Midwife Supporting a Student: Kolb

Concrete experience

I was practice supervisor for a second-year student midwife on a six-week labour ward placement. In the first fortnight she was quiet but competent in tasks. By week three she was avoiding opportunities - finding documentation to do when a birth was imminent - and her practice assessor raised the possibility of a failed placement, describing her as 'not engaging'. Before the mid-point review, I took her for coffee off the ward and asked, without paperwork on the table, how she was actually finding it. She disclosed that she had been present at a traumatic shoulder dystocia in week one - attended but never debriefed, as she was supernumerary and had been sent to another room during the recovery - and had been managing mounting dread of birth rooms ever since, while believing that admitting it would end her career. We arranged a proper debrief of that birth with the professional midwifery advocate, adjusted her learning plan to rebuild birth-room exposure gradually with me alongside her, and informed her academic assessor with her agreement. She completed the placement, passing genuinely, and told me at the end that the coffee conversation was the first time anyone had asked a question she could answer honestly.

Reflective observation

What unsettles me is the trajectory she was on before that conversation, and my part in it. For three weeks, everyone around her - including me - was reading avoidance as attitude. The formal supervision structures all pointed towards documenting a concern, and none of them pointed towards asking why a previously willing student had changed. I also have to notice what almost stopped me: taking a student for coffee felt indulgent on a busy ward, and I nearly settled for a corridor check-in, which would have produced the same guarded 'I'm fine' the ward had been collecting for weeks. The setting was not a nicety; the disclosure was only possible away from the assessment machinery. And underneath it all was the systems failure that started everything - a supernumerary student present at an obstetric emergency was invisible to the debrief that followed it.

Abstract conceptualisation

The principle I take is that in supervision, a change in a student's behaviour is data before it is a performance concern - and the assessment framework, left to run on its own, converts data into judgement without passing through curiosity. Effective supervisors have to deliberately insert that missing step, and it requires conditions the ward does not provide by default: time, privacy and a question that is not attached to an outcome. More broadly: students are present at trauma the system does not see them witnessing, and 'supernumerary' too easily means 'unaccounted for' in the emotional arithmetic after an emergency.

Active experimentation

I have changed my supervision pattern: every student I supervise now gets a no-agenda conversation off the ward in week one and at mid-point, before any concern exists - I am testing whether early trust changes what students disclose, and with the two students since, it demonstrably has. I proposed at our unit's education meeting that the post-incident debrief checklist include a named prompt for students and other supernumerary staff present, and the practice development team has adopted it. I have also shared the anonymised pattern - avoidance read as attitude - with our practice assessor group, because the near-miss here was not clinical: it was a capable midwife almost leaving the profession because everyone assessed her and nobody asked her.