A qualitative evaluation of a preceptorship programme to support newly qualified midwives

Background. Contemporary UK midwifery practice has its own particular pressures upon – and requirements of – newly qualified practitioners. The NMC recommends that the focus of pre-registration programmes of midwifery must be on the skills and attitudes needed to support and promote normal birth (NMC, 2007). In relation to the skills of caring for women at high risk of complications, the NMC states that ‘skills required for taking on the role of lead carer for women with complex medical and/or obstetric needs is developmental, and competence is to be achieved after initial registration’ (NMC, 2009: 19). It is therefore likely that the midwife, at the point of qualification, will not be fully conversant with the range of skills associated with the care of women with complex needs, and some structured programme is required (DH, 2008). Aim. A midwifery programme of preceptorship was implemented in 2004 in one NHS foundation trust in north-west England and a structured evaluation was undertaken, starting in June 2009, to identify strengths and weaknesses to further develop the programme. Method. Focus groups and interviews were used to collect data from one cohort of six newly qualified midwives (NQMs), six preceptors and four midwifery managers over an 18-month period from June 2009 to December 2010. Data were collected on participants’ perceptions of strengths and weaknesses in the programme with regard to curriculum content, support and professional development. Data were analysed using thematic analysis. Three overarching themes were identified from the data: developing competence and confidence, support, and organisational constraints. The head of midwifery gave permission for the study to be conducted and the proposal received ethical approval from the university ethics committee. Results. The structured preceptorship programme was viewed as helpful in developing the NQM’s confidence and competence. The relationships built up during this time were considered to be valuable and mutually beneficial. Organisational constraints at times made achieving the aims of the programme more difficult and necessitated a flexible, individualised approach. Implications. The evaluation supports the evidence for implementation of a personalised, structured, and equitable approach to UK midwifery preceptorship, accompanied by further research on its effects on the care of women and retention of staff