Student midwives’ experiences of clinical placements in secondary and tertiary hospitals
Ideally, clinical placements in secondary and tertiary hospitals provide appropriate opportunities for midwifery students to learn clinical skills and develop confidence in the provision of midwifery care. Midwives play a key role in the support and nurturing of students in this environment. But what is the student midwife experience like? This research study examines ‘student midwives’ experiences of clinical placements in secondary and tertiary hospitals’. The methodology employed was an interpretive descriptive approach developed by Thorne, Reimer Kirkham, and MacDonald-Emes. Eight second and third year midwifery students were interviewed and asked about their experiences of clinical placements in secondary and tertiary hospitals. The participants’ stories were analysed and interpreted, and research findings produced experiential dimensions of the student midwife experience. Four experiential dimensions emerged from the data: a sense of belonging, the opportunity to learn, challenges in clinical placements, and having confidence. The findings suggest that student midwife clinical placement experiences occur on a continuum ranging from being supported and nurtured by midwives, to negative experiences where obstacles were present and confidence and learning were challenged. A sense of belonging to the team and the profession was important for the participants. Being welcomed and wanted in clinical placements often set the scene for students. In order to belong participants worked to fit in with the midwife, which sometimes came at a cost to the student. The opportunity to learn was orchestrated by the participants themselves, and the midwives and women the participants worked with. Learning in an environment affected by institutional constraints, such as high acuity and staff shortages impacted on student learning. Participants faced multiple challenges in clinical placements. They had to deal with reluctant midwives and feeling, at times, a burden to the midwives. Sometimes the working environment was unsupportive and participants were party to questionable practice which caused consternation. Self-confidence was the starting point from which participants entered clinical placements; this was sustained, empowered, or challenged further by the woman and midwife. The one factor present in all these findings was that the midwife is significant to the experience of the student midwife. While the student has a role to play in the shaping of her learning experiences in clinical placements, it is the midwife that takes the major role as conductor of those experiences. Discussion of the findings revealed two key messages: the importance of continuity of the midwife and the need to support the midwife. While relevance to the student midwife and the research question may appear distant, these key messages directly address the circumstances that surround the student midwife experience. Continuity of midwife would optimise learning opportunities for the student and foster socialisation into the midwifery profession. For learning to be facilitated in the institutional setting, attention must be directed to the working environment of the midwife and her role as a preceptor to students. It is anticipated that this research study will have the potential to benefit both midwives and the educative experience of future student midwives.