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

To examine (1) what role preceptors play in students' learning; (2) how student-preceptor relationships can impact students' views of the profession and their decision to leave the program; and (3) what strategies can be used to improve the preceptor-student relationship to facilitate student retention.

We used a qualitative methodological approach utilising semi-structure interviews with 31 midwifery students across Canada. Participants were recruited from all midwifery education programs and were in various stages of their educational journey. The interviews were conducted in English and French. Inductive analysis followed Charmaz's guidelines moving from line-by-line to focused coding and development of analytical categories.

The results show that positive relationships with preceptors boosted students' confidence and contributed to the constructive learning experiences among trainees. Students pointed out that their best learning experiences were facilitated by preceptors who created a safe space to make mistakes and were knowledgeable and invested in students' learning. Students also suggested that power imbalance is embedded in student-preceptor relationships and can negatively impact students' learning experiences and their decision to stay in the program.

It is important to consider how to mitigate the power imbalance embedded in preceptor-student relationship. Offering more training to preceptors, oversight of preceptors' mentorship skills by midwifery educators, and creation of ombudsperson's position might mitigate some of the power differential and facilitate students' ability to complete midwifery training.