A qualitative study exploring student midwives' experiences of carrying a caseload as part of their midwifery education in England

Objective: to explore student midwives' experiences of caseloading to develop an understanding of how they perceive this educational strategy has impacted on their learning journey to becoming a midwife. Design: a qualitative approach drawing upon the principles of grounded theory. Data were collected by in-depth semi-structured interviews. Setting: a university in the South of England providing undergraduate pre-registration midwifery education across Advanced Diploma and BSc (Hons) programmes. Participants: eight Caucasian female final-year student midwives aged 23-50 years who had completed their caseloading experience. Findings: one core category ('making it good') and four major categories emerged: (1) 'developing and managing caseload', (2) 'learning partnerships', (3) 'feeling like a midwife' and (4) 'afterwards'. The core category was reflected in all the other categories and was dependent upon them. Key conclusions and implications for practice: students identified caseloading as a highly beneficial learning approach, facilitating application of theory to practice and acquisition of new skills promoting confidence and competence in practice. Students articulated an overwhelming desire and concern to meet and facilitate women's expectations. Perceptions of letting the woman down evoked feelings of inadequacy and failure. Flexible working practices, on-call commitment and carrying a caseload alongside academic and home commitments was, for many, emotionally stressful. Effective preparation of students for the realities of caseloading, the development of realistic caseloads that take account of the student's individual situation, and the provision of supportive frameworks are essential. (c) 2010 Elsevier Ltd. All rights reserved.