Assessment of clinical skills in midwifery: some ethical and practical problems

The assessment of clinical midwifery skills can present ethical and practical problems. Following an outline of recent changes in midwifery education, this paper discusses the conflict between research-based and traditional knowledge, the preparation of assessors and their understanding of assessment documents which may be couched in educational language unfamiliar to them, the involvement of recently qualified midwives as assessors and the stress this may cause, frequent change in clinical placement, and lack of regular contract between student and assessor. All these factors impinge on the validity and reliability of assessment. Recommendations to address these problems include greater collaboration between teachers and practitioners in promoting research-based practice, and increased teacher involvement in clinical areas helping practitioners develop as assessors. This would, it is suggested, lead to increased consistency in standards and increase the validity and reliability of clinical assessment.