Student perceptions of ideal and actual midwifery practice.

This research was conducted to document midwifery students' observations of ideal midwifery care in different educational and clinical midwifery settings. A survey questionnaire using the 39 processes of exemplary midwifery process identified by Kennedy in 2000 was sent to a group of newly graduated certified nurse-midwives, all members of the American College of Nurse-Midwives. The questionnaire was constructed to permit the respondent to evaluate "ideal" and "actual" midwifery practices. Significant differences between actual observations and ideal perceptions of midwifery practice were found in two of the four clinical settings (birth centers and homebirth) and one type of education program (BA to BSN to CNM). No difference was found between traditional versus distance learning programs. Of most concern was that half of the respondents perceived a lack of congruity on ideal and actual midwifery practices that supported normal birth. The results of this study represent a "theory-practice" gap and should be considered by educators and preceptors in the development of curriculum and clinical experiences.