I was chatting to a group of student midwives recently, and casually asked, have you ever experienced practice in the ‘clinical areas’ which just didn’t fit with the stuff you have been taught at university?
The answer was quick in coming: ‘have we ever’!? One of the 3rd years almost shouted, ‘on a daily basis’! The group went on to recount episode after episode of encounters where mentors had behaved in a way that directly contradicted what they had been reading and learning from lecturers.
To be honest I was not surprised, when I qualified in 1994 we where having the same conversations, if it wasn’t ‘coaching pushing with breath holding’ it was using the ‘lithotomy position’ to speed up the birth.
What is going on?
When will this mad ‘theory practice gap’ be bridged? When will newly qualified midwives enter practice confident that they won’t have to ‘battle’ out dated practices that they know are, if not wrong, not the best we could be offering pregnant women and their families?
Seems obvious to me, because of the way we are ‘wired’ to learn mentors in the clinical areas have more power to influence the practice and learning of student midwives than academics.
It’s simple really if we reflect on our own experience of learning, I hate to say it but my children are walking in the footsteps I thought I covered up.
All learning is a deeply unconscious process, we watch, we listen, we imitate, our behaviours are the outflow of what we have modelled from those around whose opinions are important for our survival.
Hey, I know getting on with your mentor is not a ‘life or death’ issue, but when you’re a student it feels like it right?
If you are going to survive the course and at some point fit into the workforce your behaviours have to become consistent with the spoken and unspoken rules of the institution.
What is the answer to the ‘theory practice gap’?
I’m guessing there isn’t one answer, but seeking to point midwifery education in the direction of the ‘old paths’ would be a good place to start; an apprentice model rather than a purely academic one.
‘Wise woman, with wise woman’, the lecturer being in practice with a ‘caseload’ of pregnant women and small group of students that they work with day to day.
The students are guided in their reading and reflection outside of the times when they are just being with their midwife/educator/mentor, no separation between what they are learning and what they are seeing, hearing, experiencing every day as they ‘become’ midwives.
Imagine many, many, birth educator/practitioners each with a small group of students, little or no classroom work, yes, lots of study, writing and reflection but outside of the times that students are just with women as they birth, learning from their ‘wise woman midwife’.