preceptors. Importantly, feeling welcomed and receiving critical feedback were identified.

CONCLUSION

The student/preceptor relationship is based upon feeling welcomed, and relatability, and is developed more easily with novice preceptors. Expert preceptors provide insightful and valuable feedback and are more able to actively teach. Novice preceptors' consolidation of practice can impact student learning opportunities. Including students in decision-making aids development of critical thinking. Allocation practices which address student learning needs will improve the student professional practice experience. Midwifery students benefit from working with midwifery preceptors of all experience levels. Translating the findings from this project into preceptorship training programs for midwives will improve student satisfaction and outcomes.

Development and testing of the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool

OBJECTIVE

Develop and test a tool to measure midwives' perceptions of their role in preceptoring midwifery students.

DESIGN

A multi method exploratory study design was used.

POPULATION

Preceptor midwives from three maternity units in south-east Queensland Australia.

METHODS

A three-phase process was used: item generation; expert review; psychometric testing including content analysis of qualitative responses. The survey was online or paper-based and included demographic details, the Clinical Preceptor Experience Evaluation Tool (CPEET) role subscale and draft tool. A focus group discussion explored the open-ended responses.

FINDINGS

A large sample of preceptors (n = 164, 64.2 % response rate) participated. Factor analysis revealed a two-factor structure with 24 items accounting for 40.2 % of variance. The mean total score of the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool was 103.31 (SD = 9.47). The scale was reliable (Cronbach's alpha 0.89) and valid. Test-retest reliability showed moderate to excellent temporal stability across the scale and subscales. Measures of concurrent validity showed little agreement with the CPEET tool. Qualitative analysis revealed the way midwives were taught as students had a powerful influence on their approach to teaching in practice.

CONCLUSION

This tool is specifically designed to assess midwifery preceptors' perceptions of their role in student learning in practice. Psychometric testing of the MidPaACT tool confirms its reliability and validity.

IMPLICATIONS FOR PRACTICE

Midwifery preceptors are a key influence on the development of students' capability as a midwife. Midwives' perceptions of their proficiency in student learning are under-reported. The MidPaACT tool provides a reliable and valid means of measuring preceptors' perceptions and identifying areas for future educational and workforce improvement.

Midwifery students' perceptions of clinical learning experiences and midwifery preceptors in Turkey

BACKGROUND

The clinical education environment presents a valuable opportunity for students to learn, acquire and develop the clinical skills essential for professional midwifery practice. The presence of competent and relevant preceptors plays a pivotal role in ensuring the success of midwifery students and fostering positive clinical experiences.

AIM

This study was conducted to evaluate the clinical practice experiences of midwifery students and their perceptions of midwifery preceptors.

DESIGN

A descriptive and cross-sectional study.

METHODS

This study was conducted with 205 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data collection used a participant information form and the Clinical Learning Environment and Midwifery Preceptor Scales designed to assess factors affecting midwifery students' clinical learning. Data analysis was performed using the SPSS 22.0 program, employing methods such as the Independent Sample T-Test, One-Way Analysis of Variance and Tukey test.

RESULTS

The average total score on the Clinical Learning Environment scale was 31.08±2.16 out of a possible 32, while the average total score on the Midwifery Preceptors scale was 17.60 (SD 1.27) out of a possible 18. The mean total score of the Midwifery Preceptor Scale and the mean scores of the sub-dimensions of Skill Development and Midwifery Practice Philosophy were found to be statistically significantly higher in those aged 21 years and older than aged 20 years and younger (P < 0.05). The Midwifery Preceptor Scale total score, the Clinical Learning Environment Scale total score and Skill Development sub-dimensions mean scores of the second-year students were found to be statistically significantly higher than the first and third-year students (P <0.05). Furthermore, students who received education in larger groups and willingly chose and had a passion for the midwifery profession demonstrated significant positive perceptions regarding their clinical learning environment experiences and the impact of their preceptors on their professional growth.

CONCLUSIONS

Understanding the perspectives of midwifery students regarding the clinical education environment, preceptors and the teaching and learning process holds great importance for enhancing the quality of the clinical education environment and fostering the development of clinical competencies among midwifery preceptors.

Can peers improve student retention? Exploring the roles peers play in midwifery education programmes in Canada

PROBLEM

Peer support is understudied as a factor that can impact midwifery student retention.

BACKGROUND

Retention of midwifery students is essential for creating a sustainable maternity care workforce. Research shows that peer support positively influences students' experiences, but it needs more focus on the role peers play in student retention.

AIM

We aimed to examine how peer support can facilitate midwifery students' retention by exploring the role peers play in students' experiences and identifying the types of support students offer each other.

METHODS

We conducted 31 semi-structured interviews with students attending Midwifery Education Programmes across Canada. Data were analysed inductively, following the constructivist grounded theory method.

FINDINGS

While motivated and engaged peers improved students' learning experiences and desire to remain in their program, peers who created an overly competitive academic environment hindered learning. Students also noted that a lack of diversity, particularly of Black and Indigenous peers, limited their ability to learn about culturally safe care. Most students felt a sense of community and relied on one another for emotional, academic, and instrumental support.

DISCUSSION

Peer support has mostly positive effects on student learning and should be formalized by midwifery educators to improve retention. Reducing pressure to succeed, targeting recruitment of students who are Black, Indigenous, and People of Colour, and establishing formal mentorship programmes could enhance the role peers play in student retention.

CONCLUSION

While retention of students is a complex issue, positive interactions with peers can create a stimulating learning environment and increase students' desire to stay in their programme.