The Confidence to Practice Midwifery: Preceptor Influence on Student Self‐Efficacy

Abstract

The imperative for midwifery educators is to transmit to their students midwifery's unique body of knowledge and hallmarks of care that guide midwifery practice. Concerns have been raised about the ability to maintain the unique aspects of midwifery practice in a culture where routine use of intervention prevails. A theory-practice gap may lead to fewer student midwives exposed to the perspective and practices of midwifery during their clinical education. Preceptor role modeling is important to developing student confidence, conceptualized as self-efficacy, to persist in the practice of midwifery hallmark behaviors, particularly under conditions that undermine these practices. This study examined student perceptions of preceptor behaviors of two midwifery hallmarks of practice: therapeutic presence and non-intervention in the absence of complication and student self-efficacy for performing these behaviors. Recent graduates of education programs accredited by the American College of Nurse-Midwives Division of Accreditation completed researcher-developed tools regarding perceptions of preceptor behaviors of therapeutic presence and non-intervention and their outcome expectancy and self-efficacy for the same behaviors. The results indicate that preceptor behaviors influence student confidence to perform hallmark behaviors. Student belief in the value of the hallmark to benefit women is the biggest predictor of self-efficacy for hallmark behaviors. Clinical and educational implications and directions for future research are discussed.

How midwifery students experience learning conditions in labor wards

“…The relationships could cause stress, which some participants considered to be eustress or strengthening and others considered distress and hampering their learning. This corresponds with the findings in several studies [13,14,16,19] and emphasizes the importance of good relationships between students and mentors.…”

“…Hunter reported that midwifery students rarely questioned the midwives' rules because senior midwives assessed their clinical competence. [12] Midwives are important in developing midwifery students' confidence in practice, [13] and in ensuring that they are competent. [14] Midwives are also important role models for midwifery students, both positively and negatively.…”

The self reported confidence of newly graduated midwives before and after their first year of practice in Sydney, Australia

“…There is little empirical evidence to guide the development of programs for newly qualified midwives though a number of small studies point to the value of preceptorship, highlighting the importance of the quality of the preceptorship provided. 35 A supportive clinical environment is important to learning for undergraduates [36][37][38] and is equally important for new graduates. 39 In addition, there appears to be value in developing programs that are focused on the development of the clinician rather than organisational needs.…”

Assessing self-efficacy of frontline providers to perform newborn resuscitation in a low-resource setting

“…SE has also been found to predict clinical performance in nursing students. 18 In the field of midwifery, Jordan and Farley 19 found that SE can be enhanced in recent midwife graduates by appropriate instruction. Nevertheless, because SE is domain-specific, any assessment should focus on the specific task being assessed.…”