Challenges of Clinical Education in Midwifery and Strategies to Improve It: A Qualitative Study

Abstract
Background: Recognizing the barriers to clinical training and providing appropriate solutions to them significantly enhance the quality of clinical training. Objectives: The present study was conducted to evaluate the challenges of midwifery clinical training, and propose solutions from the perspective of midwifery instructors and students. Methods: The present qualitative study was conducted on 10 midwifery instructors and 10 midwifery students using semi-structured interviews (n = 12) and focus groups (n = 8). Each interview or focus group lasted 45 - 90 minutes. The interviews and codes extracted were stored in Max QD. Content analysis was also used to analyze the qualitative data. Results: Analyzing the data led to the extraction of two main themes, i.e. efficient clinical training and strategic planning challenges, four categories, i.e. efficient clinical instructors, quality of clinical setting, learners’ perception of the situation and efficient educational planning, eight subcategories, i.e. instructors’ clinical competence, instructors’ motivation, professional attitude, humiliating experiences, restricted resources, inappropriate atmosphere of the clinical setting, inefficient curriculum and inefficient educational methods, and twenty semantic units. Conclusions: Clinical training can be improved by considering the job motivation of the midwifery instructors, reviewing the system of selecting and evaluating the instructors, paying attention to the psychological dimension and academic motivation of the students, enhancing the intra-organizational cooperation in line with training, optimally allocating educational resources, reviewing the educational curricula based on the community needs and developing midwifery references tailored to professional goals.
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