Background: Practice supervision is among the most influential factors for student learning and self-esteem development in clinical placement. Effective clinical education and training contribute to improved patient outcomes and safe maternity care (such as increased patient satisfaction and quality patient care). There has been limited evidence of Black Asian Minority Ethnic (BAME) midwifery students’ practice supervision experiences in the clinical environment.

Aim: This study aims to explore BAME undergraduate midwifery students' experience of working with and being supported by practice supervisors and/or practice assessors/mentors during clinical placements.

Method:

A systematic review was conducted to explore BAME undergraduate healthcare students' (midwifery, nursing, and medicine) practice supervision experiences during clinical placement. A sequential mixed-methods study was conducted using intersectionality theory and Eraut’s framework based on the results of this systematic review. This research consisted of two phases, which built on each other:

Phase 1: A cross-sectional design was used, recruiting participants (n=159) from seven universities with varying levels of ethnic minorities midwifery undergraduate students across England using validated scales. Descriptive and further analyses were applied with SPSS.

Phase 2: Semi-structured one-to-one interviews (n=21) of midwifery students were conducted across England. Thematic analysis was applied to the data coded through NVivo v14.

Finally, the integration of the quantitative and qualitative phases presented aims to strengthen support for ethnic minorities students on clinical placements.

Results:

Phase 1: All students (N = 1268) were invited across the seven universities, where it is estimated that of them identified as BAME. According to the findings of the study, a total of 159 students submitted responses. The majority of participants were highly satisfied with the clinical learning environment (58%) and ward atmosphere (54%); however, almost all students (77%) were dissatisfied with the supervisory relationship, and 63% of participants reported feeling discriminated against in practice supervision in clinical placements.

Phase 2: Findings highlighted that ethnic minorities midwifery undergraduate students faced discrimination, isolation, loneliness, prejudice, bullying, and having to prove one's competence. The mental health of these students who were exposed to discrimination was negatively affected, and they experienced serious health problems such as depression. Findings highlighted that these students felt that these negative experiences might impact patient care. In addition, results indicated that students exposed to negative emotions could not establish an effective practice supervisor-student relationship. Another significant result revealed that the practice supervisor-student relationship is directly related to the professional growth of students and clinical learning success.

Conclusion: BAME midwifery students in this study faced significant challenges which have an impact on clinical learning. Given the significant correlation between learning environments and midwifery students and practice supervisors need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections. This study presented new findings of practice supervision experience from ethnic minorities midwifery students in clinical placements and has the potential to influence future studies and strategies to improve clinical learning experience, patient experience, reduce attainment and academic gap and ultimately improve safe and effective care.