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The Confidence to Practice Midwifery: Preceptor Influence on Student Self-Efficacy


  • Robin Jordan CNM, PhD,

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    • Robin G. Jordan, CNM, PhD, is Coordinator of the Antepartum Care courses for the Frontier School of Midwifery and Family Nursing, and a member of the ACNM Division of Research and the ACNM Basic Education Section of the Division of Education.

  • Cindy L. Farley CNM, PhD

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    • Cindy L. Farley, CNM, PhD, FACNM, is faculty at the Midwifery Institute of Philadelphia University. She is in part-time clinical practice with the Greater Cincinnati Nurse-Midwives practice and serves as a consultant to develop clinical doctorate programs in midwifery.

Robin Jordan, CNM, PhD, 8480 Bear Cove Lane, Petoskey, MI 49770. E-mail:


The imperative for midwifery educators is to transmit to their students midwifery's unique body of knowledge and hallmarks of care that guide midwifery practice. Concerns have been raised about the ability to maintain the unique aspects of midwifery practice in a culture where routine use of intervention prevails. A theory–practice gap may lead to fewer student midwives exposed to the perspective and practices of midwifery during their clinical education. Preceptor role modeling is important to developing student confidence, conceptualized as self-efficacy, to persist in the practice of midwifery hallmark behaviors, particularly under conditions that undermine these practices. This study examined student perceptions of preceptor behaviors of two midwifery hallmarks of practice: therapeutic presence and non-intervention in the absence of complication and student self-efficacy for performing these behaviors. Recent graduates of education programs accredited by the American College of Nurse-Midwives Division of Accreditation completed researcher-developed tools regarding perceptions of preceptor behaviors of therapeutic presence and non-intervention and their outcome expectancy and self-efficacy for the same behaviors. The results indicate that preceptor behaviors influence student confidence to perform hallmark behaviors. Student belief in the value of the hallmark to benefit women is the biggest predictor of self-efficacy for hallmark behaviors. Clinical and educational implications and directions for future research are discussed.