Analyzing and strengthening the clinical support of undergraduate midwifery students and developing a mentorship training program at a higher education institution in KwaZulu-Natal, South Africa: a mixed method and action research design.

Abstract

The competence of midwifery students is highly dependent on the quality of clinical support they receive during clinical placement. Offering support and training to midwifery practitioners, who supervise students during placement, is necessary in South Africa. This study aimed to analyze and strengthen the clinical support of undergraduate midwifery students, and develop a mentorship-training program. This study adopted a mixed-method and action research approach incorporating a descriptive and exploratory design. A convenient and purposive sampling technique, multiple research tools (systematic scoping review protocol, questionnaires, interviews and focus groups), and three different study populations (60 midwifery students, 28 practitioners and 10 educators) complimented the aim of conducting a mixed-methods study. Data collection commenced for Cycle 1 in May 2019 and concluded with Cycle 4 in April 2022. Quantitative data was inserted into SPSS version 27 for descriptive and comparative analysis whilst qualitative data used a thematic content analysis approach. Cycle 1 results highlighted that 93% of students had support from midwifery practitioners and found that the clinical placement benefitted their learning outcomes. Although students received three types of clinical support, namely clinical supervision, mentorship and preceptorship, 80% of clinical support was clinical supervision. Postclinical placement, students were incompetent in 11.4% of their clinical requirements. In Cycle 2, a two-round Delphi method evaluated the quality of a mentorship-training program using midwifery experts in round 1 and midwifery practitioners in round 2. There was an overall quality score achieved of 81% round 1 and 96% in round 2. In Cycle 3, three themes emanated from the focus group discussions. Mentorship training was a new phenomenon, empowered mentorship abilities, and an investment toward midwifery leadership. Interview results showed that the mentorship training program was a new, well-structured and valuable program; a refresher course for midwifery clinical practitioners and educators, adequate to support midwifery practitioners in their mentorship roles and responsibilities, and produced recommendations for midwifery practice and education. Mentorship during clinical placement is likely to strengthen the clinical support of midwifery students. A mentorship training program for midwifery practitioners developed in this study is valuable to midwifery educators and practitioners in South Africa.