Student midwives' self-assessment of factors that improve or reduce confidence in clinical practice during a 1-year training period in Zimbabwe

Abstract

Background/Aims Several studies demonstrate that midwifery students do not feel confident in their ability to practice independently post-qualification, both globally and in Zimbabwe. To build competence, it is critical that midwives are encouraged to assess factors that improve or reduce their confidence in clinical practice. This study aimed to explore factors enhancing or reducing midwifery students' confidence in clinical practice in Zimbabwe, following a 1-year training course. Methods A total of 300 midwifery students from 22 government midwifery training schools in Zimbabwe participated in a cross-sectional survey that assessed self-confidence at completion of a 1-year training course. Students responded to the question ‘What factors improved or reduced your confidence in clinical area during training?’ Thematic analysis was used to describe and interpret students' responses. Results The main theme taken from students' answers was that resource availability in the clinical learning environment is key. There were four sub-themes: (1) the midwifery education programme, (2) teaching-learning methodologies, (3) clinical instructor/supervisor professional behaviour, and (4) student fear and insecurity. Conclusions Confidence development is a process to be cultivated and nurtured in students during midwifery training. Student midwives are faced with multiple factors inherent to an unsupportive clinical learning environment, which negatively impacts their confidence. These include shortages of resources and the attitudes and teaching practices of supervisors or instructors. Focus should be given to creating a supporting clinical learning environment, to improve students' confidence and competence.