A contextual clinical assessment for student midwives in Ireland

Newly qualified midwives are required to be competent, safe practitioners providing high standards of care for mothers and babies. The role of educators is to teach for a sense of salience to enable students to meet this challenge with confidence and competence and to develop clinical reasoning skills. The difficulties of formulating an assessment that captures all these elements is challenging for all involved in midwifery education. Although the Objective Structured Clinical Skills Examination (OSCE) is a useful format for assessing aspects of practice, it does not capture the students' simultaneous interaction with a woman and her baby while performing routine care where a variety of issues can be assessed in a contextual way. In University College Cork, a clinical assessment has been developed whereby students perform an aspect of clinical care followed by a low-fidelity simulated pregnancy complication or emergency appropriate to the student's level of learning. The students demonstrate their level of knowledge and skills in a contextual environment. Assessment in practice is challenging for midwives and educators but is essential in determining fitness for entry into the profession.