Issues for debate Learning to be a midwife in the clinical environment; tasks, clinical practicum hours or midwifery relationships Lyn Ebert a, * , Olivia Tierney b, 1 , Donovan Jones a, 2 a School of Nursing & Midwifery, Faculty of Health and Medicine, University of Newcastle Callaghan, NSW 2308, Australia b Mid-North Coast Local Health District, Port Macquarie Hospital, NSW 2444, Australia article info Article history: Accepted 9 August 2015 Keywords: Midwifery Clinical education Continuity of Care Experience Midwifery relationships Competency Work Integrated Learning abstract Discussions continue within the midwifery profession around the number of and type of clinical expe- riences required to ensure competent midwifery graduates. Introduction of the three year Bachelor of Midwifery in Australia, almost two decades ago, was intended to reduce the pressure students were under to complete their academic requirements whilst ensuring students developed midwifery practice that encapsulates the philosophical values of midwifery. Currently, midwifery students are mandated to achieve a minimum number of clinical skills and Continuity of Care Experience (CCE) relationships in order to register upon completion of their degree. To achieve these experiences, universities require students to complete a number of clinical practicum hours. Furthermore students are required to demonstrate competent clinical performance of a number of clinical skills. However, there is no evidence to date that a set number of experiences or hours ensures professional competence in the clinical environment. The aim of this paper is to promote discussion regarding the mandated requirements for allocated clinical practicum hours, specified numbers of clinical-based skills and CCE relationships in the context of learning to be a midwife in Australia. © 2015 Elsevier Ltd. All rights reserved. “Midwifery is a woman centred, political, primary health care discipline founded on the relationships between women and their midwives” (Australian College of Midwives [ACM], 2004) with the midwife “recognised as a responsible and accountable professional who works in partnership with women …” (Nursing and Midwifery Board Australia [NMBA], 2006). However working in partnership with women during their childbearing experience and developing womanemidwife relationships can be problematic within the context of learning to be a midwife in Australia. The implementa- tion of the Bachelor of Midwifery in Australia was portrayed as a means to facilitate midwifery models of care for childbearing women and a midwifery education that provides learning oppor- tunities more closely aligned with the philosophical principles of woman-centred care. The Bachelor of Midwifery commenced in Australia in 1997. The degree was developed and adapted from similar programs in the United Kingdom and New Zealand. It was proposed that the introduction of the Bachelor of Midwifery degree in Australia would have two professional benefits for Australian midwives and birthing women. Firstly, negating the requirement to complete a nursing degree prior to entering the discipline of midwifery while increasing the length of the midwifery degree would facilitate student learning underpinned by the philosophical values of midwifery; woman-centeredness, and allow greater opportunities for models of clinical practice that aligned with those philosophical underpinnings. Secondly, the three year undergraduate degree would provide comparable academic and clinical practice stan- dards for the Australian midwifery profession to those of the United Kingdom and New Zealand, resulting in reciprocal registrations between these countries. However, reciprocal registrations have not eventuated. Prior to the introduction of the Bachelor of Midwifery degree in Australia, registered nurses undertook post-graduate pre-registra- tion midwifery program. The term ‘pressure cooker course’ was often referred to when discussing postgraduate midwifery pro- grams. The three year Bachelor of Midwifery was intended to reduce the pressure students were under to complete their aca- demic and mandated clinical midwifery skills requirements and * Corresponding author. Tel.: þ61 438923246. E-mail addresses: lyn.ebert@newcastle.edu.au (L. Ebert), Olivia.Tierney@ncahs. health.nsw.gov.au (O. Tierney), Donovan.jones@newcastle.edu.au (D. Jones). 1 Tel.: þ61 2 65816359. 2 Tel.: þ61 2 49216940. Contents lists available at ScienceDirect Nurse Education in Practice journal homepage: www.elsevier.com/nepr http://dx.doi.org/10.1016/j.nepr.2015.08.003 1471-5953/© 2015 Elsevier Ltd. All rights reserved. Nurse Education in Practice xxx (2015) 1e4 Please cite this article in press as: Ebert, L., et al., Learning to be a midwife in the clinical environment; tasks, clinical practicum hours or midwifery relationships, Nurse Education in Practice (2015), http://dx.doi.org/10.1016/j.nepr.2015.08.003