Early Career Midwives' Recommendations to Improve Clinical Education: "Honestly, We Just Need to Do Better"

The Accreditation Commission for Midwifery Education determines the accreditation criteria and ongoing evaluation for midwifery education programs, which ensures program quality, including clinical education experiences. Increasing evidence about the deficits and strengths in clinical education experience can improve the evaluation process. Little is known about which elements of clinical education are most valued by early career midwives. The purpose of this research was to identify early career midwives' recommendations to improve clinical education.

We surveyed early career certified nurse-midwives (CNMs) and certified midwives (CMs) who were certified between 2019 to 2024 (n = 640) using an electronic mailing list with the American Midwifery Certification Board. We conducted a thematic analysis on 371 (58%) responses to the open-ended question, "What recommendations do you have to improve the clinical education experience?"

Recommendations were grouped into 3 themes: (1) programs should protect students from short and long-term harm by securing vetted, trained preceptors and ensuring clinical education promotes balance and prevents burnout; (2) programs should take a more active role in securing and overseeing clinical education; and (3) national accrediting and professional organizations as well as midwifery education programs should lead systemic reform to strengthen midwifery clinical education, including revisions to current clinical requirements and rethinking its funding and structure.

Study findings highlight multiple actionable steps for improving US midwifery clinical education. Investing time, resources, and oversight into preceptor preparation is critical to ensure midwifery students learn in safe, welcoming environments. Ensuring that high quality clinical education is available and accessible to all midwifery students is necessary to sustain and grow the workforce.