Background: The assessment of clinical competency is a complex activity. Prospective midwives in the United Kingdom (UK) are required to demonstrate competency in providing midwifery care. Evidence is sought and gathered from a range of sources to inform the assessment of a student midwife. However, there is limited understanding how student midwives are assessed in clinical practice employing an evidence-based assessment approach.
Aims: To explore the practices of assessment within clinical pre-registration midwifery education employing a sociomaterial approach to understand how student midwives are assessed in clinical practice.
Methods: A qualitative case study was employed drawing on the principles of Actor Network Theory (ANT). Individual interviews with eight human participants were undertaken using an Interview to the Double technique (Nicolini, 2009). Non-human actors including professional standards and the e-portfolio were ‘interviewed’ to gain a heterogenous understanding of assessment practices. The data were analysed using an iterative approach, drawing on the work of Callon (1986), Adams and Thompson (2016) and a Tetrad Analysis (McLuhan and McLuhan, 1988).
Results: Student midwives, clinical midwives, and academic assessors strived towards facilitating evidence-based assessment, constituting multiple realities and a ‘knowing’ about a student’s competency. This evidence extends beyond what is described as ‘evidence’ by professional regulators. The e-portfolio was a focal actor in mediating, expanding and facilitating assessment practices. However, this was challenging in contemporary midwifery practice, as network effects emphasised the power of student midwives and the subsequent disempowerment of clinical midwives.
Conclusions: The unique enactments of assessment practices challenge the assumption in achieving an objective, reliable and valid assessment assumed by employing an evidence-based approach. Strengthening the connections between students, midwives, academic assessors, and the e-portfolio in relation to consistency, accessibility and availability requires consideration to promote stability in assessment practices.
