Background: It is important for midwifery students to have appropriate and timely access to clinical placement to support their theory learning. This placement must be supported by midwives who are able to share their expertise and knowledge in a supportive manner. In clinical placement students are immersed in the culture of midwifery and are socialised to the profession. Students first learn by rote and master individual skills however by third year students are expected to understand that midwifery knowledge is complex and shifting, and not always well defined or even explicit. The quality of this placement influences the students’ learning and their understanding of the culture of the midwifery profession.

Midwifery practice is conducted against a background of a long standing midwifery shortage. The growth in scholarship supports the emerging professional status. Midwives work in an interdependent relationship with the medical profession with competition evident at times for normal birthing. Amongst this concerns about the safety of birthing are regularly raised and societal expectations are such that midwifery care is delivered under constant public scrutiny. In a society that values technology and seeks reassurance, expertise in low risk birthing is not highly valued.

Method: Ethical approval was gained from The University of Waikato, NZ. An invitation to participate was sent to all midwives who regularly work with midwifery students within a midwifery school in New Zealand. Two focus groups, with six midwives in each group, were held in a community venue using semi structured interviews. The transcripts were then thematically analysed.

Results: The first theme described the midwives work with students. The midwives enjoyed the mutual learning that occurred working alongside a student. At third year students were expected to demonstrate the mix and match of midwifery care, rather than rote learning. They were encouraged to understand that every experience has a learning opportunity. The midwives described working with students who had experienced ‘putdowns’ in the past and how they worked to build the students’ confidence. They found students varied in their initiative. The ability for the student to anticipate what might occur was valued by the midwives. Third year placement was described by the midwives as the time of students “pulling it all together”.

Learning to be professional seemed to be one of the biggest challenges for some students. Many had issues with professional issues such as confidentiality, personal organisation and timekeeping. Midwives stated that at times they found it hard to feed back some of the professional issues to the student.

The second theme described the implications for midwives’ practice. The midwives were aware of the responsibility they had to ensure the student practiced in a safe manner. They were conscious of their own “potential ... to muck it up”. At times they described juggling different expectations from the woman and the student. The midwives were aware of the scrutiny that some students placed on the midwife’s practice. This did not always feel comfortable for the midwives. The midwives also described how they did not enjoy providing written feedback on the students’ performance and in particular struggled with students who were not achieving at the expected level.

Discussion: The relationship between the student and the midwife is very important to support the students’ learning in a safe environment. Midwives need to allow time to understand the students learning needs, and to debrief after working together to ensure the appropriate learning has occurred. The midwives described the “mix and match” they expected students to demonstrate in their third year, rather than a series of skills. It is this complexity of midwifery knowledge that we claim as a profession, and is the hardest to learn since many aspects are not well documented or understood. However the process of critical thinking has been documented and this explains the importance of expert practitioners describing the thinking and rationale that lie behind their decision making. This dialogue is very important to support student learning.
The midwives saw themselves as role models for the students and felt it was important to share their knowledge to grow the profession. However they also felt they juggled the conflicting demands on them describing the tensions between the needs of the woman and the student, and the tensions the midwives experienced as she moved between the role of teacher, supporter and assessor of the student.
The notion of “hero, martyr and workaholic” pervades midwifery literature and was evident in many of the stories the midwives shared. Students were expected to show this same commitment and were criticised for not doing so.