Interdisciplinary Journal of Nursing and Health (eISSN 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).
Understanding Clinical Teaching in Midwifery Education: Validation of the MidPaACT Tool in the Italian Context
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Keywords

Midwifery
Nurse Midwives
Clinical Teaching
Preceptorship
Midwifery Education
Clinical Education

How to Cite

Understanding Clinical Teaching in Midwifery Education: Validation of the MidPaACT Tool in the Italian Context. (2026). Interdisciplinary Journal of Nursing and Health, 5(3). https://doi.org/10.82051/ijnh-2025-481

Abstract

Introduction. Midwifery education integrates theoretical instruction with clinical practice, in which supervisory relationships are pivotal. The quality of mentorship substantially influences students’ competence, confidence, and professional identity, and is largely determined by midwives’ awareness of their role as preceptors and how this is enacted in practice. This study aims to provide a valid instrument for evaluating clinical teaching in midwifery education by translating, culturally adapting, and psychometrically validating the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool in the Italian context.

Methods. The MidPaACT questionnaire was translated and culturally adapted following established international guidelines. The process included forward translation, synthesis, back translation, expert panel review, and pilot testing. Data were collected through an online survey completed by preceptor midwives involved in undergraduate midwifery education. Construct validity was assessed using confirmatory factor analysis using a Diagonally Weighted Least Squares estimator. Model fit was evaluated using RMSEA, SRMR, CFI, and TLI indices. Internal consistency reliability was assessed using Cronbach’s alpha coefficients.

Results. A total of 168 preceptor midwives participated. Confirmatory factor analysis supported the original two-factor structure (‘Supporting students to learn’ and ‘Safety in learning’) and indicated acceptable model fit (RMSEA = 0.08; SRMR = 0.105; CFI = 0.973; TLI = 0.971). Internal consistency was satisfactory for both subscales (α = 0.88 and α = 0.77). Participants reported high levels of engagement in supporting student learning and ensuring safety in clinical practice, while highlighting areas for improvement in academic–clinical collaboration and culturally responsive supervision.

Discussion. The Italian version of the MidPaACT demonstrates satisfactory psychometric properties and provides a valid tool for the systematic evaluation of clinical teaching in midwifery education. Its use can support the development of targeted faculty development initiatives and strengthen evidence-informed approaches to improving the quality of clinical education.

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References

Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014

Dash, G., & Paul, J. (2021). CB-SEM vs PLS-SEM methods for research in social sciences and technology forecasting. Technological Forecasting and Social Change, 173, 121092. https://doi.org/10.1016/j.techfore.2021.121092

Griffiths, M., Creedy, D. K., & Carter, A. G. (2021). Systematic review of tools to measure preceptors' perceptions of their role in undergraduate health clinical education. Nurse Education Today, 102, 104913. https://doi.org/10.1016/j.nedt.2021.104913

Griffiths, M., Creedy, D. K., Donnellan-Fernandez, R., & Carter, A. G. (2023). Development and testing of the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool. Nurse Education Today, 130, 105948. https://doi.org/10.1016/j.nedt.2023.105948

Griffiths, M., Fenwick, J., Gamble, J., & Creedy, D. K. (2020). Midwifery student evaluation of practice: The MidSTEP tool—Perceptions of clinical learning experiences. Women and Birth, 33(5), 440–447. https://doi.org/10.1016/j.wombi.2019.09.010

Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424

Hughes, A. J., & Fraser, D. M. (2011). “There are guiding hands and there are controlling hands”: Student midwives’ experience of mentorship in the UK. Midwifery, 27(4), 477–483. https://doi.org/10.1016/j.midw.2010.03.006

International Confederation of Midwives. (2014). International code of ethics for midwives. https://internationalmidwives.org/resources/international-code-of-ethics-for-midwives/

Kabirian, M., Gooshki, E. S., & Khadivzadeh, T. (2024). The Process of Professional Ethics Development in Midwifery Students: A Grounded Theory Study. Iranian journal of nursing and midwifery research, 29(3), 302–308. https://doi.org/10.4103/ijnmr.ijnmr_12_23

Mauri PA, Cortinovis I, Guerrini Contini NN, Soldi M. (2020). Midwifery Education Institutions in Italy Creation and Validation of Clinical Preceptors' Assessment Tool: Students' and Expert Midwives' Views. Nurs Rep, 10(2), 172-181. https://doi.org/10.3390/nursrep10020021

McKellar, L., & Kempster, C. (2017). We’re all in this together: Midwifery student peer mentoring. Nurse Education in Practice, 24, 112–117. https://doi.org/10.1016/j.nepr.2015.08.014

Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., Bouter, L. M., & de Vet, H. C. W. (2010). The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: An international Delphi study. Quality of Life Research, 19(4), 539–549. https://doi.org/10.1007/s11136-010-9606-8

Neri, S., Frati, F., Marletta, G., Smith, M., & Colaceci, S. (2026). Fear, anxiety and stress in midwifery students: An integrative review of the literature. Acta Biomed, 97(1): 17623. https://doi.org/10.23750/abm.2026.17623

Nespoli, A., Sacco, G. G. A., Bouhachem, F. Z., Motta, F., Paredi, S., Antolini, L., Panzeri, M., Pellegrini, E., & Fumagalli, S. (2024). Assessment of the psychometric properties of the Italian version of the Midwifery Student Evaluation of Practice (MIDSTEP-IT): A validity and reliability study. Midwifery, 133, 103991. https://doi.org/10.1016/j.midw.2024.103991

Sheehan, A., Elmir, R., Hammond, A., Schmied, V., Coulton, S., Sorensen, K., Arundell, F., Keedle, H., Dahlen, H., & Burns, E. (2022). The midwife-student mentor relationship: Creating the virtuous circle. Women and Birth, 35(5), e512–e520. https://doi.org/10.1016/j.wombi.2021.10.007

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in Health, 8(2), 94–104. https://doi.org/10.1111/j.1524-4733.2005.04054.x

World Health Organization. (2021). Global strategic directions for nursing and midwifery 2021–2025. World Health Organization. https://www.who.int/publications/i/item/97892

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Copyright (c) 2026 Serena Neri, Maria Panzeri, Margaret Smith, Simona Fumagalli, Sofia Colaceci

Interdisciplinary Journal of Nursing and Health (eISSN: 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).