Clinical practice and midwifery programmes

These standards and requirements set out the standards and requirements for approval of the clinical practice and clinical learning environment for undergraduate midwife registration programmes.

Clinical Practice Experience and the Clinical Learning Environment

Clinical practice experience is an integral component of the midwife registration education programme. This experience, whether in the community or hospital care settings, is the central focus of the midwifery profession and must complement theoretical input to ensure safe, quality midwifery care for women, their babies and their families.

The aim of clinical practice learning is to facilitate midwifery students to become safe, competent, kind, compassionate, respectful and reflective midwife practitioners who develop the prescribed competencies over the four-year programme.

Clinical practice experience will facilitate the student to accept personal and professional accountability for evidence-based practice and equip them with the skills for problem solving, decision making, critical analysis, self-directed and life-long learning.

Clinical practice experience will provide opportunities for integration of theory and practice, and the opportunity to work in collaboration with other members of the health care team to provide care. Clinical placements are based in health care settings that are subject to audit as to their suitability as quality clinical learning environments and to ensure that the setting meets the Standards and Requirements for midwifery registration education programmes as stipulated by NMBI.

  1. Prior to placement of students on new clinical placement sites, verification of the completed audit as endorsed by the HEI must be submitted to NMBI.
  2. The selection of environments for clinical practice experience supports the achievement of the learning outcomes of the educational programme, and reflects the scope of the health care settings and the students’ individual needs.
  3. Clinical placements are subject to audit as to their suitability as quality clinical learning environments in accordance with the Nursing and Midwifery Board of Ireland’s Standards and Requirements for programme approval.
  4. Student allocation to clinical placements is based on the need to integrate theory and practice, and to facilitate the progressive development of clinical skills, knowledge and professional behaviours culminating in successful achievement of the prescribed competencies for the midwife registration education programme.
  5. Opportunities for students to experience direct contact with women and their babies are provided early in the educational programme.
  6. Clearly written, up-to-date learning outcomes appropriate to the individual clinical practice environment are available and accessible to ensure optimal use of valuable clinical practice experience. Learning outcomes specific to each year of the programme are available, and are reviewed and revised as necessary.
  7. Students and all those involved in meeting their learning needs are fully acquainted with the expected learning outcomes relating to that clinical placement.
  8. The staff resource supports the delivery of the educational programme at the stated professional and academic level. This includes a ratio of one clinical placement coordinator to every 15 midwifery students, and 0.5 of an allocated liaison officer for up to 50 students.
  9. Each student is allocated a named primary preceptor, who is a registered midwife (or a registered nurse/midwife in a NICU placement), during midwifery clinical placements to provide support, supervision and assessment. In the absence of the primary preceptor, a named midwife or nurse must be allocated to support and supervise the student.
  10. Preceptors and midwives who have a role of supporting, supervising and assessing students have completed a teaching and assessment course approved by NMBI that enables them to support, guide and assess students in the clinical practice setting and assist students to learn the practice of midwifery.
  11. Registered midwives should undertake the role of primary preceptor when they have experience of midwifery practice and have completed a teaching and assessment course approved by NMBI.
  12. Preceptors and midwives should have the opportunity to maintain and develop their competence and skills in supporting, supervising and assessing students on an ongoing basis.
  13. Mechanisms are in place to facilitate preceptors to supervise and assess students.
  14. Mechanisms for preceptor support and evaluation are explicit.
  15. Clinical practice includes experience of the 24-hour cycle of caring for women and their babies, and this must be facilitated for all students in their midwifery programme. At all times, whether the student is supernumerary or in internship, there must be sufficient registered midwives to facilitate the supervision and support of midwifery students to achieve the expected learning outcomes of the programme.
  16. Named clinical placement coordinators, midwifery preceptors, registered midwives and clinical midwifery managers in liaison with named midwife lecturers, monitor the quality of clinical learning environments on an ongoing basis and guide and support students to ensure that the clinical practice placement(s) provides an optimum learning environment.
  17. The supernumerary status of pre-registration midwifery students is clearly articulated and respected.
  18. Specific periods of time are allocated for reflection during supernumerary placements and the clinical placement internship:
  • Protected reflective practice during supernumerary placements and the structures in place for the implementation of protected reflective time during the period of internship should be agreed formally between the HEIs and the associated health care providers and included in the memorandum of understanding.
  • Protected reflective practice time of a minimum of one hour per week should be an integral component of any supernumerary midwifery and specialist placement.
  1. Protected reflective practice time of a minimum of 4 hours per week should be an integral component of the internship period of clinical allocation to enhance the consolidation of theory to practice. The responsibility rests with the HEIs in collaboration with the associated health care providers for ensuring that a clinical placement site for student placement is of an appropriate standard to meet the learning outcomes of the midwifery programme, and is a learning environment of adequate quality.

Quality assurance indicators are identified and measured in relation to:

  • The number of midwives and support health care staff to ensure that safe, quality care is provided to women and their babies;
  • The number of preceptors, midwives and nurses to facilitate the support, supervision and assessment of students;
  • The availability of multidisciplinary evidence-based practice guidelines and policies to support care;
  • The availability of mechanisms for the development and review of evidence-based guidelines with multidisciplinary involvement;
  • Proof of application of evidence-based practice;
  • Evidence of individualised, woman and baby-centred care;
  • The availability of policies and protocols in respect of medication management, and good practice in recording midwifery care and interventions;
  • Evidence of mechanisms for audit of midwifery documentation and audit of medication management;
  • Evidence of continuing professional development for all practice staff and education and training programmes which involve all members of the multidisciplinary team;
  • Evidence of clinical risk management programmes;
  • The availability of mechanisms for student support, supervision and assessment.
  • The availability of support mechanisms for preceptors and midwives, including continuing professional development in supporting, supervising and assessment of students;
  • The availability of mechanisms for educational and clinical audit;
  • The availability of mechanisms to review the quality of preceptorship;
  • The availability of mechanisms to involve women and families in the development and evaluation of maternity care.

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