Skip to main content
College of Midwives Ontario logo
'

Closed Public Consultation: Clinical Education and Student Supervision Standard

About this consultation

As part of the College’s commitment to risk-based regulation, we have developed a rigorous approach to policy making to ensure policy decisions are based on a proper evaluation of risk, solid evidence, and a thorough analysis of options and impacts. This process ensures that regulatory tools are not adopted as the default solution, but are introduced to mitigate risk when other non-regulatory options are unable to deliver the desired results.

Consultation with midwives, midwifery and regulatory organizations, and the public is an essential part of our policy development process, and in keeping with our guiding principles of accountability and transparency.

Background

While the College has a Clinical Education and Student Supervision standard in place, it was last revised in 2017 and various aspects are outdated or contain unnecessary information. The College now has an opportunity to revise the standard to ensure it reflects current and relevant content.

Our proposal

We are requesting feedback about revisions to the Clinical Education and Student Supervision Standard.

Please review:

How to provide feedback

You may submit your comments using this page.

All comments are reviewed before being posted publicly to ensure they meet the Posting Guidelines. Your name and email will not be published with your feedback, however, you will be identified as a member of the public, a midwife, or a stakeholder. Email addresses are required to ensure that each individual only provides feedback once. If you prefer to provide feedback via email, want to respond using a different format, or if you have any questions about the consultation, please email us at cmo@cmo.on.ca.

This consultation will be open until Friday, November 12, 2021.

All Feedback

  1. Midwife

    I do not have any objection to this standard.

    • Are you a: Midwife
    • Organization: AMMA Midwives
    • On behalf of: Yourself
  2. Midwife

    I think the new standard is a good start but not enough. I think RM should have a minimum number of years of experience (3-5?) before being a preceptor AND i think an RM should be required to satisfy some preceptor orientation/training/accountability regularly with the the MEP/IMPP. It is important that RM is not under investigation or restrictions on their licence when being a preceptor. I think some more detailed outline of when students can act alone (with indirect supervision) is necessary and also some guidance regarding if a senior student can act as one of two midwives at a birth necessary.

    • Are you a: Midwife
    • Organization: West End Midwives
    • On behalf of: Yourself
  3. Midwife

    No feedback. Looks good to me.

    • Are you a: Midwife
    • Organization: Community Midwives Of Halton
    • On behalf of: Yourself
  4. Midwife

    I appreciate the addition of the new list of responsibilities for preceptors. I think that it is important that the College clearly outline what expectations are for all preceptors in terms of their relationship with students. I think that the College should add more to this section. I would like to see content which specifically addresses appropriate behavior of preceptors in their interactions with students. For example, I think the statement should outline that it is the responsibility of the preceptor to always engage respectfully with students, that preceptors must refrain from bullying behavior, and work to ensure as safe and supportive working environment for students who they are supervising.

    I am very concerned to see that the College is planning to remove the section which lays out what different students are able to do with indirect supervision, and under what conditions students can be considered one of two midwives at a birth. I am very worried that removal of this section will lead midwives to believe that they can set their own standards in this regard, and that as a result we will see students being asked to work without supervision when they are not ready to do so.

    As an instructor in the MEP I have been made aware of a number of situations over the years where students have been asked by preceptors to take on work without supervision which they did not feel confident to do. In those cases, the standard from the CMO was crucial to our ability to hold the preceptor accountable and get the student the support they need. It is important to stress that this is not just a student learning and student supervision issue, it is also an issue for client safety – which is core to the role of the CMO. Without the statement from the College on this issues, I worry that practices (with or without MEP blessing) will move to less supervision for students. This would be to the detriment of student learning and of client care.

    • Are you a: Midwife
    • Organization: Association Of Ontario Midwives (AOM) ESW instructor, mep
    • On behalf of: Organization
  5. Midwife

    Removing guidelines for how much in-person supervision preceptors provide their midwifery students when those students are providing direct client care is an entirely bad idea (although perhaps it should be the responsibility of our Association to work with the MEP to establish those guidelines? I agree it is perhaps not the public who has the insight required to do so). It could place preceptors in legally ambiguous situations in which they are not present but remain legally responsible for care. It also potentially places clients at risk; students are not fully trained midwives. Preserving clear guidelines will maintain some semblance of quality training for student midwives and protect supported learning environments until they have graduated and are registered – that’s the job of the preceptor. If students are to be thrown into situations to “learn from experience” with no teaching/supervision, that isn’t an education, it’s making our clients guinea pigs for unqualified, unpaid workers.
    I fail to see how changing this standard will help ensure high quality training of future midwives at all but if the question is one of who should decide on those guidelines, I can hear that. Otherwise, a hard no.

    • Are you a: Midwife
    • Organization: Kawartha Community Midwives
    • On behalf of: Yourself
  6. Midwife

    I agree with the removal of the standards around postpartum visits/attendance at births, as setting those guidelines should be the responsibility of the MEP. I also agree with NR midwives not being eligible to take students, but would add that GR midwives with conditions/supervision should also not be eligible.
    I think that if there are going to be guidelines around a specific number of years a GR midwife would need to have practiced in order to take on a senior student, that should be determined by the MEP and not the CMO.

    • Are you a: Midwife
    • On behalf of: Yourself
  7. Midwife

    Every student needs equal attention & guidelines in the line of work as a health worker. I want to join this platform to assist in making a change.

    • Are you a: Midwife
    • Organization: Ridge Hospital
    • On behalf of: Yourself
  8. Midwife

    Absolutely agree ! Clerks should have a workshop similar with the ESW to prove their basic minimal clinical skills before going to placement. A clerk should be able to keep up sterile field. Knowing the birth kit/instruments are outside dirty and inside sterile and the sterile gloves-on is not the first step. The third year on the L&D should be the place to practice the basic hospital skills like vena punction/IV skills at least on basic level . If the supervisor has to start with those basic skills no time to complete the full puzzle.
    Midwife to supervising a clerk should have at least 5 years active experience as GR.

    • Are you a: Midwife
    • Organization: Organization
    • On behalf of: Yourself
  9. Midwife

    It looks as if you are trying to remove completely guidelines for when a student can independently see a client, probably not wise

    • Are you a: Midwife
    • Organization: east ottawa midwives
    • On behalf of: Organization
  10. Midwife

    I like the simple, direct and non-prescriptive format of the new standard
    I love the direct statement demonstrating the College requirements to be a preceptor (example, GR without New Registrant conditions.

    And I appreciate the direction of the College to minimize prescriptive standards and to rely on the midwife to know the student’s knowledge and skills when deciding on appropriate care for their client.

    Thank you for these changes…the new standard looks great!

    • Are you a: Midwife
    • On behalf of: Yourself
  11. Midwife

    I agree with one of the comments below and I am also not exactly sure if this is MEP or CMO territory, but midwives who are in their first few years of practice should NOT be precepting students. New midwives are often pressured into taking a student by practice owners when they are not ready. Midwives in their first few years of practice should be focusing on their own skill set and not have to enter into the role of a preceptor. Similarly, senior students should be precepted by a midwife with at least 5 years experience. I have watched brand new midwives forced to take on this role and it is stressful and inappropriate for the preceptor and student alike.

    • Are you a: Midwife
    • On behalf of: Yourself
  12. Midwife

    Standard is good overall. Ensuring that the client is aware of all possible roles the student has prior to student involvement can be misconstrued. It would be better to phrase it as similar to what midwives do. In that the clients will retain informed choice in all aspects of their care involving students including what aspects of their care are performed by a student.
    The second concern with this document is gender-specific terminology in the standard. This standard refers to the registered midwife as “she”. This language is non-inclusive and not up to present standards.

    • Are you a: Midwife
    • Organization: Blue Heron Midwives
    • On behalf of: Organization
  13. Midwife

    I find the revised standard much less confusing and like that it promotes the level of student involvement/independence based on a student’s level of competency per the preceptor.

    • Are you a: Midwife
    • Organization: Born Midwives
    • On behalf of: Yourself
  14. Midwife

    The sentence near the end of page one seems grammatically awkward: …including discussing the extent…and record informed choice discussions….

    I think “record” should be changed to “recording”

    Otherwise no other comments.

    • Are you a: Midwife
    • Organization: Community midwives of thunder bay
    • On behalf of: Yourself
  15. Member of the public

    The new standard seems much less detailed. For example, allowing students in MNP and Clerkship to be a second midwife at a hospital birth is now not specified. Additionally, the details of allowing senior students to attend some postpartum visits under indirect supervision is removed in the updated versions. Will these no longer be permitted? Or will it be the role of the MEP to create those standards?

    I believe it should also be mandatory for those who are preceptors to take a course from the MEP about being a preceptor, expectations for them and for their student. Many students are not treated fairly or equitably by their preceptors, which leads to trauma and burnout before they even begin their career. A midwife should be a preceptor because they have an interest in teaching/guiding a student to learn, not because it a requirement placed on them by their practice.

    • Are you a: Member of the public
    • On behalf of: Yourself
  16. Midwife

    I believe this standard to be very reasonable, however I am concerned about the reality where some preceptors will delegate postpartum visits inappropriately. It’s already a reality with the current standard and there seems to be a great reluctance on the part of the college to actually act on complaints made when midwives behave inappropriately.

    • Are you a: Midwife
    • Organization: n/a
    • On behalf of: Yourself
  17. Midwife

    The standard appears appropriate in terms of setting out what should be the expectations of a Registered Midwife from her regulatory college. It’s not clear to me that professional conduct would be considered in determining whether a midwife should be a preceptor and I think that is something that should be considered. Part of what we are expected to teach students is ethics, appropriate business practices, healthy interprofessional and intraprofessional relationships and a midwife who has not developed that skill set themselves should not be either teaching a learner how to do so, or worse inflicting those poor skills on a learner. I’m not as clear if that is the regulatory body’s responsibility to manage or that of the Education Program? In the same way, in determining what level of supervision is appropriate for a learner, is the notion that the Education Program will continue to provide guidance around the level of supervision for the various placements? If so, then I think it’s appropriate to remove those details from the CMO’s responsibility.

    • Are you a: Midwife
    • On behalf of: Yourself
  18. Midwife

    I approve of the new standard as it keeps the the role of the regulatory body and does not micro-manage the role of the MEP. The previous detail about attendance at births and PP visits is duplicated in MEP policies, where it belongs, not in a CMO standard.
    I like the addition of the responsibilities of preceptors in detail.

    • Are you a: Midwife
    • Organization: Laurentian University
    • On behalf of: Organization
  19. Member of the public

    I appreciate that the proposed standard is much less prescriptive about what a preceptor can allow a student to do without direct supervision. I assume that the guidelines on what students are / are not allowed to do is actually covered by the MEP rather than the CMO, which is, in my opinion, the correct entity to prescribe what students can do.

    Like another commenter, I believe that student evaulations of preceptors should have some bearing on whether or not they can continue as preceptors, but believe that the more appropriate entity for handling that is the MEPs rather than the CMO unless it is a professional conduct issue.

    • Are you a: Member of the public
    • On behalf of: Yourself
  20. Midwife

    I support the changes made in this standard around expectations of preceptors. I think a preceptor must not have conditions on their practice to supervise a student. I would like to keep the rules around what a student can do independently at what level as it protects students from being “abused” for the purpose of doing visits and also protects students from doing work without a midwife on-site that they are not ready for.

    • Are you a: Midwife
    • Organization: Ottawa Valley Midwives
    • On behalf of: Yourself
  21. Midwife

    Student should not be sent to placement before meeting a minimal level of clinical knowledge.
    Midwives should have more experience before being allowed to mentor a student.
    An GR in their second year of practice should not be mentoring student

    • Are you a: Midwife
    • Organization: Osm
    • On behalf of: Organization
  22. Midwife

    New proposal reflects the role of the preceptor student and client relations accurately.

    • Are you a: Midwife
    • Organization: Blue Heron Midwives
    • On behalf of: Yourself
  23. Midwife

    This method is standard

    • Are you a: Midwife
    • Organization: St philomena Catholic hospital
    • On behalf of: Yourself
  24. Midwife

    I think that it is both reasonable and advisable for the requirements for preceptors to be included in the policy. I also think that student evaluation of preceptors should play a part in whether preceptors continue to have students.
    I do think that the specifics of what students are allowed to do (in C&C, MNP and clerkship) being written in policy provides some much needed consistency between students at different locations in the same placement

    • Are you a: Midwife
    • Organization: Huron midwives
    • On behalf of: Yourself
  25. Midwife

    Seems like a positive change, putting the onus on the clerking midwifery individual rather than the midwife preceptor.

    I do take issue with the word “student” for the IMPP. People in the IMPP are already trained and have met standards from their country of origin. They are being assessed as competent and receiving guidance on navigating the unnecessarily complicated Ontario system. It was insulting to be called a “student” having successfully graduated with a Bachelors with honours and worked for 10yrs to be called a “student”

    Consider consulting with the IMPP program director for a less offensive term to call internationally trained midwives completing their assessments of competency.

    • Are you a: Midwife
    • Organization: N/A
    • On behalf of: Yourself
  26. Midwife

    Clear, concise and achievable. I appreciate the additional statements, that a NR should not be supervising a student..

    • Are you a: Midwife
    • Organization: Markham Stouffville Midwives
    • On behalf of: Yourself

Comments are closed.