Working and learning: post-registration student midwives' experience of the competency assessment process

Abstract

Aim: to explore student midwives experiences of the Clinical Competency Assessment process utilised on the Higher Diploma in Midwifery (18 month) programme.

Background: the assessment of clinical skills and practice has traditionally been an integral part of midwifery educational programmes; however the method of clinical assessment has changed and developed. Similar to other countries, in Ireland assessment of clinical practice is achieved through the utilisation of a broad competency framework provided by the regulatory body, An Bord Altranais (2005) which is yet to be evaluated from a midwifery perspective.

Method: a descriptive qualitative study was undertaken once ethical approval had been granted by the University's Ethics Committee. All student midwives (n=20) in one cohort were invited to participate and nine students were interviewed. Interviews were tape recorded. Data were analysed using Burnard's (2006) framework.

Findings: the process of competency assessment was perceived by many of the students to facilitate continuous assessment of clinical practice but there were issues in relation to the language and the number of competencies to be assessed. There were challenges also associated with the written evidence required as part of the assessment with many of the students questioning the usefulness of this in a clinical assessment. A variety of supports were identified and utilised by the students. Continuity and availability of preceptors were noted to be factors impacting on completion of the assessment as were the competing demands of clinical care.

Recommendations: the findings of this small study are congruent with much of the international literature focusing on clinical competency models. Consideration needs to be given to identifying and integrating into practice, a clearly defined process for competency assessment, by all the relevant stakeholders. An opportunity for feedback throughout the process is considered very significant and the mechanism for this needs to be made explicit in any competency assessment documentation Competency documentation currently in use needs to be reviewed in light of the findings of this study and the rationale for inclusion of a written evidence component needs to be carefully considered. Further research is warranted in relation to the effectiveness of the competency tool in assessing competency in practice.