Clinical Placement Policies
Students complete seven clinical placements during Years Two, Three, and Four of the UBC Midwifery Program.
|BC or Canada|
Several combinations of clinical placements are possible over the duration of the Program.
A student will be placed with at least two different midwifery practice groups over the course of the program.
- Clinical placements occur in the province of British Columbia with the exception of the Global Elective (MIDW 370) and the inter-professional Elective (MIDW 350) offered in third year
- All placements must be arranged by the Midwifery Program
- All changes to placements, including changes in dates and assigned preceptors, must be approved by the Academic Support Committee and the Program Director
- Each student is expected to be in at least two different practices during the program
- Each student is expected to complete one term in a rural placement
The program cannot guarantee that placements will be available in student’s preferred communities.
Students complete a placement preference survey in the winter term of each year. The survey responses are matched with available clinical placement sites. Fourth year students are given highest priority in the placement process.
Placements are determined based on the following:
- Available placements within the province
- Students with a unique learning situation established as a result of a formal process
- Students stated preference
- Wherever possible, the program will arrange for the student to have a different preceptor in the MIDW 420/ MIDW 440 placement than she had in any previous placement
- Students returning from a leave of absence will be placed after all continuing students have a placement
Midwifery Clinical placements will occur in British Columbia with the exception of MIDW 350 and MIDW 370. Student requests for MIDW 350 placement in a Canadian setting may be considered. MIDW 370 students elect to travel to established international placements. All living and travel expenses associated with attending clinical placements are the responsibility of the student. All students are required to complete at least 1 rural midwifery clinical placement during the program. This does not include placements for MIDW 370.
Situations may present (such as the COVID-19 pandemic) where the number of rural placement sites is reduced. In such cases, the program reserves the right to waive the rural requirement.
Wherever possible, students will complete their rural requirement in a regular midwifery placement. In some cases, the rural requirement may be accomplished through a MIDW 350 or 380 placement.
Last Revised: October 21st, 2020
A conflict of interest may be described as "any situation in which a person has one or more loyalties or obligations." There are many situations within the Program in which faculty, students, and preceptors may potentially have a conflict of interest. Awareness, appropriate planning, and intervention can prevent problems from developing.
Examples of conflict of interest situations include those which may provide students with access to confidential information about a midwifery practice or other students who have been in a practice, or impede the ability of a preceptor or faculty member to provide an unbiased opinion or judgment. The midwifery community in British Columbia is relatively small. It is therefore important that the Program make every effort to ensure that pre-existing relationships or knowledge do not bias the admission, education, evaluations of an individual student, or the treatment of midwives and midwifery practices.
Faculty, students and preceptors are required to notify the Director in writing within 14 days if they are requested to have as a student, preceptor, tutor, or faculty advisor with whom a present or previous relationship could potentially create a circumstance of conflict of interest.
- A relative or friend, or where a significant prior relationship exists.
- A prior or current caregiver or client.
- An employer or employee of the midwife or the midwife’s practice, including second attendants, administrators, and staff.
- An employee of any agency related to funding or governance of the midwife’s practice.
- Any circumstance that may be construed as having influence over the fair and impartial evaluation of a student.
The Program Director will review the information and inform faculty members as appropriate. The Program will attempt to avoid perceptions of conflict by providing an alternate arrangement when appropriate and possible.
In some cases a simple written declaration of potential conflict by the parties may suffice. When circumstances that have the potential for breach of confidentiality arise, other measures such as a confidentiality agreement may be required.
A formal offer of employment should not be given at any time prior to mid-term in the clerkship by a preceptor or her practice.
The dates for placement and the reasons for adhering to university sessional dates will be communicated to students during intensive sessions where placements are discussed and in tutorials when evaluations are planned. Clinical placement dates outside of the University sessional dates are generally not permitted and must be based on exceptional circumstances. Each placement is part of a university course. It is therefore expected that students will begin and finish their placements on the dates published for academic terms. Extensions are generally only permitted in cases where a deficit in a student’s clinical experience or performance has been identified and documented by the preceptor. A written plan must be placed in the student’s file that sets out the dates of an extension to a placement. The responsible faculty member must ensure the objectives are met during the extension. A final grade cannot be submitted until the conclusion of the extended placement.
The Midwifery Student Support Committee and Program Director must approve all extensions.
Please refer to the “Clinical Placement Start and End Dates Policy” for further clarification.
Last Revised: February 24, 2020
Students begin attending births in MIDW 200. Their level of involvement progresses from observation, to assisted or guided hands-on to solo hands-on during the placement and as circumstances allow. By the time the student reaches their clerkship the management of clinic, call and birth is completely in the hands of the student under the direct supervision of the preceptor. Clinical experience enables application of theory to practice, provides the venue for skill development, and enables formative and summative evaluation. Students are placed in clinical sites that offer adequate volume to enable the learning and evaluative components built into each course to occur.
Guide to planned birth numbers during the program
Continuity of Care
|350 or 370||
Total Minimum Required by CMBC*
TOC 1/5 or 20%
*The minimum requirements for registration with the College of Midwives of BC.
There is some flexibility possible – if numbers are lower in one course, they must be planned to be higher in the next term.
The goal of the Midwifery Program is to achieve entry to practice competency, not to obtain a specific number of clinical experiences. Some students will master certain areas of skill and knowledge with less exposure, and others will need more experiences.
The preceptor and the student should inform the tutor as soon as possible if the student’s birth opportunities are significantly less than outlined in this guide.
For more information around birth number tracking expectations and definitions, please visit the "How to Count Birth Numbers" tab.
Last Revised: February 25th, 2020
HOW TO COUNT BIRTHS
UBC Midwifery evaluates learners based on their competencies. However, the College
of Midwives of BC has established a base minimum for experience including birth
numbers as a requirement for registration. Thus, students must document their
attendance at all births and track the pre and postnatal visits with those people to
provide evidence that they meet these CMBC registration requirements. This list
provides the Definitions for each of these base requirements.
Attended = 60
These births occurred where you were in attendance in any capacity as a student
in the program. These do NOT include births attended outside your role as a
2nd Attendant = 2
You functioned as the 2nd attendant – prepared birth equipment and space,
monitoring fetus in 2nd stage, receiving newborn, assisting with active
management of third stage if done, ongoing maternal & newborn care &
assessments as indicated. Students must have demonstrated competency in acting as a Second Attendant prior to graduation. Competency in acting as a Second Attendant should be encouraged in the fourth year.
Continuity = 30
You attended the birth & had an additional 6 clinical visits with the person during
the prenatal and/or postpartum period.
Primary = 40
Acting under supervision, within the expectation of your student role and within
your level in the program, you were actively involved in the provision of care,
decision making and managing the case for 1st, 2nd, 3rd, and 4th stage. You
conducted the birth or your hands were on the baby as it was being born
There was an intrapartum transfer of care* and a MD conducted the birth.
Hospital = 5
You were the primary & conducted the birth in hospital.
Home = 5
You were primary & conducted the birth at home or in an out of hospital setting.
Count 1: If the birth was intended to be at home, you were present at the home
and transfer to hospital during labour occurred.
Transfer of care *: up to 8 of the 40 primary can be counted towards primary numbers
You were primary during the labour and you transferred care – the physician
conducted the birth and you were in attendance at the birth.
Last Revised: April 27th, 2020
A “clinical encounter” is defined as any client interaction where clinical assessment and care management or planning has taken place.
Students will attend at least 15 antenatal or postnatal encounters on average per week. These include clinic, home, and hospital visits in addition to intrapartum and perioperative care.
In cases where a visit is broken into two parts (e.g. a phone or video call, followed by an in-person assessment for the same purpose), these two portions should be considered the same, single encounter. Please note, reporting a normal lab result by phone should not be counted as a clinical encounter. However, reporting a lab result where assessment and/or follow up is performed, does count.
In addition to this, students should plan to attend department and practice meetings, educational forums such as rounds, peer review sessions, telehealth or online consultations with clients and consultants, and pre or postnatal education sessions, with an expected minimum of 2 and maximum of 4 of these activities per month.
Last Revised: October 21st, 2020
A permanent electronic experience record must be maintained and kept up to date by students engaged in clinical placements. It is an absolute requirement that students document relevant clinical experiences on a weekly basis while enrolled in a clinical course.* A Student Orientation Guide to T-Res can be reviewed here
*Students enrolled in MIDW 370 will have limited internet access. They can update their online experience record as soon as practical, and no later than before the onset of MIDW 405.
Documentation requirements include:
- Clinic encounters
- Specific clinical skills
- Birth details including
- Role (primary or observed)
- Planned place of birth and actual place of birth
- Transfer of care
- Continuity of care (attended birth plus an addition 6 other client encounters)
These data will provide ongoing information to the program about student progress and will be used to provide evidence for registration with the regulatory body upon graduation.
- Students are required to be familiar with the competencies required by the CMBC under “Competencies of Registered Midwives.”
- We recommend keeping a copy along with the student evaluation materials in order to help estimate development of each competency.
- Preceptors are required to review the students clinical experience record on a regular basis (weekly is ideal) during the term and verify them where indicated to confirm the supervision of the birth or experience.
- Birth numbers must be recorded and verified on the Evaluation Form at midterm and final.
- Students are required to be familiar with the competencies required by the CMBC under “Competencies of Registered Midwives.”
For definitions on counting births, please click here
UPDATED January 22nd, 2020
UBC Midwifery clinical faculty and their clients donate their time and considerable experience to help students gain the competencies they need to become midwives. They are vital to student education. It is important to establish effective communication with the clinical preceptor several weeks prior to starting the placement and arrange adequate time to ensure a comprehensive orientation to the clinic and hospital setting as well as meet the team midwives and clinic staff. The following guidance allows for some flexibility in initiating contact and establishing mutually acceptable timelines for moving forward.
Students are required to ensure the following steps are undertaken after they are assigned a clinical placement:
- ≥ Two months prior to placement: Provide a biography (document or e-portfolio ) to the Student Services Manager. This will be formatted and sent to the preceptor by UBC Midwifery.
- > Three weeks prior to placement: Contact preceptor and arrange a meeting in the first week of the placement.
- In the first week and ideally prior to clinical care: Set aside time with the preceptor to review:
- Course syllabus
- Learning objectives
- Evaluation timelines
- Tutorial times/dates
- Assignment/exam dates
- eLearning Plan
- Clinical Experience Record
- Evaluations tools
- Undertake an orientation to the practice and hospital - Clinic Orientation Checklist, Hospital Orientation Checklist
- Establish schedule for clinic, call and off call times and logistics for contact.
- Book Mid Term and Final Evaluation reviews.
- Course syllabus
Students may perform non-client related work in the practice if it is work that practice members normally do and if it contributes to the student’s understanding of the functioning of the practice and the nature of midwifery care, i.e., checking supplies, sterilizing equipment.
Please take your professional resume with you when you meet your preceptor.
UPDATED MAY 13th, 2020
Students are required to provide a short biography to be shared with their assigned preceptor prior to commencing each placement. The biography is approximately 100 words. Students may choose a photo to accompany it or the Midwifery Program will attach a copy of their UBC photo ID. Midwifery Student Services will format every student’s biography on UBC letterhead and forward it to each clinical preceptor. Biographies must be submitted to the Student Services office at least two months prior to starting any clinical placement. We also encourage students to develop and keep up to date an Academic Resume which can be done in Word or within their E-Portfolio which will be shared with the practice sites.
Students must always wear UBC photo ID when attending clinics, doing home visits and when in hospitals. Some hospitals may also require a hospital ID and this will be arranged where required. Students are required to notify the Student Services office if ID is lost and will bear the costs of replacement photo identification badges.
Students are required to dress professionally and appropriately at all times as they will be working with the public and other health professionals. “Business casual” attire such as skirts, pants and dresses are appropriate. Jeans are generally not acceptable; nor are low-cut or revealing tops. Shoes should be sturdy and comfortable, given the length of some days (and nights), especially during clinical placements.
Students are reminded that they may be working with pregnant women with body image issues. In addition, some communities may have specific expectations and comfort levels related to modesty in attire. Midwifery students are required to respect the customs and traditions of various women and their families when working in their homes. Professional dress requires attention to hair, body piercing, tattoos and jewelry. The same guidelines apply when students are in attendance at hospital rounds, meetings, and going to and from clinical work. Students are encouraged to clarify such requirements with preceptors, especially with regard to special dress codes for midwifery practices, the local hospital, or for the particular community she serves.
In order to experience the role of primary caregiver, students are expected to take full responsibility for client care and client relationships in collaboration with the preceptor.
- Prepare for client visits in advance.
- Arrange access to the paper or electronic health record through the preceptor or office administrative staff.
- Review the health record prior to each encounter.
- Research conditions, investigations and treatment plans.
- Develop a plan for each client encounter in advance:
- identify role with the preceptor by confirming plan and degree of involvement and;
- consult with preceptor to review the plan prior to each visit.
- Arrive on time, respond promptly to pages.
- Always wear UBC Student ID
- Strictly adhere to confidentiality guidelines.
- Always ask the preceptor questions about care in private and away from the client.
- Diverse practice styles are common in multiple midwife practices.
- This can be confusing to students so one should ask the preceptor how her practice group would like questions about different approaches addressed. Some practice groups have special times in their meetings when students can address questions about practice protocols and discuss students’ changing learning needs.
- Check with the preceptors to see how they prefer to travel to births and post-partum visits:
- are students and preceptors expected to travel together to births and clinic or separately?
- Remain flexible and adapt to the individual approaches of preceptors.
- Dress according to the expectation of the practice group.
- Be helpful, and assist with tasks that the midwives normally would do. This might include such activities as filing, checking inventory, tidying office.
- Be respectful of and polite with the administrative staff.
MIDW 200 through MIDW 440
Preceptors are responsible for all aspects of prenatal care including when a student is involved in providing such care. The preceptor will decide the portion of the prenatal visit in which a preceptor should be present in the room. The preceptor’s decision is based on the clinical course the student is registered in and the preceptor’s assessment of the student’s level of competence, skill, and knowledge.
The preceptor must participate in all or part of a clinical visit in MIDW 200 to MIDW 420.
- The preceptor will be on-site and immediately available during all antenatal, postpartum and intrapartum client encounters.
- Second Attendant: Students in MIDW 200 through 420 may only act in this role under the supervision of a second midwife or registered nurse. Students in MIDW 440 may act as the sole second attendant at births.
- Students and preceptors should arrange travel to client homes to ensure preceptor presence for all aspects of care. In the event that a student arrives prior to her preceptor, she should contact her preceptor for guidance, remain with the client in a Good Samaritan role, and/or contact emergency services as needed.
Clerkship (MIDW 440)
The Clerkship is the final opportunity for students to integrate theory and practice before comprehensive examinations and the Canadian Midwifery Registration Exam (CMRE). Clerkship offers midwifery students the opportunity to provide primary care under the supervision of a preceptor who facilitates the role of the clerk within the bounds of safe care, as acceptable to the client. Both clinical experiences and opportunities for review of basic and advanced course materials are necessary to prepare for safe entry-level practice.
The clerk must balance academic and clinical demands throughout the placement. The clerk must be granted time off for the five peer-review sessions in this term. The clerk will cover most of the clinic and call schedule of one full-time midwife. Although all students must have twelve hours per week of protected study time, these can occur at flexible times. The clerk should provide approximately 30-35 hours per week of actual clinical work and should attend an average of 15 clinical appointments per week throughout the placement.
Prenatal Care in Clerkship
Providing care to women in early pregnancy will help the student to maintain and demonstrate her competency in the range of skills required across the trimesters.
Clerkship students are expected to undertake prenatal appointments on their own with clients, however, a midwife must be on site and immediately available for consultation. The midwife/preceptor should review and sign-off on the chart before the client leaves the clinic in case she needs to intervene and/or something has been overlooked. For prenatal home visits, the clerk may do the visit prior to the midwife’s arrival, but the midwife/preceptor must review and sign-off on the chart at the client’s home on the same day.
Intrapartum Care in Clerkship
Clerkship students should plan to attend at least twelve births as a primary caregiver with at least two of these as a second attendant. A registered midwife is legally responsible for all care provided, and is on-site whenever a clerkship student is present for active labour. A clerk may provide labour care in the home or hospital by herself as long as the registered midwife is on the premises, immediately available, and receives regular reports from the clerk. Clerkship students are expected to have solid hands-on experience, except in situations requiring new skills. In such situations the preceptor will provide guidance to the student.
Clerkship students can also benefit from latent phase management experiences. Students may independently observe, assess, and provide supportive care during latent phase labour over the course of the Clerkship, under the following conditions:
- The midwife has confirmed the status of labour either by phone or in person.
- The midwife feels that the clinical situation is appropriate for clerk management.
- The midwife engages the student in creating a specific plan for latent phase support and management.
- The midwife and student make a plan for ongoing communication for each case.
- The midwife is available to return to the site upon request, change in maternal-fetal status, and upon onset of active labour.
- Distance or weather should not delay the midwife’s ability to be available on site within 15-20 minutes.
Students in MIDW 440 may act as the sole second attendant at births.
Home Visits: Students attending without Preceptors
Students may only provide midwifery care for home visits in the absence of a preceptor in limited and prescribed situations of postpartum care, as follows:
- MIDW 320 and 322: A student may attend one postpartum visit without a midwife on-site provided that the visit is not within the first three postpartum days and is not the final discharge visit.
- MIDW 420: A student may attend two postpartum visits without a midwife on-site provided that the visits are not within the first three days and it is not the final discharge visit.
- MIDW 440: A student in Clerkship may attend three postpartum visits without a midwife on-site provided that the visit is not the first visit after the birth and it is not the final discharge visit.
In the above situations the preceptor and the student must plan in advance the care the student can complete on her own. The preceptor should be available to attend the visit in the event that the student identifies a problem. Preceptors should inform clients that MIDW 320 and 322, MIDW 420 and Clerkship (MIDW 440) students are able to make postpartum visits without a preceptor if circumstances are appropriate.
In situations where a plan has not been developed for the student to do all or part of the visit on their own, it is appropriate for the student to enter the client’s home and visit socially (as long as she does not initiate care or assessments until the preceptor arrives). In order to ensure that the time a student is waiting for the preceptor is minimal, we recommend the following arrangements be communicated:
- Time of the visit; and
- Change of plans such as postponing or canceling home visits.
If a student is going to visit a client, the midwife should be available and aware of the visit. All students who make postpartum visits unaccompanied by a registered midwife must comply with the policy of the College of Midwives of British Columbia (CMBC), and report promptly to the supervising midwife before and after the visits.
Pages Directly from Client: Students receiving calls and pages
In MIDW 240, students will begin to orient to taking calls directly from clients. By the end of MIDW 240, students should have some experience and confidence with taking these calls. Taking client calls should be an integral part of the student’s role in MIDW 320 and 322, MIDW 420, and Clerkship (MIDW 440). Students at all levels should be in touch with their preceptor immediately after each phone call or page. Students should not be responsible for any emergency situation. For reasons related to both professional liability and effective teaching, each practice group should develop clear guidelines that outline the procedure for students taking client calls, and define the roles and responsibilities of student and preceptor.
Practice groups should consider the following when creating practice guidelines for students receiving calls directly from clients:
- Have an informed choice discussion with clients regarding the student’s involvement in receiving and responding to calls and pages.
- Develop instructions for clients about how and when to contact the student and/or the midwife, including when the client believes the situation is an emergency and how to redirect such calls.
- Provide supervision and follow-up for calls and pages the student receives from clients, including which midwife is responsible when the designated preceptor is off-call.
- Instruct the student how and when to redirect pages or phone messages as well as whom clients must contact when the student is off-call.
- Arrange how and when the preceptor will keep the student informed of client interaction that occurs directly with the preceptor.
UBC Midwifery students are required to develop and regularly update an electronic learning plan for all clinical courses. The eLearning plan is a component of T-Res. Students will share many common learning objectives (also referred to as needs or goals). However, development of an individual learning plan allows each student to highlight areas considered in need of improvement as identified by themselves, their preceptors, or their course tutors. The learning plan also tracks student expertise and progress in meeting these objectives at regular intervals throughout the program.
In order to be most effective, the learning plan engages each student in self-reflection and is updated regularly with input from clinical preceptors and course tutors. Updated learning plans must be filed with your Course Tutor at regular intervals including at the course onset, midterm and final evaluations.
Students will meet with their tutor and preceptor on a regular basis to review and discuss the clinical experience record and learning plans. To prepare for this activity students will be asked to do the following:
- Describe accomplishments toward their set goals
- Describe challenges faced in meeting course objectives, and describe how they were overcome or the plan to overcome this challenge.
- The learning plan should be updated at mid-term and after the final evaluation to reflect accomplishments, new or revised goals.
The Learning Plan
|Objectives||Describes what you need to accomplish|
|Time||Provides a reasonable and achievable timeline for meeting the objective|
|Current Knowledge, Skills, & Attitude||Provides applicable information that helps you and your faculty highlight your strengths|
|Plan||Lists strategies for how you will meet each stated objective|
|Actual||Describes what you were able to do|
|Evaluation||Describes the knowledge, attitude or skills measured at that time following the interventions|
Preceptors and the Student Learning Plan
At the onset of each clinical course schedule the student arranges a first meeting with the preceptor to allow adequate time to review the learning plan and the course objectives. This enables a professional introduction and fosters goal setting for the term. Use the learning plan to highlight personal and course based objectives for the term. The preceptor can provide the student with realistic suggestions and begin to consider how she and her colleagues can help the student meet these objectives.
Students’ previous experience and acquired knowledge, skills and attitudes are important. Combine these with the midwifery competencies found in the CMBC handbook and the clinical course evaluation form on CONNECT to provide the basis for the learning plan for each clinical course as students progress through the program.
Success in achieving learning objectives can be tracked through “experience” as well as demonstrated competency of skills. The following inform your progress and meeting objectives and can be confirmed in your outcomes related to learning objectives: your reflective notes on encounters and learning opportunities, a count of procedures done, a written report on a topic, a journal of your observations and feelings, feedback from clients or preceptor, or your personal judgements. Plan that during this process you may need to adjust your plan if you have set unrealistic expectations or your learning objectives were not met in the time set.
A common approach for writing objectives is to use this format:
With what material/subject
At the end of the practicum I will be able to:
...Conduct an informed choice discussion on at least 3 topics.
...Complete a physical examination of a pregnant woman without assistance.
...Explain the use of 10 commonly prescribed medications used by midwives.
...Inject an IM medication.
Selecting Behavioural Verbs
Behavioural outcomes are categorized into the three traditional areas:
Recalling information, solving problems
Attitudes/beliefs about things
Some verbs are better than others for use in communicating intended learner behaviors. Verbs such as “know,” “really know,” and “understand” are too vague for objectives; do not use them.
Educators would ask the classic question, "What does the learner need to do to demonstrate that s/he has achieved the objective"
Listed below are the three learning areas followed by verbs that have been found to be useful in descriptions of objectives.
- Cognitive (recalling information, solving problems)Knowledge Verbs: Define, List, Recognize, State
Knowledge involves the recall of learned information.
List the immunization schedule for an infant.Comprehension Verbs: Describe, Discuss, Explain, Report
Comprehension requires understanding concepts. A person who comprehends something can discuss it or explain it in his/her own words.
Explain the emotional changes of pregnancy.Application Verbs: Compute, Use, Predict, Determine, Demonstrate
Application refers to the ability to use learned material in new, concrete situations. Persons may be asked to apply rules, algorithms, theories or laws.
Determine if glucose screen is necessary.Analysis Verbs: Discriminate, Analyze, Compare
Analysis is the ability to break something into its constituent parts. Analysis requires a higher intellectual level than comprehension or application because it requires an understanding of the content and structure of the material.
Discriminate among common rashes in newborns.Synthesis Verbs: Diagnose, Manage, Summarize, Plan, Construct
Synthesis is the ability to creatively put information together to form a plan of care for a client.
Manage care during the second trimester of pregnancy.Evaluation Verbs: Compare, Assess, Justify, Rate
Evaluation is the ability to judge the value of something – a lecture, a drug choice, a client management plan, or an article. Evaluation includes the use of all skills lower in the cognitive taxonomy.
Assess a client’s over the counter medications that could interfere with her prescription meds.
- Psychomotor (skills, doing things)These generally refer to procedures performed. Sample verbs include: sew, clean, perform, apply.
Palpate the thyroid.
Assist in birth of the placenta.
- Affective (attitudes about things)These statements refer to responses to situations and willingness to read, motivation to get involved in situations, how the learner relates to others, etc. Sample verbs are: pay attention to, assist, respond, show concern, accept responsibility, maintain.
Volunteer to attend rounds and report to practice.
Take every opportunity to listen to hearts and lungs.
Read a chapter from xxxxxxx each night.
Feel comfortable with xxxxxx.
Linking objectives to learning and assessment
The language in the objectives can guide you to strategies for learning the skills. If your objective is to be able to “recognize postpartum depression,” some possible learning activities include
- Read about postpartum depression
- Talk to women about their feelings during the postpartum period
It is important to view the learning plan as a dialogue tool, as a tracking tool and a communication tool. Review your experience record with your preceptor and any previous clinical evaluations in order to track and support your progression in the program.
The learning plan is brought forward after every clinical term to be used as the introduction tool for subsequent clinical courses as outlined here:
Students are reminded of their obligation to protect client information and confidentiality as per the Confidentiality Agreement signed on admission to the program, the College of Midwives of BC Standards of Practice, and the Freedom of Information and Privacy Act. The student midwife may be responsible for chart entries during clinic or during a labour, birth, or postpartum encounter. It is the student’s responsibility to make sure the appropriate registered midwife signs off on their note(s).
The student is responsible for documenting all aspects of care including:
- Admission note
- Admission history
- Physical assessment
- Progress notes
- Perinatal Services BC forms including Antenatal Part 1 and 2, Labour and Birth Summary, Newborn Record, Community Liaison
- Vital Statistics Notice of Birth**
- Discharge summary
- Pertinent referrals & requisitions
- Other hospital forms including medication administration, intake and output, signature sheets, regional analgesia record, etc.
*Due to the nature of data entry for electronic hospital orders, the student will discuss plans for orders with the preceptor, and the preceptor will enter the data into the relevant computer systems.
**The supervising midwife must sign the Notice of Birth and countersign all documentation by the student midwife.
While on call, the student midwife must be accessible at all times by pager or phone. The preceptor will assume the student midwife on call is at the listed home or pager number unless advised otherwise. If contact information changes for a particular call shift, the student midwife may leave a message detailing how they can be reached using the email, phone, or pager number of the midwives with whom they are on-call. They should ask the preceptor to confirm receipt of message.
The student can arrange their call schedule with the preceptor. It is recommended that preceptors and students make arrangements that will allow the student maximum exposure to clinical work and yet allow the student to fulfill academic, personal and family commitments.
- All students are entitled to 3 days off call per month in addition to scheduled time for study, classes and examinations.
- Every student is off call for 12 hours prior to and during class AND an additional 3 hours immediately following class (the latter is to be used at the student’s discretion).
- Students will require the equivalent of 1/2 day per week off for private study time, which she will arrange with the preceptor. It is not necessary to be off call at this time. If the student is called to attend a client during scheduled study time the unused study time should be rescheduled as soon as possible. The student will inform the preceptor of any other clinical commitments that have been arranged by the Program.
- MIDW 420: Students are entitled to one continuous 24-hour period per week to work on their graduating essay. The day of the week used to do this will be negotiated with the preceptor.
- MIDW 440: Students are entitled to one continuous 12-hour period per week to prepare for the comprehensive exam and case dialogues. The day of the week used to do this will be negotiated with the preceptor.
- Students are to be allowed protected study time for examinations. They should be off call for births and practice appointments/meetings for a minimum of 72 hours prior to a final exam and 24 hours prior to a midterm.
- For safety and learning, students who have been awake for 24 hours must be off call at the 24th hour. They must be provided adequate time to get home and an additional 8 hours of sleep before taking call again. Preceptors should encourage students to take appropriate rest breaks where a prolonged work day is anticipated.
- If a student identifies that she is incapable of functioning in a safe and competent manner because of stress, illness, or sleep deprivation, she must immediately notify the preceptor to make appropriate arrangements. The Program allows students 3 flex days off call per term to be used at the discretion of the student or preceptor for these types of situations.
Absence for Illness or Stressful Outcomes
It is the student’s responsibility to exercise good judgment in deciding whether she is too ill to function safely as a clinician. Awareness of risk to mothers and babies, as well as good self-care, governs this decision. The student must negotiate coverage for her shift if she is too ill to be in the clinical area and her presence is expected. The appropriate preceptors should be notified by the student midwife. If the student is too ill to make these contacts for herself, a faculty tutor or program staff can help.
Students are strongly encouraged to make use of UBC’s Mental Health Support at Counselling Services in the case of stress or physical or emotional illness.
Preceptors and students may need to develop new approaches to working in a collaborative fashion. Students are expected to take an active role in their learning, to help define their own learning objectives, to continually develop plans for learning, and to develop self-assessment skills. Even though students develop their own learning plans, and take considerable responsibility for their own learning, preceptors have a vital and active teaching role. The preceptor’s role includes spending time reviewing students’ learning plans and designing appropriate learning opportunities which are linked to objectives which both the preceptor and student midwife understand and agree on. These plans should be frequently reviewed, at a minimum during orientation sessions, midterms, and finals.
The preceptor is the clinical evaluator for the Midwifery Program and takes responsibility for ensuring that students can competently and consistently perform the skills identified for each course and provide documentation for the program. Even students who are performing well require frequent informal feedback and formal clinical evaluation. Each student will have unique needs, and these needs will be dynamic as the student progresses through the program.
Preceptors, like students, have a variety of “styles.” Being aware of and discussing learning and teaching styles can help preceptors and students adapt to each other. There are a variety of ways to conceptualize how learners organise and internalise information and experiences. David Kolb’s Learning Style Inventory is one example of identifying how people learn. Kolb describes learning styles as an acquired, consistent pattern of learner – environment interaction. Students and preceptors can explore their own learning styles using Kolb’s Learning Style Inventory or other learning styles tools. What may seem like issues unrelated to learning, teaching and assessment (e.g., age differences, conversational styles, sense of humour, energy levels) can be very important in terms of enjoying or not enjoying work with another person. Students and preceptors should try to find out some of these things about each other, and identify approaches that can maximize enjoyment of their work experience together.
The preceptor / student relationship is a professional relationship, founded on mutual respect and a commitment to good communication. Both the student and the preceptor will often experience stresses due to the unique demands placed upon them. Most problems that occur in clinical placements can be resolved by open and direct communication between preceptor and student within the practice. However, in the event a problem occurs and communication is not successful at resolving the issue (or if at any time the preceptor evaluates the student’s performance to be unsatisfactory), then the student and preceptor should meet with the tutor. Refer to the Clinical Evaluation Process.
Students should be aware that there is diversity among preceptors and practices. Students should be prepared to adapt to different teaching and practice styles with a genuine desire to learn from each experience.
The preceptors in the Midwifery Program are aware that the student experience can be very stressful. Students in turn must remember that being a preceptor is a very significant time commitment for the midwife and that it can be much more stressful than working without students. Student and preceptors should therefore focus on the rewards of working together. The course tutor is always available as a resource if questions or concerns arise.
The Program tries to avoid situations that may pose a conflict of interest, such as when the tutor and preceptor are in the same practice. However, as the midwifery community is small this may not always be possible. In these situations, alternate faculty can be involved in evaluation or problem-solving.
All injuries must be reported within 24 hours.
Which incidents need reporting?
These are examples only. Other incidents may occur. If in doubt, make a report.
- Any event involving injury to a person or damage to property
- Fetal, maternal or newborn deaths that occur while a student is involved in care
- Fetal, maternal or newborn injuries that occur while a student is involved in care
- Unanticipated clinical outcomes: a newborn needing NICU care, a women having a cesarean section that results in a hysterectomy
- Medication errors
- An allergic reaction that results in hospitalization
- Needle stick injuries or lacerations during surgery
- Falls-student, patient, faculty or visitor
Injuries that need attention are managed according to the procedures and policies of the clinical site at the time needed. Reporting can commence once the incident is managed.
Who should be notified by the student?
- The supervising clinical preceptor
- The Midwifery tutor and course lead
Who should be notified by the course lead?
- Undergraduate Program Lead
- Midwifery Program Director
- Manager, Health & Safety Advisor/Faculty of Medicine https://mednet.med.ubc.ca/HR/myHRfaculty/WorkingEnvironment/Pages/Reporting-Accidents-Incidents.aspx. Instructions for the online reporting form and how to contact the Health and Safety Manager are on this website.
Who will be notified by the Program Director?
- Director, Department of Family Practice
- Associate Dean for Health Professions
- Faculty of Medicine Dean’s Office Communications, Media Relations, Issues Management
Last Revised: February 21, 2020
Students who experience personal or emotional challenges can access student services at the university or ask for help from the Associate Director. Students are strongly encouraged to make use of UBC’s Mental Health Support at Counselling Services in the case of physical or emotional illness.
Students with special needs (e.g., medical appointments), should plan them well in advance with their assigned preceptor or tutor. If in the clinical setting students must also take responsibility for informing clients if they will not be available. Students should inform preceptors and tutors of any problems that might affect clinical or academic performance. The preceptor should not be expected to be responsible for problem solving or making accommodations unless requested by the Program.
Working with students can bring enjoyment and also present challenges to midwifery practices and practitioners. Students bring new energy, perspectives, interests, and resources to a practice, including current theoretical knowledge. Students who are keen to develop their midwifery skills are appreciative of the experience, teaching, assessment and encouragement provided by preceptors. Students can share the midwives’ workload by providing labour support and care to women, and contributing to the work of prenatal and postpartum care.
It can sometimes be difficult for midwives to share the relationships they have with clients with the student. It takes energy and skill to present students to pregnant women and to be teaching and assessing during prenatal appointments, labours, births, and postpartum home visits. Many preceptors, however, enjoy the added challenge and complexity of providing excellent care while teaching. They also enjoy sharing their skills and knowledge, and value the contributions that students bring to the practice.
Preceptors and students both need support from peers. Some practices regularly discuss teaching challenges at practice meetings and brainstorm approaches and solutions. Sharing problems, dilemmas and solutions between preceptors and students is essential to developing skills and improving teaching and learning. It is imperative that this kind of sharing and discussion be done in a manner that is respectful and maintains confidentiality. The practice of midwifery in British Columbia is a very small community indeed, and this necessitates a professional and respectful approach.
Practice Education Program (PEP) University of Western Ontario
This asynchronous on-line program is available to support preceptors and students. Complete the short registration process and instantly receive your login information.
Once in you can access the PEP program anytime, anywhere. Each module takes about 30 minutes to complete and is full of quick tips and downloadable learning activities and tools. It is easy to navigate, colourful, fun to use, and many of the modules are designed so that preceptors and students can work through them together. A certificate can be printed at the end of the module to record the education completed.
Last Reviewed February 1, 2017