Preceptors for Midwifery Clinical Education: A Call to Action in This Unprecedented Time

From the American College of Nurse-Midwives (ACNM), the Accreditation Commission for Midwifery Education (ACME), and the American Midwifery Certification Board (AMCB)
October 2020

Clinical education is essential to midwifery education. Real-world clinical placement under the guidance and supervision of an experienced midwifery preceptor reinforces knowledge and strengthens skills critical for mastery of the Core Competencies for Basic Midwifery Practice. The integration of clinical experiences into the overall midwifery educational curriculum assures that graduates of accredited midwifery education programs are prepared to both take the certification exam to become a Certified Nurse-Midwife (CNM) or Certified Midwife (CM) and to enter the midwifery workforce as safe beginning practitioners.

Midwifery program directors have historically and consistently cited a lack of available clinical sites and preceptors as a contributing factor for unfilled student cohorts within their programs (Midwifery Trends Report 2019). The advent of the COVID-19 pandemic has exacerbated this shortfall in clinical educational resources for midwifery students to a critical point.

In March 2020, institutions across the nation temporarily barred students from attending clinicals, considering them non-essential in the environment of restricted resources evident in the first months of the pandemic. Months into the pandemic, many institutions are still in the process of re-opening to students.

Interruptions in the continuity of clinical experiences have resulted in midwifery cohorts overlapping, thus increasing the demand for clinical sites and preceptors. The result is untenable delays for midwifery students unable to acquire the experience necessary to achieve beginning competency and progress toward graduation. Because of these delays, students are facing multiple financial challenges, including:

• Paying for extra semesters of school (e.g. continuing with part-time credit hours not covered by student loans).
• The costs associated with having to move or extend or relinquish housing arrangements.
• Losing opportunities for part-time work in the current economy.

Students are being faced with the serious question of whether they can continue in their midwifery education program or if they need to step away and consider returning at another time.

Precepting is hard work, even in non-pandemic times. Academic programs and potential preceptors are also feeling strain. Midwifery educational programs are experiencing budget cuts and hiring freezes. Midwifery practices have temporarily closed, experienced furloughs, or reduced hours. In the current environment of COVID-19, it is understandable that preceptors are overwhelmed with personal and professional demands and feel unprepared devote time and effort to students’ clinical education.
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ACNM, ACME, and AMCB stand together in support of our accredited education programs, faculty, and clinical preceptors. We strongly support the student midwives whose passion for the midwifery profession has brought them this far in their education. As such, we request that CNMs/CMs in clinical practice for over a year:

• Evaluate the potential of having a student accompany you for their clinical experience, either full-time or part-time, in full scope or in a limited scope now. If you are interested in being a preceptor, please contact an accredited midwifery program right away or send an email to [email protected]. The list of accredited midwifery education programs can be found on the ACNM website.
• Implement innovative ways to incorporate multiple students in your clinical setting, such as, but not limited to:
  • Pairing more experienced students with newer students and have them both work with you in the clinical setting; and/or
  • Taking two students and have them alternate seeing patients in a busy office or take turns providing labor support vs. birth care when they attend a birth.

We respectfully ask ALL midwives and friends of midwifery to consider financial ways to show your support for midwifery education and students by:

• Donating to The A.C.N.M. Foundation, Inc. for student scholarships;
• Purchasing a gift card or sending a note of encouragement to a student or preceptor; or
• Donating to Midwives-PAC to help with the passage of legislation that seeks to create a permanent federal funding stream for accredited midwifery education programs that can be used for direct student support or as stipends for preceptors.