Becoming a midwife – A phenomenographic study of students' conceptions of learning within a midwifery continuity of care experience project

BACKGROUND: Midwifery continuity of care (MCoC) is a key aspect of woman-centred midwifery care, associated with improved outcomes for both women and midwives. In many countries, maternity care is fragmented, and MCoC uncommon in clinical practice and midwifery education. To address this gap, a pedagogical project entitled "Midwifery Student All the Way" was introduced in a midwifery programme in southern Sweden. The project was designed to provide students with MCoC experience throughout pregnancy, birth, and postpartum care. AIM: This study aimed to describe midwifery students' conceptions of learning within a pedagogical midwifery continuity of care project. DESIGN: A qualitative study with a phenomenographic approach was conducted to explore midwifery students' conceptions of the skills they acquired through participation in the project. METHOD: Focus group interviews were conducted with a total of 22 students at the end of their education. Data were analysed using the seven-step phenomenographic method. RESULTS: Five categories and thirteen conceptions were identified. The result showed that students developed knowledge in a unique way through relational learning and by being with the women. The students needed to navigate challenges and create their own role in the project. They benefited from a collaborative experience with their peers contributing to their learning. CONCLUSION: The midwifery continuity of care experience project was proven beneficial for student-centred learning, even within a fragmented context of clinical healthcare placement and in a developing phase. Students described participation in the MCoCE project, which offered continuous engagement with women during childbearing, as highly enriching their learning through active involvement, thus boosting and strengthening their professional confidence and identity. They described a possibility to develop meaningful relationships, internalise the core principles of midwifery, and acquire essential clinical competencies and perspectives that often are less accessible through ordinary education. Identified challenges must be addressed when formalising the project.