AN OVERVIEW
The pandemic has been hard on all of us, but especially for California-based midwifery students. California nurse-midwives precept student midwives from California-based programs (UC San Francisco and Cal State Fullerton), as well as distance learning programs ( Frontier Nursing University, Georgetown University, and Shenandoah).
According to a recent survey sent to students and program directors in California by Devon Herbst (Chair of the Midwifery Workforce Development and Education Committee), more than 50% of the students in California are in distance learning programs and more than 90% of the midwifery students in the state are having difficulty finding preceptors to complete their programs.
Because more than 90% of student midwives can’t find preceptors, midwifery students are migrating to other states for academic completion. This migration creates a huge obstacle for keeping graduating midwives in California. We need more midwives, not fewer. It is time for CNMs and CNM practices across California to engage in conversations about strategies to precept student midwives within their organizations. The more preceptors we have available, the more we can diversify and encourage the growth of the midwifery profession in California.
The pandemic has been hard on all of us, but especially for California-based midwifery students. California nurse-midwives precept student midwives from California-based programs (UC San Francisco and Cal State Fullerton), as well as distance learning programs ( Frontier Nursing University, Georgetown University, and Shenandoah).
According to a recent survey sent to students and program directors in California by Devon Herbst (Chair of the Midwifery Workforce Development and Education Committee), more than 50% of the students in California are in distance learning programs and more than 90% of the midwifery students in the state are having difficulty finding preceptors to complete their programs.
According to a recent survey sent to students and program directors in California by Devon Herbst (Chair of the Midwifery Workforce Development and Education Committee), more than 50% of the students in California are in distance learning programs and more than 90% of the midwifery students in the state are having difficulty finding preceptors to complete their programs.
Because more than 90% of student midwives can’t find preceptors, midwifery students are migrating to other states for academic completion. This migration creates a huge obstacle for keeping graduating midwives in California. We need more midwives, not fewer. It is time for CNMs and CNM practices across California to engage in conversations about strategies to precept student midwives within their organizations. The more preceptors we have available, the more we can diversify and encourage the growth of the midwifery profession in California.
The pandemic has been hard on all of us, but especially for California-based midwifery students. California nurse-midwives precept student midwives from California-based programs (UC San Francisco and Cal State Fullerton), as well as distance learning programs ( Frontier Nursing University, Georgetown University, and Shenandoah).
According to a recent survey sent to students and program directors in California by Devon Herbst (Chair of the Midwifery Workforce Development and Education Committee), more than 50% of the students in California are in distance learning programs and more than 90% of the midwifery students in the state are having difficulty finding preceptors to complete their programs.
Because more than 90% of student midwives can’t find preceptors, midwifery students are migrating to other states for academic completion. This migration creates a huge obstacle for keeping graduating midwives in California. We need more midwives, not fewer. It is time for CNMs and CNM practices across California to engage in conversations about strategies to precept student midwives within their organizations. The more preceptors we have available, the more we can diversify and encourage the growth of the midwifery profession in California.
STUDENT PERSPECTIVES ON THE PRECEPTOR CRISIS
Frontier Nursing University student Merilee Vance shares her story:
“When I started my clinical search I was fairly new to the state, therefore I wasn’t working and didn’t know any CNMs or RNs. I reached out to our clinical advisor at Frontier and she gave me a list of former clinical sites in California. I started searching in a short radius from my location and realized I was more in trouble than I had originally thought. I only heard back from a handful of sites, all of which were full or no longer taking students. Several places told me they couldn’t believe that we weren’t automatically placed by our school because the other two schools in the state have secured the majority of clinical sites. After about a year of no success, I ended up deciding to split up my last two classes to have more time to find a site. Unfortunately, this delayed my graduation by a term. My Regional Clinical Faculty advisor through Frontier lived in Phoenix and told me I would likely find a site there because there are no midwifery schools in Phoenix. The second site I called was able to take me as a student and I started just a couple of months later! During my clinical site search in California, I was hoping to find a website where current, available CNMs were listed or some sort of assistance that would have made me feel less alone in my search. I placed a bio on the California ACNM site but didn’t hear from anyone. Not knowing anyone in the area was a barrier but having all of the sites taken “locked-up” by the in-state schools was my biggest obstacle. I can only look to pay it forward when I’m able to precept. I want to help students find placement in any way I can.”
Despite the work that in-state schools do to help place their students in clinical sites, their students also face challenges to secure preceptor placement. Summer Felcyn-Ghenco from Cal State Fullerton shares:
“I am a senior Women’s Health Nurse Practitioner student. My experience with the shortage of preceptors has been profound and has negatively affected my academic experience. I was able to find a clinical site that requires me to drive 3 hours and am only scheduled a few times a month. The preceptor shortage has left me with feelings of academic abandonment and doubt regarding my future in this field. If my clinical placement circumstances don’t improve quickly, I won't be able to graduate on time. I have struggled with fears about how this shortage will impact not only my future job opportunities but also my practical abilities. We absolutely must do better!” Although Summer is a WHNP student her experience is a reflection of the difficulties faced by many student midwives.
Another respondent to the survey shared:
“Midwifery care has its roots in empowering communities. It’s hard to believe that we as a profession of midwives would make it so challenging for students to get clinical placement. If we want midwifery to grow, we need to provide the care but also support the student learning process. We need to help the next generation of midwives learn and grow so our profession can benefit as a whole.”
We can and must do better for students and this may mean taking on the leadership at our institutions. Our institutions need us and we must embrace our power and advocate so we can support student midwives in their education!!
“When I started my clinical search I was fairly new to the state, therefore I wasn’t working and didn’t know any CNMs or RNs. I reached out to our clinical advisor at Frontier and she gave me a list of former clinical sites in California. I started searching in a short radius from my location and realized I was more in trouble than I had originally thought. I only heard back from a handful of sites, all of which were full or no longer taking students. Several places told me they couldn’t believe that we weren’t automatically placed by our school because the other two schools in the state have secured the majority of clinical sites. After about a year of no success, I ended up deciding to split up my last two classes to have more time to find a site. Unfortunately, this delayed my graduation by a term. My Regional Clinical Faculty advisor through Frontier lived in Phoenix and told me I would likely find a site there because there are no midwifery schools in Phoenix. The second site I called was able to take me as a student and I started just a couple of months later! During my clinical site search in California, I was hoping to find a website where current, available CNMs were listed or some sort of assistance that would have made me feel less alone in my search. I placed a bio on the California ACNM site but didn’t hear from anyone. Not knowing anyone in the area was a barrier but having all of the sites taken “locked-up” by the in-state schools was my biggest obstacle. I can only look to pay it forward when I’m able to precept. I want to help students find placement in any way I can.”
Despite the work that in-state schools do to help place their students in clinical sites, their students also face challenges to secure preceptor placement. Summer Felcyn-Ghenco from Cal State Fullerton shares:
“I am a senior Women’s Health Nurse Practitioner student. My experience with the shortage of preceptors has been profound and has negatively affected my academic experience. I was able to find a clinical site that requires me to drive 3 hours and am only scheduled a few times a month. The preceptor shortage has left me with feelings of academic abandonment and doubt regarding my future in this field. If my clinical placement circumstances don’t improve quickly, I won't be able to graduate on time. I have struggled with fears about how this shortage will impact not only my future job opportunities but also my practical abilities. We absolutely must do better!” Although Summer is a WHNP student her experience is a reflection of the difficulties faced by many student midwives.
Another respondent to the survey shared:
“Midwifery care has its roots in empowering communities. It’s hard to believe that we as a profession of midwives would make it so challenging for students to get clinical placement. If we want midwifery to grow, we need to provide the care but also support the student learning process. We need to help the next generation of midwives learn and grow so our profession can benefit as a whole.”
We can and must do better for students and this may mean taking on the leadership at our institutions. Our institutions need us and we must embrace our power and advocate so we can support student midwives in their education!!
THE RESEARCH
According to a 2021 survey completed by the American Midwifery Certification Board (AMCB), there are 1204 CNMs in the state of California, more than any other state in the US! According to Midwifery program leads, CSUF accepts 12 Midwifery students a year and UCSF accepts 12-16 students per year. CSUF and UCSF turn away dozens of students each year because of the shortage of clinical sites. Frontier currently has 52 students based in California and at least half of them cannot find preceptors.
Why are students having such a difficult time?
It's important to recognize the Covid pandemic, staffing shortages, burnout, as well as the work it requires to precept a new midwife. Most preceptors are not financially compensated for their work. Additionally, many CNMs are required to train OB residents and medical students, which fosters collaborative care teams, but negatively impacts student midwives in their search for clinical placements.
According to the recent Midwifery Workforce Development and Education Committee survey, the biggest barriers that students are facing in finding preceptors include:
Many students share that they are being turned away from sites because some practices will only take students from certain schools. However, both CSUF and UCSF midwifery program directors shared that their schools do not have exclusive contracts with clinical sites for their students.
Why are students having such a difficult time?
It's important to recognize the Covid pandemic, staffing shortages, burnout, as well as the work it requires to precept a new midwife. Most preceptors are not financially compensated for their work. Additionally, many CNMs are required to train OB residents and medical students, which fosters collaborative care teams, but negatively impacts student midwives in their search for clinical placements.
According to the recent Midwifery Workforce Development and Education Committee survey, the biggest barriers that students are facing in finding preceptors include:
- Lack of response to emails inquiring whether a person or site are taking students
- Practices not accepting students, taking too few students, or only taking students from certain schools
- COVID-19 pandemic training restrictions established at the start of the pandemic limit hosting trainees despite school vaccine requirements for students
- Lack of accountability amongst schools identifying students placement, especially since this is a requirement by the Accreditation Commission for Midwifery Education (ACME)
Many students share that they are being turned away from sites because some practices will only take students from certain schools. However, both CSUF and UCSF midwifery program directors shared that their schools do not have exclusive contracts with clinical sites for their students.
LET’S ALL BE PART OF THE SOLUTION
The California Nurse-Midwives Association (CNMA) and the California Nurse-Midwives Foundation (CNMF) are working synergistically to find solutions and help build our workforce.
CNMA has started the Midwifery Workforce Development and Education Support Committee to develop short and long term strategies and solutions and better understand why CNMs and sites are not taking midwifery students. We are dedicated to ensuring this is done equitably. Please consider joining this committee!
CNMF recognizes that precepting often comes at a cost, whether accepting students as an individual preceptor or advocating to allow for precepting at your institution. We partnered with Anthem and currently have $16,000.00 for a grant to support: a) precepting and b) mentoring. Click here to fill out a 1-page application. We are exploring the best strategy to encourage sites to open up now while we also look at long term strategies. A short term strategy may mean supporting individual CNMs (time for onboarding, orienting, decreased templates) or to support your ability to advocate for your institution to open up for student precepting. Please fill out the application and let us know what you need to become a preceptor in the short term, and share your ideas on how we can address this going forward.
CNMA has started the Midwifery Workforce Development and Education Support Committee to develop short and long term strategies and solutions and better understand why CNMs and sites are not taking midwifery students. We are dedicated to ensuring this is done equitably. Please consider joining this committee!
CNMF recognizes that precepting often comes at a cost, whether accepting students as an individual preceptor or advocating to allow for precepting at your institution. We partnered with Anthem and currently have $16,000.00 for a grant to support: a) precepting and b) mentoring. Click here to fill out a 1-page application. We are exploring the best strategy to encourage sites to open up now while we also look at long term strategies. A short term strategy may mean supporting individual CNMs (time for onboarding, orienting, decreased templates) or to support your ability to advocate for your institution to open up for student precepting. Please fill out the application and let us know what you need to become a preceptor in the short term, and share your ideas on how we can address this going forward.
CONNECT WITH US
If you or your organization are interested in precepting student midwives in the near future, let us help you! Programs can offer logistical assistance and ongoing support. Click here for further resources and contacts for all programs. We encourage you to reach out directly and NOT wait for a student to reach out to you! The programs will do their best to match students with preceptors. You may also reach out to Melanie Phipps or Paris Maloof-Bury to connect with the Midwifery Workforce Development and Education Committee for support.
