Dual role conflict and its impact on student midwives' clinical experiences at The Maldives National University Campuses: Descriptive qualitative study.

Background

Clinical learning is central to midwifery education, equipping students with essential skills and competencies for high-quality maternal care. At The Maldives National University (MNU), student midwives are concurrently employed as nurses while completing an Advanced Diploma in Midwifery and undertake placements at decentralised hospitals. However, the quality, consistency, and support structures of these clinical experiences, particularly in decentralised campus settings remain under-researched. A clearer understanding of students' learning experiences and contextual barriers and enablers in these settings is needed to inform programme improvement and strengthen maternal and newborn care.

Aim

To explore how student midwives at MNU's Thinadhoo and Kulhudhuffushi campuses experience clinical learning, and to identify barriers and enablers to meeting programme requirements.

Methods

A qualitative descriptive study using in-depth interviews and focus group discussions, with ten student midwives from two campuses. Data were collected between August 2023 - February 2024 using a semi-structured guide and analysed inductively with reflexive thematic analysis. Trustworthiness was enhanced through double-coding, peer debriefing, and an audit trail.

Results

Three key themes were revealed based on experiences of participants; 1) Navigating a challenging dual role: balancing full-time nursing duties with student responsibilities constrained learning opportunities and blurred role boundaries;. 2) Supportive work environment with technical and administrative backing 3) Insufficient opportunities to complete required clinical procedures: high Caesarean rates and low birth volumes limited exposure to core procedures, reduced opportunities to complete required clinical procedures.

Conclusion

Addressing role conflict, ensuring adequate procedural exposure, and leveraging supportive environments are essential for improving clinical training in decentralized campuses. Integrating the student perspectives into curriculum planning can directly enhance the quality of midwifery education in the Maldives.