In recent years attrition for student midwives and those who are newly qualified has increased. Students experience difficult challenges across their programmes, particularly in practice, and there is need to increase support. Dr Helen Recchia, Lead Midwife for Education (LME), Director of Midwifery Education at the University of York and Professional Midwifery Advocate (PMA), shares how provision of Restorative Clinical Supervision has been included in Undergraduate education to support students.
What is the issue?
The journey to becoming a midwife is very rewarding but also can be a challenging one. After sixteen years’ experience in midwifery education, it has become increasingly apparent that student midwives need supporting and nurturing through this journey, more than ever before. Providing this support can be undertaken in several ways; one way we have done this at the University of York is to embed restorative clinical supervision (RCS) into the midwifery curriculum. We know that recently the National Education and Training (NETS) Survey (2024) reported that 50% of student midwives have considered leaving their course. Whilst there has been some promising data published by the Royal College of Midwives (RCM) this year, indicating that the number of midwives on the register has increased overall, the percentage increase in new midwives joining the register is still on the decline. Similarly, The Nursing & Midwifery Council (NMC) reports that there are now more registrants with five years or less experience leaving the register. Student midwives face a number of challenges whilst undertaking their studies, including increasing financial pressures, graduating with debts exceeding £40,000 and may also experience trauma due to the emotional cost of caring.
What are the benefits of Restorative Clinical Supervision (RCS)?
The role of a Professional Midwifery Advocate (PMA) is to deploy the model of supervision for England called the A-EQUIP (Advocating & Educating for Quality Improvement). Part of the model’s focus is about promoting professional resilience and providing a supportive function for those providing care. One model of clinical supervision which is highlighted by NHS Employers is RCS. RCS, using the principles of the A-EQUIP model. It is a versatile model which has been identified as having significant benefits for both those providing health care and those using services. The model encourages innovation and can lead to higher job satisfaction rates.
What have we done to support student midwives?
We embedded RCS sessions into our midwifery curriculum. The RCS sessions have been purposely timetabled at the start of a theory block, when the students return from practice learning. The sessions are usually an hour in length, with groups of a maximum of 8-10 students. They are facilitated by one, or two of the PMA educators, of which there are currently four within the midwifery education team. In addition, we also offer optional ‘drop in’ sessions for one-to-one support following the group sessions. The format of the student RCS sessions follows a similar structure to restorative clinical supervision and includes an opportunity for the students to ‘check-in’ at the start of the session and ‘check-out’ at the end.
What were the challenges and opportunities?
In an already loaded midwifery curriculum, that is required to adhere to the NMC Standards of Proficiency to meet the skills, knowledge and attributes all midwives must demonstrate, finding space for scheduled and regular RCS sessions was tricky. To promote student engagement during these sessions we offered some of them online and some of them face-to-face. Sometimes the students find it confusing with the number of roles a midwifery lecturer may hold. For example, they may be a personal supervisor, an academic assessor and a PMA. Clearly explaining to the student midwives, the distinctions, but also the commonalities of these overlapping roles were helpful in distinguishing them. The student midwives have evaluated the RCS sessions positively and have reported that they offer a safe space to reflect on their practice learning. One student suggested that ‘hearing everyone else’s experiences and being able to have a group discussion is reassuring before going back into theory’. The RCS sessions are another platform for students to access support throughout their programme. They mirror RCS sessions which students have observed in their clinical placements and may have been involved in with qualified midwives. This may also help the transition of students into their qualified roles.
What next?
Retaining student midwives requires the right support at the right time. Student midwives need to feel supported and nurtured during their education; embedding RCS into the curriculum is one way this can be enhanced, and in turn may reduce attrition rates. The PMAs at the University of York are exploring other opportunities, as well as RCS, to offer students alternative ways to promote their well-being throughout their studies.
Dr Helen Recchia is speaking at the Midwifery Education: Educating Future Midwives Conference in Leicester on Wednesday 12 November.
Dr Helen Recchia
Lead Midwife for Education (LME), Director of Midwifery Education at the University of York and Professional Midwifery Advocate (PMA)
November 2025
