Midwifery Students' Experiences of Clinical Education: What Helps and What Hurts

Clinical education is a cornerstone of midwifery training. Although international studies highlight the importance of preceptor support, predictability, and a positive learning environment, little is known about which aspects of clinical education in the United States best support or hinder student learning.

We conducted a national, cross-sectional survey of certified nurse-midwives and certified midwives certified between 2019 and 2024. Eligible participants were recruited via email through the American Midwifery Certification Board. The survey included 46 items, including 23 items about their clinical education experiences and 23 items about their current practice and demographic characteristics. In this article, we have analyzed 3 open-ended questions that asked participants to describe the best and worst parts of their clinical education using reflexive thematic analysis.

We received 640 completed surveys resulting in a response rate of 16%. From our analysis, we identified 3 themes. The first was the centrality of the preceptor as a make-or-break component of clinical education. Participants overwhelmingly emphasized the central role of preceptors in influencing the quality of their experiences, describing supportive mentors as crucial to building confidence, independence, and professional growth. Conversely, negative preceptor behaviors, including bullying and discrimination, hindered learning. The second theme, the need for diversity in setting and care to produce a full-scope midwife, highlighted the various clinical experiences needed to create a full-scope midwife. The third theme described participants' desire for clinical education that fits within their lives.

Findings demonstrate that the quality of clinical education hinges on supportive preceptors and diverse learning environments; yet students frequently encounter mistreatment and systemic barriers. Midwifery programs and professional organizations must enhance oversight of clinical placements, invest in accessible preceptor training, and provide structured support for students navigating challenging sites. Strengthening clinical education is essential to sustaining a well-prepared, resilient midwifery workforce that can provide equitable, evidence-based care.