Clinical Program

The Clinical Program at MCU is based on the principles and philosophy of the original model of midwifery training-apprenticeship. We believe that student midwives are best prepared for practice by learning directly from experienced midwives.

Who can be a preceptor?

Your preceptor must be approved by MCU before you can receive credit for clinical work.The clinical site that you will be working in must meet basic safety standards. Your preceptor will be required to complete an application that documents the above criteria and basic safety standards.

Our goal is to prepare midwives for the scope of practice outlined by the Midwives Alliance of North America (MANA, www.mana.org). These standards are outlined in the Core Competencies for Basic Midwifery Practice.

The MCU clinical program meets and exceeds all of the National Association of Registered Midwives requirements (NARM, www.narm.org).

A student must be able to show adequate performance of all NARM Skills and MANA Core Competencies in order to complete MCU graduation requirements.

Does MCU help me find a preceptor?

MCU does not place students with preceptors. Students are responsible for finding a preceptor and securing an apprenticeship for themselves. All preceptors must be approved by MCU. Students may contact their coach or the Clinical Dean for guidance.

All preceptors must meet one of the following criteria:

· Be a nationally certified midwife (CPM, CM, CNM); or

· Be legally recognized in a jurisdiction, province or state as a practitioner who specializes in maternity care; or

· Be a midwife who has been a Primary Attendant without supervision for at least 50 out of hospital births and a minimum of three years.

The clinical site that you will be working in must meet basic safety standards.
Your preceptor must be approved by MCU before you can receive credit for clinical work.

How do I find a preceptor?

Students should prepare in advance in order to secure a preceptorship. The suggestions below are given to help students build relationships of trust with potential preceptors. MCU has found that when students take the time to build relationships of trust with preceptors, the likelihood of obtaining a solid preceptorship increases. Success is not guaranteed, but MCU students prove that these suggestions work over and over again.

Become a student member of your local, state, or provincial midwifery organization. Be as active as you can in attending meetings, serving on committees, volunteering for special projects, etc. Midwives are interested in knowing that you are willing to do work that might not be as fun as catching babies, that you are interested in the larger community of midwifery, and most importantly, they get to know you.
Arrange a face-to-face meeting with any midwives that you might be interested in working with. Your objective is to offer your services as a volunteer. Make sure that you are very clear that you are not asking the midwife to teach you anything or to take you on births; you are only asking to serve her in any capacity that she needs--clean her instruments, file birth certificates, build a website, or arrange for a toy box. You may find that after a few months of volunteering your services, the midwife may offer you a preceptorship. Your volunteer work will give you the opportunity to make sure that this would be a preceptorship you would be comfortable in.

Do I pay my preceptor?

Some preceptors charge a fee for training students. If a student chooses to apprentice with a preceptor that charges fees, the student alone is responsible for these fees. MCU does not pay preceptors. MCU does recommend that if a student chooses to apprentice with a preceptor that charges a fee, the student and the preceptor create a formal agreement including the fees that will be paid, a payment schedule and a refund agreement.

Can I work with more than one preceptor?

We recommend that you apprentice with more than one preceptor at various times during your clinical program. However, if your preceptor has a busy practice, we recommend that you work with only one at a time. All preceptors with which you precept must be approved in order for your records to count.

When do I start my clinical program?

You are free to begin the clinical component of your training when you feel ready to integrate the theoretical knowledge you have gained through your academic courses with the hands on care of midwifery apprenticeship; and you have completed the necessary prerequisites which are:

Maintain a 2.5 GPA
Current CPR and NRP
Completion of MDWF 144b

To begin your clinical area of study you will fill out the Application to the Clinical Area of Study found in the MCU Clinical Handbook.

When am I ready to begin precepting?

MCU recommends that you do not begin your preceptorship until you are close to finishing your first year of studies; however, you are not limited to this time parameter. You should begin within your first year if you are a 3-year ASM student.

If you are more prepared to be a helpful and knowledgeable apprentice you are more likely to find and retain a successful preceptorship.

Skills Requirements

During the course of your apprenticeship, you are expected to acquire the full range of entry-level midwifery skills as defined in the NARM Candidate Information Bulletin (CIB) which can be obtained through http://www.narm.org/cib.htm.

MCU documents your progress in mastering skills through the Practical Skills Guide for Midwifery by Pam Weaver and Sharon Evans, and through the MCU Apprentice Skills Check-off List found in the MCU Clinical Handbook.

MCU Minimum Clinical Requirements

General Clinical Experience Policies

Clinical experience numbers are the required number of prenatal exams, births, postpartum, and newborn exams that you are required to complete for graduation. These numbers must be properly recorded and completed under very specific circumstances. The basic policies and guidelines regarding these numbers are below:

1. All of your clinical experience numbers must be done under the direct supervision of an approved preceptor. (Please see “EXCEPTION” below.)

The preceptor(s) you work with, who will be signing off your record sheets, must have completed an MCU Preceptor Application and have been accepted as an MCU preceptor.
All of the experiences you choose to record must be done with your preceptor in the room with you.

2. All of your clinical experience numbers must be done with you in the Primary Attendant position. (Please see “EXCEPTION” below.)

This means that you can perform all aspects of the midwifery care you are responsible for to the satisfaction of your preceptor.
This also means that you will need to do a number of exams and births before you are ready to officially record any for your clinical experience numbers.

3. Your clinical experience numbers must span at least one year in length.

The date of your first prenatal must be one year from the date of your last primary birth. These dates will be verified by the Clinical Dean.
You should complete the majority of your Active Participant and Assist Births before your primary births. These dates will be verified by the Clinical Dean.

4. Determination of Primary Attendant and/or mastery of skills are at the discretion of your preceptor.

5. The Initial Prenatal Exam includes "covering an intake interview, history (medical, gynecological, family) and a complete physical examination. These examinations do not have to occur all on the first visit to the midwife, but the [student] should perform at least twenty (20) of these examinations on one or more early prenatal visits." NARM CIB

6. Births as a Participant Attendant and Assistant Attendant are births where the student "is being taught to perform the skills of a midwife. Charting, other skills, providing labor support, and participating in management discussions may all be done in [these] births in increasing degrees of responsibility. Catching the baby is a skill that is taught [within the Assistant Attendant] period, but not counted as a supervised primary [birth]." Students do not need to perform all the skills at every birth as a Participant and Assistant Attendant, "but should be present throughout the labor and birth and should perform at least some skills at every birth." NARM CIB

7. Ten (10) of your twenty (20) Participant Attendant births may be births with you acting as an official Doula. The remaining ten (10) must be with you in another role.

8. "Births as a Primary [Attendant] under supervision . . . means that the [student] demonstrates the ability to perform all aspects of midwifery care to the satisfaction of the preceptor, who is physically present and supervising the [student's] performance of skills and decision making." NARM CIB

9. Continuity of Care means that you have given primary care to one woman that includes at least four (4) prenatal exams, the labor and birth, a postpartum and newborn exam. Continuity of Care experience can also be counted individually as part of your clinical experience numbers.

EXCEPTION

Births done as a Participant Attendant do not need to be done under the direct supervision of an approved preceptor. These births need only the signature of a witness to verify that you participated in that birth.

Required Clinical Numbers

1. Complete seventy-five (75) prenatal exams including twenty (20) Initial Prenatal Exams. (Student in Primary Attendant role)

Attend twenty (20) births as a Participant Attendant. These births do not need to be under the direct supervision of an approved midwife, they only need the signature of a witness. Ten (10) of the Participant Attendant births may be Doula births. (Student not in Primary Attendant role.)
Attend ten (10) births as an Assistant Attendant. (Student not in Primary Attendant role.)
Attend twenty-two (22) births as a Primary Attendant. (Student in Primary Attendant role.)
1. 10 of these 22 births must be in-home or other out-of-hospital settings
2. For at least 3 clients of the 22 primary births you must provide continuity of care. This includes 4 prenatal visits, the birth, a newborn exam, and postpartum exam.
Complete 20 newborn exams. (Student in Primary Attendant role.)
Complete 40 postpartum exams. (Student in Primary Attendant role.)

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