Opportunities and challenges in clinical learning of midwifery students in public Universities of Tigray Region, Ethiopia, 2020: a qualitative study

BACKGROUND: Clinical learning focuses on real problems in the context of professional practice in which learners are motivated by its relevance and active participation. Studies showed that midwifery students were challenged by the absence of a variety of cases in non-teaching hospitals, overcrowded teaching hospitals, absence of objective-based evaluation methods, and lack of supervision from clinical instructors. If the theory learned in class was applied in practice, it is helpful to produce skillful and competent midwifery professionals. The aim of this study was exploring opportunities and challenges for midwifery students in the clinical learning environment. METHODS: the study was conducted in public Universities of Tigray, Ethiopia. Phenomenology study design and purposive sampling technique were employed; four focused group discussions and five key informant interviews were conducted. Data were collected using an open-ended guide, transcribed verbatim, entered into ATLAS ti7 software, and translated. Then codes and themes were derived from the transcribed data, and finally analyzed thematically. RESULTS: a total of 33 participants in which 28 in four focused group discussions and five key informant interviews participated in this study. Based on the result, midwifery students were getting opportunities to practice when they were assigned to non-teaching hospitals, working with close supervision, having smooth relationships with staff, receiving constructive feedback, and evaluated based on their skills. Whereas, they were challenged by aggressive staff, poor follow up, overcrowded teaching hospitals, low usage of skills lab, and short time for clinical practice. CONCLUSION: Midwifery students have positive attitude, and were getting opportunities to practice while they were assigned to a very conducive clinical learning environment with supportive and skillful clinical instructors/ preceptors. However, they have negative attitude, and were challenged to work due to the poor attention given to midwifery students’ clinical learning. It is recommended that midwifery students have to practice well in skills lab before they assigned for clinical practice so that the skills lab have to be strengthen with all necessary materials for clinical practice and clinical instructors have to be integrated to teaching hospitals so as to educate students while their hands-on.