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Florida School of
Traditional Midwifery
Preceptor Manual
Fall 2014
Table of Contents
I.
Welcome- Introduction
Page
Welcome from the Clinical Director
History of the Florida School of Traditional Midwifery
II.
Mentoring Midwifery Students
Roles & Expectations of the Preceptor
Acceptance & Placement of a Student
Developing Critical Thinking in the Student
Evaluating Student Progress
III.
FSTM Clinical Preceptor Faculty
Rights & Responsibilities
How to Become a FSTM Preceptor
IV.
Roles of the Student at a Preceptor Site
Student Readiness
Clinical Requirements
Clinical Documentation
Year 1, Year 2, Year 3
NARM Exam & CSE Preparation
V.
Student Clinical Documentation Forms
Clinical Hours Log
Birth Related Absence Policy
Semester Clinical Summary
VI.
VII.
Clinical Skills Check-Off Documentation per
Term
Clinical Student Orientation Forms
Clinical Requirements
Required Clinical Documentation for Graduation of the Clinical
Program
Clinical Observation Midwifery Clinical Lab
VIII.
Appendix
IX.
Continuing Education for Preceptors
Precepting Midwifery Students
Table of Contents will change with revisions November 2014.
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Adding the following after MANA Convention October 2014:
1. Updated information on OOC experiences per new MEAC guidelines
for MEAC schools.
2. New policy for Midwives supervising students with less than 3 years’
experience.
3. Adding to the Challenges in the Clinical Site information section.
4. HIPAA policy per our new catalog and examples and ways to teach
students.
5. Include common scenarios in the preceptor/student relationship.
6. Q&A section
7. How to approve electronic forms on Birth Tree – details for accuracy.
8. Other improvements post AME meeting and MANA Convention in St.
Louis.
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Dear Florida School of Traditional Midwifery Preceptors,
Thank you for the invaluable service you provide to our midwifery students. Without you
our students would not have the hands-on training they need to become the guardians
of childbirth. We value you and welcome your feedback about our students, our
curriculum, and our school.
Your role as a preceptor is to teach our students the skills they need to become
midwives. This manual will help to guide you along the way to training the students you
have taken under your wing.
Mid Term Evaluation Forms will be sent to you by email midway through each semester.
We would like for you to have ample time to sit down with the student to fill in
information about your student’s progress. We know it is sometimes hard to give
constructive feedback, but without this valuable information, the student midwife cannot
fully grow into a well-trained Licensed Midwife. I want to encourage you to share
detailed information about the student’s progress in the clinical setting. I will review this
evaluation form with the student during their check-in meeting each semester.
I am available to help whenever you have questions or difficulties. I would like to be
contacted if you are having any problems teaching your students, any
miscommunication issues, or non-compliance with the rules of your practice. Please call
or email at any time you would like to discuss your student or your role as a preceptor. I
check my work email Monday through Friday and that is the best way to reach me. If
you do not get a prompt response, feel free to call the school.
After reviewing the Preceptor Manual, you will be able to fill out the continuing education
form by answering a few questions about what you have read. Upon returning this form
to FSTM, we will provide you with three units of continuing education.
I look forward to meeting with you in person in the near future. Thank you again for
taking such good care of our students!
Stacey Walden, L.M.
Clinical Director
[email protected]
Office: 352-338-0766 x 301
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History of the
Florida School of
Traditional Midwifery
FSTM is the result of years of hard work on the
part of many dedicated women to the tradition, art
and education of midwifery throughout the state of
Florida.
In 1920 the Florida Department of Health estimated that approximately 4000 midwives
were practicing in Florida. Licensing became a requirement in 1931 after fewer than 1400
midwives were licensed. Their numbers dwindled further following desegregation and the
majority retired by the 1960s. However, a renewed interest in natural childbirth began to occur in
the mid-1960s. Many women became more educated and involved in their pregnancies and in
the birth of their children. The demand for midwives grew in Florida and across the United
States.
In 1982 Florida’s Midwifery Practice Act, F.S. 467 was updated. At that time provisions
were added requiring the completion of a three-year direct entry educational program and
passage of the state licensing examination.
Two schools opened in Florida in January of 1984, one in Miami and one in Gainesville.
At the same time the Florida legislature, during its Sunset Review process, found licensed
midwifery to be safe and effective. In May 1984, however, licensing became restricted to only
midwives who were currently licensed, with future licensing limited to those students who were
currently enrolled in a school. Midwives and consumers throughout the state worked tirelessly to
change this restrictive law and Florida’s licensing of direct-entry midwives reopened on October
1, 1992.
After the change of the law the North Central Florida midwifery community joined
together to develop a midwifery educational program that would meet the requirements for
licensed midwives in Florida. In 1993, after many meetings, planning sessions and sheer
determination, the Florida School of Traditional Midwifery was incorporated as a not-for-profit
501C3 organization in the state of Florida.
In 2000 FSTM reached another important milestone as we received national
accreditation from the Midwifery Educational Accreditation Council (MEAC). Currently we are
one of only nine direct entry, MEAC accredited schools in the United States and the only
accredited school currently serving students in Florida. After nine more years of work and
dedication, our school achieved federal recognition from the Department of Education in order
for our students to be able to receive Title IV funding.
We are proud of our accomplishments and are honored to offer this unique educational
experience to those seeking to become Florida Licensed Midwives. FSTM graduates are also
eligible for national certification through the North American Registry of Midwives (NARM) to
become Certified Professional Midwives.
The profession of midwifery continues to grow and flourish as the American health care
system is reformed. We feel it is essential for midwives to be involved and provide input,
planning and policy reform for maternity care throughout the United States.
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II
Mentoring Midwifery Students
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Roles and Expectations of the Preceptor
Preceptors are role models, clinical instructors, evaluators and mentors to
midwifery students. As a Preceptor you have an opportunity to imprint
students with good clinical work habits, professionalism, and excitement for
midwifery education. While supervising a student midwife can add
responsibilities to a busy day, the chance to influence the development of
future midwives is deeply gratifying and is the "traditional" component of
passing on your acquired wisdom and skills.
Clinical experiences offer students:
 A real life model for providing midwifery care
 Opportunities to apply newly acquired knowledge
 Opportunities to practice clinical skills
 Evaluation of their progress during semester check-ins
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Preceptor as Role Model
Students observe, learn, and emulate role models
to develop their own standards for appropriate
midwifery care and behavior
 Some behaviors can't be taught but must be experienced
through modeling and observation.
o For example, how the preceptor cultivates client
relationships and responds to their emotions;
o how she motivates clients to change behaviors;
o how she self-discloses as a tool in client care; and
o how the preceptor balances her personal and
professional life
 These are all concepts that don’t translate well to the
classroom, but are crucial to becoming a midwife.
 Students observe the nuances of a midwife’s relationship
with her clients, staff and colleagues
o How preceptors discuss clients outside of the clinical
setting
o Discussing difficult topics with clients
o How to handle emergencies
o How to process the professional and personal
experiences and prevent burn-out
o Many of the behaviors a student learns from her
preceptor will be incorporated into her professional
identity
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General Guidelines
Preceptor as Clinical Faculty
As a preceptor, your primary responsibility to the student is to teach! Students
come to a clinical site hungry to learn everything you have to offer. Not only do
you initiate students into the culture of midwifery and introduce them to
midwifery customs, language and procedures, you will be teaching skills and
helping them put the knowledge base they gain in the classroom into practical
use.
 Keep clinical teaching simple and organized, and build skills and duties as the
student masters each task.
 Reviewing FSTM curriculum, skills lists and discussing student progress with the
Clinical Director will help determine appropriate clinical duties for the student.
 Students may not feel empowered to say no when they feel unprepared for a
particular learning opportunity. Remembering your own early client encounters
may be helpful in deciding what to emphasize and teach.
 It is helpful to check in with students as new experiences and clinical
opportunities begin. Some students may need a "push out of the nest" when you
know they really are ready.
 Allow a few minutes at the end of every office day and every birth to debrief:
allow the student to ask questions, relate what she learned, and for you to give
feedback or suggestions. This can be an important opportunity for you to help the
student understand all they have experienced that day.
Preceptor as Evaluator
Students rely on clinical instructors to provide feedback on clinical performance
 First-year students need a safe place in which to learn by observation and
inquiry. This will allow a comfortable way to disclose uncertainties or learning
needs.
 When students are developing new skills, it is important to concentrate on
providing specific positive feedback for work well done. For example: “I liked the
way you made good eye contact” is more helpful than just saying “Good Job”.
 Constructive feedback should be tailored to help students understand their
learning needs. Example: "You may need to review the anatomy of the pelvis to
conduct a pelvic exam and understand the rotation of the baby through the
pelvis.”
 Constructive feedback should be given soon after the learning experience took
place. Correction should NOT be saved up for weeks or months and delivered all
at once.
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 Feedback may be appropriate at the end of completing a clinical activity, during a
private moment, or during a more thorough review when completing semester
student evaluations.
Preceptor as a Mentor
If a student is assigned to your clinical site for several semesters you will have the
opportunity to get to know the student in a more personal and in-depth way.
You will be able to provide assistance and friendship as the student formulates
professional identity and goals.
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Acceptance & Placement of a Student
Before accepting a student into your practice:
 Consider what you are looking for in a midwifery student. What kind of student
will fit well in your practice? How much commitment are you expecting in terms of
clinical time and on-call? No student can be on call 24/7, due to the nature of the
academic schedule. Those with small children or jobs may have additional
constraints.
 Discuss with the Clinical Director the type of practice you have established, your
client base, and what qualities you want in a student. This helps the Clinical
Director to match you with appropriate students. For example: Are you a small
home birth provider or a larger birth center? Do you work with a partner and/or
other staff? Does your practice aspire to a certain religious or spiritual point of
view?
 Let the Clinical Director know the time commitment you would like from your
midwifery student. Typically students stay with a clinical site for a full year before
switching to a different site to gain a variety of experiences. If you would like
more or less than one year, discuss this with the CD and your student before
they begin.
 The Clinical Director will supply you with student resumes for review and is
available to discuss questions or concerns.
 The student midwife should not be a replacement for a well-trained birth
assistant. Beginning students need more guidance and training in the beginning
and may benefit from observing and working with your trained birth assistant.
Interviewing the Student:
 Allow at least one hour to meet with potential student(s).
 Discuss your practice, staff, the type of care provided and general expectations
you have of the student.
 Review and clarify mutual expectations with the student. New students need
specifically to be informed about what is expected of them. If this is not the
student’s first preceptor site she may expect that ground rules to be the same as
a previous clinical rotation. Students rarely realize that even though they may
have some clinical experience already, in a new site, they are a beginning
student until their skill level is observed and evaluated by the preceptor.
Orienting the student to the practice:
 Schedule the student for a detailed orientation which should include clearly
defined expectations before she begins working with you. She should be
informed of the procedures and protocols of the practice. A contract between the
preceptor and student is helpful to clarify your goals and guidelines in writing.
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 You should also discuss:
- Appropriate attire for clinical visits and births
- Scheduling for clinical visits and on-call
- What time to arrive
- Any duties assigned to the student (e.g. clean up or restocking) and
procedures for completing them
- Safety protocols and procedures
- Call schedule including weekends and holidays if different from the regular
schedule
- How should a student contact the preceptor if they are running late, are ill
or other related emergencies
- Where student should store her personal items
- Meal and rest breaks
- Supplies and telephone procedures if applicable
 Request the student be specific regarding academic course requirements and
schedule.
 Students will need adequate time to study and prepare for academic courses and
testing. We have realized over the years that students are not successful unless
they have a comprehensive balance of didactic and clinical instruction. We have
found specifically, that 1st and 2nd year students must have adequate time built
into their schedules to learn academic material.
 Therefore FSTM Birth Related policy is as follows:
o Attendance at a birth will be an excused absence from FSTM classes with
the exception of workshop style classes.
o Students will be granted only two (2) birth related absences per semester;
defined as 4 hours per credit hour.
o After this, absence for attending a birth will be counted as an unexcused
absence and will be reflected in the student’s final grade.
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Sample Student-Preceptor Contract
This is a contract between ________(student)________ and _______(preceptor/name
of practice)____ starting on __(date)__. The Student and Preceptor will start a working
relationship for a trial period of 3 months. If after the trial period, the Student and
Preceptor agree to continue working together, they will do so on a semester by
semester basis.
1. The Student will come to clinic on ___(days)___ each week. The student will be
on-call ___(days per week / days per month)___. Each month the Student will list
their on-call days on the following month’s calendar.
2. The Student must have reliable transportation and be available by telephone
while on-call.
3. The Student is responsible for costs related to travel room and board at Clinical
Sites.
4. Initials The Student has read the dress code policy and understands the
appropriate attire for clinic and births.
5. The Student agrees to adhere to the policies and procedures set forth by FSTM
(current catalog available on website).
6. The Student shall review and abide by Florida Statute 467/Law and Rules.
7. In the event that the Student and Preceptor are having communication issues or
a dispute, they should do one or more of the following:
- Make an appointment between Preceptor and Student.
- Set up a phone conversation between Preceptor, Student and Clinical
Director.
- Make an appointment between Student and Clinical Director.
- Make an appointment between Preceptor and Clinical Director.
8. The Student acknowledges the importance of HIPPA confidentiality and agrees
not to use real names when discussing client cases in the clinical site or
otherwise. This means: Clients, Midwives, Physicians, and events that take place
at Preceptor / Clinical Sites.
9. The Student agrees to be respectful and professional when in the clinic and birth
setting.
10. The Student agrees to not be under the influence of alcohol or drugs when oncall and/or in clinic.
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11. The decision to switch clinical sites will be made between the Preceptor, Clinical
Director and the Student. At least 3 months’ notice should be given to the
current Preceptor before switching sites.
12. The Student will not arrange interviews with potential Preceptors without
approval from the Clinical Director and current Preceptor.
13. The Student will remain with their Preceptor for the duration of the FSTM
semester unless the Clinical Director and Preceptor have determined it is in
everyone’s best interest to discontinue the relationship.
14. The Student agrees to not take current clients from their clinical site to their new
practice upon graduation.
I have read and agree to the terms of the Student-Preceptor Contract and HIPPA rules
outlined above.
Student Signature ______________________________
Preceptor
Signature
__________________
FSTM Preceptor Manual
Date _________________
______________________________
2014-2015
Date
14
Preceptors and Students Working Together:
 Introduce students to your clients as a midwifery student who is working
under your supervision in a manner that will be comfortable for you, your
clients and the student.
 Expose the student to educational experiences based on their academic and
clinical level.
 Schedule ten minutes a day for debriefing and review of the day’s activities,
chart review, client review and general questions.
 Schedule a midterm review and evaluations at the beginning of the semester.
 It is important not to give a passing evaluation if you do not feel the student
has earned it. Please give evaluations that clearly indicate a student’s
performance.
 It is imperative that the evaluation accurately reflects student performance.
Please notify the CD if you have concerns and/or suggestions for an
appropriate course of action.
Supporting the Midwifery Students:
Midwifery students are undertaking an enormous challenge and are endeavoring to
remake themselves as midwives. While it is certainly true that a practicing midwife’s
primary concern will be her clients, student midwives benefit greatly from support and
encouragement from their preceptors.
 Always keep in mind that students are new and in unfamiliar surroundings and
may be under a great deal of pressure to learn well and fast. Please help to
reduce anxiety with small phrases of reassurance, support and understanding.
 Give positive and corrective feedback regularly and in close association with the
event it pertains to.
 Please LISTEN to your student midwife, particularly when she makes mistakes.
Find out why she made the choice she did and try to understand how she arrived
there. This is not the same thing as allowing her to make excuses, but rather
helps you to understand her thought process and direct her back on the right
track.
 In the event of difficult clinical and birth outcomes please notify the Clinical
Director so that we can support you and the student.
 Individual supervision can convey to the student a feeling of security and your
special understanding and support.
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Developing Critical Thinking in the Student
As students develop from novice to competent student midwives they are able to make
judgments of increasing complexity. Preceptors have the opportunity to structure the
clinical experience so students begin with low risk situations with minimal stress or
distractions and with adequate time to develop successful outcomes. As a student
develops confidence, the ability to handle more critical situations will increase.
Experienced clinicians have developed the ability to think quickly with so little effort that
they sometimes have difficulty explaining the process. Because critical thinking takes
place in the clinicians mind, the process often seems mysterious to the beginning
student. The challenge for the preceptor is to help the student progress through the
steps of critical thinking until they are able to integrate all facets of midwifery care and
begin the journey on their own.
Critical thinking is a reflective, self-corrective, purposeful thinking process which
requires the professional to take into account knowledge, context, evidence, methods,
conceptualization and a variety of criteria and standards of excellence. It is the
integration of information and its application to unique clinical situations that is practiced
under the preceptor’s guidance.
Why critical thinking is essential:
 To making sound judgments as students apply theoretical knowledge to real
clinical care
 Because there will always be clinical situations in which the "rules" do not fit
 Because there are students who learn academic knowledge and successfully
pass tests on didactic material but who have not mastered the practice of all
aspects of midwifery care
Seven habits of mental preparedness that preceptors can nurture as
students become skilled at clinical judgment are:







Intellectual integrity
Open-mindedness
Mental alertness
Systematic diligence
Confidence and ability in the use of reason
Intellectual curiosity
Maturity of judgment
Ways to evaluate the student's ability to think critically:





Direct observation of patient encounters
Questioning for the purpose of explanation and exploration
Opportunity for reflection following clinical experience and attending births
Chart review
Having students SOAP note
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Evaluating Student Progress
Clinical education is designed to involve students in the hands-on application of
theory as well as relating information learned in class to clinical problems. It will be
further enhanced and reinforced by continuous evaluation and feedback. The Preceptor
evaluates a student’s learning curve by observation of her interactions with clients and
colleagues, and by discussing her own critical thinking process.
Evaluation is particularly important because as a school we must eventually
certify that student midwives are competent to provide health care to the general
population. It assures that future midwives possess appropriate knowledge, skills and
attitudes.
What barriers might keep preceptors from the important task of evaluation? There are
many factors including time, personal experiences, and not knowing quite how to give
feedback to the student. Perhaps one of the greatest barriers is our feelings associated
with observing and giving feedback. Midwives are trained to be compassionate and
empathetic. We know it does not feel good to receive anything less than a perfect
evaluation and sometimes try and avoid the situation by being overly generous or
avoiding the process all together. If we are to fulfill our obligations as educators, we
have to give complete and honest evaluations. On the other hand, we shouldn’t wait to
critique a student, giving many weeks’ or months’ worth of feedback at one time.
Two common mistakes that observers can make are trying to observe too much in a
short period of time, and focusing too narrowly on a single aspect of the encounter.
Effective evaluation requires a framework of “what to observe” including a method to
record the observation and a sound plan for sharing results.
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Feedback and Evaluation:


Feedback and evaluation are often confused. Feedback is frequent, ongoing
review of strengths and areas for growth with suggestions for further study and
practice. The intention of feedback is to improve performance.
Evaluation is the comparison of actual performance to the desired requirements
or standards. It is the summation of performance at the mid-term of a semester.
The purpose of the evaluation is to document achievement and/or competence.
Strategies for Evaluation:
 Define Expectations: Review students’ clinical and academic achievements
according to which year she is in in the midwifery program. At this specific point
in the students training, what should the student be able to do?
 Define Performance: How does the student perform? To answer this, the
preceptor will need the information that occurs from direct observation,
observation of other staff members and /or comments from the clients. You can
also incorporate some self-assessment by asking the student to evaluate her
own progress.
 Identify Differences: Compare the performance with expectations. Which ones
were met, exceeded, overlooked?
 Document: Write it down as soon as possible. The longer the lapse in time
between the observing and the documenting the harder and more vague the
feedback will become.
Mid-Term Evaluation
Many people conduct an evaluation in a brief meeting. However evaluating student
progress is an on-going process which includes setting clear expectations on the first
day, and continual observation and assessment of the student’s performance. Behaviorspecific feedback creates a framework for the information shared in your final evaluation
session. We suggest you use the evaluation tool sent to you each semester to review
with your student so they are aware of your assessment. This is the perfect time to
discuss ways to improve in weak areas as well as praise them for ways they are
excelling and improving.
 Review your expectations with the student: Advise them of the policies and
procedures as well as your expectations with the student at the initial orientation.
Describe how you plan to evaluate according to the actual FSTM evaluation tool.
Students should be aware that you will be evaluating them and understand the
criteria you will use.
 Assessment & Observation of the student should occur throughout the
semester. Timely and constructive feedback regarding weakness and strengths
allows the student an opportunity to improve and gives the preceptor a chance to
observe the student’s efforts and successes. Similarly positive comments on a
“job well done” should not wait. Few things reinforce good behavior and growth
more than timely feedback.
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 The Mid-Term Review provides an excellent opportunity to reinforce the
student’s strengths and points of weakness, identify problems, clarify
expectations and set new goals and strategies for success. Midterm reviews can
dramatically improve the ultimate satisfaction of the student and preceptor.
1. Set aside a minimum of 30 – 60 minutes for the mid-term review.
2. Both preceptor and student should fill out a FSTM evaluation form
separately.
3. Ask the student to think about whether the semester has met her needs
thus far.
4. Compare evaluation forms and review the student’s performance to date.
5. Highlight areas of good performance and areas for improvement – give
specific recommendations for improvement.
6. Discuss areas where either the preceptor’s or the student’s performance
expectations were not met and agree on a plan for improvement.
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III
FSTM Clinical
Preceptor Faculty
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Preceptor Rights & Responsibilities
This agreement is between the Florida School of Traditional Midwifery, hereafter referred to as
FSTM, and its clinical preceptor sites.
I/we hereafter referred to as the preceptor, am/are willing to participate in the clinical education
of FSTM students.
In consideration of the mutual agreements set forth herein, The Florida School of
Traditional Midwifery and the preceptor hereby agree as follows:
Clinical Facility / Birth Center / Home Birth Practice
- The Preceptor shall provide clinical experience according to FSTM recommendations. At all
times during clinical experiences, Florida Law, F.S. 467, 59DD-4.007 will be adhered to.
- The preceptor shall provide proof of professional liability insurance to FSTM, indicating the
limits of liability and effective dates of coverage, and to apprise FSTM of any changes in
said insurance.
- The preceptor shall provide FSTM with copies of the preceptor’s license and/or facility
license.
- Preceptor shall provide their ACHA inspection report if the clinical site is a licensed birth
center.
- The preceptor shall provide a copy of their State of Florida, Department of Health,
Biomedical Waste Generator/Transporter/Storage/Treatment Inspection Report to FSTM.
- The student shall work under the direct supervision of the preceptor, who will be physically
present at every birth and shall be available to the student at all times while the student is
performing in a (clinical) midwifery capacity with clients. (F.S 467.59DD-4.007 Clinical
Training)
- The preceptor may only precept 2 students at a time during clinical experience. (F.S.
64B24-4.006 )
- Clinical preceptors must be licensed for three full years in order to provide hands on
management of care to students under their supervision. (F.S.467.003 #12)
- It is the preceptor’s responsibility to inform the client and secure client consent for student
participation in client care.
Preceptor Responsibilities to the Student(s)
- The preceptor has the right to interview the student prior to acceptance at the site. FSTM will
designate the expected length of affiliation between student and preceptor.
- The preceptor shall provide, for the student’s review, all rules, regulations, protocols,
policies & procedures and personnel policies of the preceptor’s clinical site/practice.
- Changes in clinical staff acting in the role of preceptor(s) require notification and prior
approval of FSTM.
- The preceptor is available to review the student’s progress and communicate with FSTM the
nature of each student’s clinical education at the site.
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-
-
-
-
-
The preceptor shall be responsible for arranging immediate emergency care of student(s) in
the event of accidental injury or illness at the preceptor’s site, but the preceptor shall not be
responsible for costs involved, follow up care or hospitalization.
The preceptor is required to conduct a clinical check in with each student assigned to the
preceptor’s practice each semester.
Clinical experience may progress through a tiered process of observation, assistance and
management in the antepartum, intrapartum and postpartum periods in midwifery care. Type
of experience available shall be reviewed with the Clinical Director.
The preceptor has the right to be informed of the student’s immunization status.
As stated in the FSTM catalog, we honor that each woman’s birth experience is unique.
Given this, the exact number of hours required to attend the mandated number of birth
experiences cannot be pre-determined. Students are informed at clinical orientation that
intrapartum hours (time spent at a birth) may be in addition to clinical hours as defined in the
curriculum.
The preceptor shall have the right to direct FSTM to withdraw a student from the preceptor’s
site and will notify the FSTM Clinical Director in writing and/or verbally when the clinical
performance of the student is disruptive or detrimental to the preceptor’s practice or clients.
It is agreed by all that there shall be no discrimination based on race, religion, creed, sex,
sexual orientation or national origin.
Social Media and Networking Policies
- Social media activities include but are not limited to creating or contributing to: blogs,
message boards, RSS feeds, etc.; social networks such as Facebook, MySpace, Twitter,
and YouTube; or any other kind of social media site on the internet.
- It is expected that all who participate in social media and associate that interaction with
FSTM understand and follow appropriate usage guidelines:
- FSTM students, staff, faculty & preceptors are prohibited from posting any content that
criticizes or ridicules FSTM, its policies, students, faculty and preceptors, staff or curriculum,
on any social networking site.
- Never comment on anything related to legal matters, litigation, or any parties FSTM, its
students or preceptors may be in litigation with.
Nothing in this agreement shall be construed to remove the ultimate
responsibility for client care from the preceptor. This agreement may be
terminated at any time with written notice. Amendments to this agreement must
be in writing and must be signed by both parties. This agreement shall be
effective when executed by both parties.
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How to Become a FSTM Preceptor
The Preceptor’s role in the education and development of students is a cornerstone of
the continued success of midwifery care in our communities.
The time honored tradition of mentoring students along with a solid academic
background ensures the future of midwifery care.
If you are interested in becoming a Preceptor with the Florida School of Traditional
Midwifery, you will first want to contact the Clinical Director in order to discuss what is
expected of students and Preceptors.
Once you have decided to continue with the process, you will be provided with:
 Preceptor Application as well as a blank questionnaire titled Preceptor Letter of
Recommendation.
 You will need to provide us with two (2) written references from current FSTM
preceptors.
 Once the completed application and letters of recommendation are received by the
Clinical Director, the process of review and approval may take up to sixty (60) days.
When a preceptor is approved, the Clinical Director will provide you with a blank
Preceptor Contract and Commission for Independent Education Form 402. Both forms
need to be completed and returned within ten (10) days along with other supporting
documents (ex: proof of professional liability insurance, copies of CPR and NRP
certifications, etc.).
Students will not be assigned to a clinical site until all required documentation is
received from the Preceptor.
The Florida School of Traditional Midwifery (FSTM) Discrimination Policy:
The Florida School of Traditional Midwifery (FSTM) does not discriminate on the basis
of age, race, color, national and ethnic origin, sexual orientation, gender, disability,
marital status and/or religion; FSTM grants to all the rights, privileges, programs and
activities generally accorded or made available to any members of the organization.
FSTM Preceptor Manual
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23
IV
Student’s Role
at the Preceptor Site
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Student Readiness
The course load in the first semester focuses on academics and settling into the
classroom environment. Students are taught basic healthcare skills: focusing on
learning vital signs and birth assisting duties. Before the conclusion of the semester
students will meet with the Clinical Director and attend a Clinical Orientation in order to
prepare for beginning a clinical placement with preceptors in the Spring Semester.
Students must pass all academic classes in their first semester in order to be eligible to
take Clinical Lab in Year 1 Term 2.
First year students are excited and nervous. They have only practiced skills in a
classroom environment and may be apprehensive about starting with actual clients
while their preceptor is also watching them. Please keep this in mind as you slowly
introduce them to the wonderful world of midwifery care.
Your patience, encouragement, support, and enthusiasm will go a long way in helping to
mold a budding new student midwife into a competent and caring midwife.
“Student Readiness” will vary depending on the experience a student has had prior to
enrolling in the midwifery program. Some students may come with a birth background,
such as Doula and Childbirth Educators. In this case the student may actually be ready
to move forward quickly as compared to a new student who is attending a clinical site
and births for the very first time. With that in mind FSTM feels that participating as a
“Silent Observer” in the beginning allows the student to acclimate to their new role and a
great deal of learning does occur when participating in the silent observer role.
Please feel welcome to discuss “student
readiness” with the Clinical Director for those
students who display a higher and more
proficient skill level. This is especially true when
determining when a student should begin
attending women in a management capacity.
FSTM Preceptor Manual
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Clinical Requirements
Along with the academic curriculum of the program, midwifery students are required to
complete the following clinical requirements.
These requirements are defined by the Florida Council of Licensed Midwifery and
the North American Registry of Midwives (NARM).
PN
IPE
BO
BM
PP
NB
CC
Prenatal Exams
Assistant under Supervision
Primary under Supervision
Initial Prenatal Exams
Assistant under Supervision
Primary under Supervision
Birth Observe:
Birth Observe as Silent Observer
Birth Observe as an Active Participant
Birth Management:
Birth Management as Primary Midwife under Supervision
Postpartum Exam
Assistant under Supervision
Primary under Supervision
Newborn Exam
Assistant under Supervision
Primary under Supervision
Continuity of Care Case
Full
Partial
TOTAL clinical log hours required
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55
3
20
10
20
50
10
40
20
30
5
10
Florida: 1380
NARM: 1350
26
Clinical Documentation
FSTM has developed and implemented a system for the
documentation of all clinical requirements as defined by state and
national regulatory agencies. Following is a review of the systems we
have developed.
Clinical Lab
Each semester students register for Clinical Lab. The Clinical Director conducts Clinical
Orientation and the student is issued a syllabus. Each student will also schedule a
personal check-in with the Clinical Director each semester.
Clinical Lab – Clinical Experience forms
Students are instructed on how to complete clinical experience forms in the clinical
tracking site, Birth Tree. Individual client confidentiality is protected by the student
utilizing a client ID code number. The school has no knowledge of the clients’ identity.
Students are instructed to submit clinical experience forms on Birth Tree within one
month of the date of experience. Preceptors are encouraged to review and approve
forms within 2 weeks of receiving from the student.
Students will progress from birth observations to birth managements throughout the
program. Determining student readiness is an individual process. FSTM defers to the
judgment of the Preceptor regarding when a student is able to move forward in their
progress. Also the Clinical Director is available to discuss student readiness with the
Preceptor at all times.
FSTM and NARM define the following categories as follows:
Silent Observer: The Student participates ONLY as a quiet observer. Student midwives
can assist with retrieving supplies, taking notes, cleaning, providing comfort measures,
and taking on a doula role. First year students should be in a silent observer role at 5-10
births before moving on to more active roles.
Assistant under Supervision: The Student participates in various levels of labor and
birth support as deemed by the preceptor. Setting up the room for birth, participate in
taking vital signs, charting. and providing supportive doula care for the mother are
examples of skills student midwives should be able to master during this period.
Students must submit clinical forms for all 20 required Birth Observes: Assistant under
Supervision before starting Birth Managements: Primary under Supervision.
Birth Management – Primary under Supervision: The student midwife demonstrates
the ability to perform all aspects of midwifery care to the satisfaction of the preceptor,
who is physically present and supervising the student’s performance of skills and
decision making. Charting, providing labor support and participating in management
discussions with the preceptor may all be included in Active Participant births in
increasing degrees of responsibility. Catching the baby should be a skill that is
FSTM Preceptor Manual
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27
encouraged towards the end of the active participant period. The student should also be
present throughout the labor, birth and the immediate postpartum/newborn period.
Clinical Skill Documentation
Students are required to have all skills signed off in the Practical Skills Guide for
Midwifery by Weaver and Evans. Students must have two signatures from different
preceptors or instructors for the following skills: basic maternal physical exam, routine
prenatal exam, newborn exam, and 4-6 week postpartum check-up. The first signature
documents that the student has been taught the skill and has practiced under
supervision. The second signature demonstrates proficiency in the skill. FSTM faculty
and Preceptor faculty are qualified to sign off on skills in the text.
Per NARM and MEAC guidelines students must have two signatures from
different preceptors or instructors for the following skills:
1. basic maternal physical exam
2. routine prenatal exam
3. newborn exam
4. 4-6 week postpartum check-up
FSTM has developed a “skills check-off sheet” for each semester, which helps the
student and the preceptor know the skills the student is working on. In addition, skills
are reviewed and demonstrated in Midwifery Practicum Class. Certain skills cannot be
adequately practiced in the classroom setting and will need to be practiced during actual
scenarios at clinic or in the birth setting. Advanced skills and high risk situations may
not be available for actual practice due to the nature of low risk midwifery care. Skills
such as breach birth and manual removal of the placenta, for example, will be
conducted in simulated clinical teaching classes at FSTM. Additionally, FSTM will
conduct a thorough Clinical Skills Exam in the 3rd year of the program.
Preceptor support and participation in “skills check-off” is greatly appreciated. The text,
Practical Skills Guide for Midwifery, provides an organized format for the assessment of
student competency. We recognize skills may be conducted differently than the format
in the text by individual preceptors/midwives. The text is a nationally approved text for
evaluating student performance. Copies of the Clinical Skills Check-Off Documentation
forms are located in chapter VI of this manual.
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Year One
Silent Observer
(see appendix for detailed information)
 Beginning in an observational role allows the student to “learn by observation”
and acclimate to the clinical practice
 Students ideally should observe 5-10 prenatal and/or postpartum appointments
before beginning to participate
 First year beginning students should be in a Silent Observer role at a minimum of
10 births before moving on to more active roles
Assistant under Supervision
 Prenatal and Postpartum Exams as Assistant Under Supervision
The student is active in taking vital signs, preparing & reading urine samples for the
lab, assisting with maternal weight check and any other activities associated with
maternal care defined by the preceptor. When the Preceptor feels it is appropriate,
the student may begin taking client histories, measuring the fundus, listening to fetal
heart tones and assessing fetal position.
 Birth Observes as Assistant Under Supervision
Students will be in an Assistant under Supervision role at 20 births. When students
are ready to begin as an Assistant under Supervision, they should start slow by
performing vital signs and providing supportive coaching care to the mother.
Classes Completed in Year One:
CPR and NRP training, Anatomy & Physiology I & II, Reproductive Anatomy &
Physiology, Healthcare Skills I & II, Diagnostic Testing, Antepartum, Breastfeeding,
Florida Law and Rule, History of Midwifery, Student Success, Basic Communication
Skills, Interpersonal Communication Skills, Research Evaluation, Traditional Healing
Modalities, and Female Sexuality for Midwives.
Additionally, the students have received instruction in how to perform a GYN
exam and Phlebotomy training.
FSTM Preceptor Manual
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Year Two
During this phase of their training, midwifery students should begin to take on an Active
Participant role in their clinical setting. Some students may still be in an observer role at
births but should be able to demonstrate competency in prenatal care. When the
preceptor feels the student midwife is ready, they may begin Prenatal, Postpartum, and
Birth Management roles as an Active Participant.
Birth Management as Active Participant:
Per definition from the North American Registry of Midwives (NARM), the definition
of Birth Management as Active Participant is: A student midwife has an active role
with the attending midwife under supervision to assist in the birth.
Throughout the second year students should begin to demonstrate competency
in all areas of midwifery care:













Participate in the birth from beginning to end
Be involved in the care plan for the client
Set up the birth room
Chart all actions, as necessary in the clients chart
Take vital signs when appropriate
Assist the midwife in delivery of the baby:
Provide perineal support
Four handed delivery with attending midwife
Assist with delivery of the placenta
Assist with the care of the newborn
Assist with the newborn exam
Assist in suturing the perineum
Assist in emergency situations: resuscitation of baby,
hemorrhage, shock, etc.
Provide
postpartum instructions
to the clients
Classes Completed
in Year Two:
Intrapartum, Nutrition, Postpartum,
Newborn, Breast Feeding, Suturing
for Midwives, Psychology for
Midwives, IV Workshop, Public
Health, Microbiology for Midwives,
Pharmacology, Fetal Monitoring,
Herb Workshop, and Public Health.
They have also reviewed clinical
skills in Midwifery Practicum classes
and completed all three courses in
Interpersonal Relationships and
Communication Skills.
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Year Three
During the third year of the program students should become active in all areas of
midwifery care. Throughout the next three semesters the student will fine tune all of
their skills in providing midwifery care. Constructive feedback from Preceptors is vital
throughout the program but especially important at this time.
Primary Midwife under Supervision
A student midwife acting in the role of primary midwife under supervision provides all
aspects of care as if s/he were in practice, although a supervising midwife (preceptor)
has been primarily responsible and is present during all care provided.
Continuity of Care Case(s)
Students are required to complete a Continuity of Care Case on fifteen separate
women.
 For five Full CC cases, the student has performed five prenatal exams (spanning
at least 2 trimesters), management of the birth, 2 postpartum exams and the
newborn exam.
 For ten Partial CC cases, the student has performed at least one prenatal exam
in addition to management of the birth.
Prenatal, Initial Prenatal, Postpartum and Newborn Exams
Senior students should be working towards the goal of proficiency as a Primary Midwife
under Supervision while providing all aspects of midwifery care in the clinical setting.
Birth Management as Primary Midwife under Supervision
Students should demonstrate decision making and clinical skill proficiency in all areas of
client care throughout the Intrapartum period.
Classes Completed in Year Three
GYN and Women’s Health, Collaborative Management, Establishing and Maintaining a
Practice, Issues in Professional Midwifery, NARM Review and Traditional Healing
Modalities. They have also taken the Clinical Skills Exam and developed their individual
Protocols, Emergency Care Plan and Informed consent.
NARM Review class
Students will have 15 hours of instruction on how to study for and successfully pass the
NARM exam. The instructor will guide the students throughout a series of practice
tests, review of the test results, further study tips, and end with a comprehensive exam
similar to the actual NARM exam. This new format should prepare the student midwife
with the tools necessary to know her strengths and weaknesses to enhance her
chances of passing the actual NARM exam.
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Clinical Skills Exam (CSE)
The CSE is conducted in year 3 term 2 of the midwifery program. After students receive
a Clinical Skills Study Guide, they will attend a 7 hour orientation and study session
before taking this comprehensive 8 hour exam. The study session will consist of setting
up the lab room with manikins and models for various midwifery clinical skills and
scenarios. Students will work in teams of two with fellow students and the instructor to
practice skills according to Practical Skills Guide for Midwifery. Exam day will be held in
a medical office. Students will rotate through several offices where a proctor and
manikin or live model will be present as the student performs a particular skill.
Students should utilize the semester to practice the skills listed in the Study Guide to
adequately prepare for the CSE. Preceptors can help their students as they study for
this exam by giving them ample opportunities to practice skills in the clinical
environment.
Clinical Lab Year 3 Term 3
Our midwifery program has been re-designed to move all academic courses in the third
year to the first two semesters. This change will enable students to focus exclusively on
completing clinical requirements and studying for the NARM exam during the last
semester of the program.
Successful completion of the program and the NARM exam entitles the Student
Midwife to become a Florida Licensed Midwife and a Certified Professional
Midwife.
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V
Student Clinical
Documentation Forms
(forms subject to change)
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33
CLINICAL REQUIREMENTS
Students start clinical participation in Year 1 Term 2 of the program.
Per NARM Regulations:
- A minimum of 5 births must be conducted in the home.
- A minimum of 2 births must be planned hospital births (can be an antepartum transport but
cannot be during an intrapartum transport).
- In all categories, Assistant Under Supervision must be completed before the student midwife can
begin Primary Under Supervision.
TOTAL Clinical Lab Clock Hours
TOTAL Clinical Lab Credits
1380
23
The following is a list of clinical experiences that need to be completed before graduation:
PN: Prenatal Exams
Assistant under Supervision
Primary under Supervision
IPE: Initial Prenatal Exams
Assistant under Supervision
Primary under Supervision
BO: Birth Observation
Silent Observer
Assistant under Supervision
BM: Birth Management
Primary under Supervision
PP: Postpartum Exams
Assistant under Supervision
Primary under Supervision
NB: Newborn Exams
Assistant under Supervision
Primary under Supervision
CC: Continuity of Care Cases
Full CC: A minimum of 5 of the 50 births as Primary under Supervision, the
student midwife has provided care to 5 women, including 5 prenatal visits
spanning 2 trimesters, 1 newborn exam and 2 postpartum exams within 12 hours
and 6 weeks of the birth.
Partial CC: A minimum of 10 of the 50 births as Primary under Supervision must
include 1 prenatal visit provided by the student midwife.
25
55
80
3
20
23
10
20
30
50
10
40
50
20
30
50
5
10
15
All clinical requirements are in compliance with requirements defined by Chapter 467, Florida
Statute, NARM: North American Registry of Midwives, and MEAC: Midwifery Education
Accreditation Council.
FSTM Preceptor Manual
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Required Documentation for Graduation
Of the Clinical Program
The Clinical Director is available throughout the program to assist students with questions
and a review of the clinical policies for Clinical Lab as needed.
The unlicensed practice of midwifery in Florida is a felony (F.S. 467.201). The Student must
at all times, function within the student/preceptor relationship and the provisions of Chapter
467, Florida Law and Rules.
 Practical Skills Guide for Midwifery, 5th edition: original copy turned into the
Administrative Office with pages IX-3-20 signed (2 signatures per skill is required) by
FSTM instructors, FSTM Clinical Director and/or FSTM preceptors.
 Student has completed all clinical experience requirements as defined in the Student
Clinical Handbook.
 Documentation of clinical experience is submitted each semester to the Clinical Director.
 Student has successfully completed the Clinical Skills Exam as defined in the Student
Clinical Handbook.
 A copy of the student’s COMPLETED NARM Application-Graduate from a MEAC
Accredited Program including:
- NARM Form 205B / Document Verification
- NARM Form 200/ Continuity of Care-Practical Experience Form 200. (including
original client charts for the CC cases listed on the form)
- NARM Form 204/ Out-of Hospital Birth Documentation Form 204 (including
copies of the original client charts for all births as primary midwife)
I have read and understand all clinical requirements as defined in the Clinical Policies and
Procedures Contract.
I have been given a copy of the Student Clinical Handbook and agree to adhere to the
requirements outlined therein.
Student Name
Date
Student Signature
FSTM Preceptor Manual
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35
810 East University Avenue, Gainesville, FL 32601 www.MidwiferySchool.org
Office 352-338-0766
Fax 352-338-2013
CLINICAL HOURS LOG
Student Name
Semester and Year
Preceptor(s) Name
Preceptors: If you choose to sign the entire log sheet with “one signature” please sign on the vertical
through the entire column. Regulatory issues do not permit one signature at the top with an arrow
drawn down. Thanks so much!
Hours per Running total
Date
Preceptor Site
Preceptor Signature
Key
of hours
visit
Key:
C
BO
BM
O
LS
TOTAL HOURS
Clinical : PN, IPE, PP, NB
Birth Observe
Birth Management
Other: Per CD approval: (Midwifery Office: clerical, midwifery conference, or CBE)
Labor Support
* You cannot count driving time to and from birth and clinic.
FSTM Preceptor Manual
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810 East University Avenue, Gainesville, FL 32601 www.MidwiferySchool.org
Office 352-338-0766
Fax 352-338-2013
Birth Related Absence Policy Form





Students are required to be off-call for all classes.
Students must be in Year 1 Term 3 or beyond and enrolled in Clinical Lab.
Students will be granted up to 2 clock hours for each credit hour of the course missed for birthrelated absences each semester.
o 1 credit hour of academic classes = 15 clock hours
o 1 credit hour of academic classes with a lab component (designated with “L” after the
course number) = 30 clock hours
o Any additional birth-related absences will be considered unexcused absences.
It is the student’s responsibility to inform each instructor of the birth-related absence before the
start of each class missed, by telephone or email (when at all possible – allowing for actual
attendance at the birth).
o If at all possible students are encouraged to notify instructors in advance through either
of the following methods:
a) speaking with the instructor in person or via a phone call
b) sending an email and receiving a response from the instructor
o Simply leaving a voice message or sending an email is not considered contacting the
instructor. If the student is unable to reach the instructor through either of the methods
stated above, the student must contact the Academic Dean or Clinical Director.
Any missed course work is expected to be made up in a timely manner. Some missed work may
be unable to be made up, at the instructor’s discretion.
Student Name ________________________________ Attending Preceptor
_______________________________
Please Print
Please Print
Date and time of birth ______________________________________________
Time student arrived at birth site __________ AM/PM
AM/PM
Course code number
Time student left birth site ___________
Classes missed
Course Name
Preceptor Signature ________________________________________________________
FSTM Preceptor Manual
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SEMESTER CLINICAL SUMMARY
Student Name
Semester
Credits Registered for:
Preceptor Name
Site Location(s)
Total # of Hours Required:
Total # of Hours Completed:
CLINICAL CATEGORIES
#1
#2
#3
Possible Pts.
Semester Clinical Summary
Clinical Hours Log
Clinical Experience Forms
Earned Points
50
50
50
CLINICAL EXPERIENCE FORMS
Total Clinical Numbers
PN- Prenatal Exams
Required
#4
*Assistant under Supervision
25
#5
*Primary under Supervision
55
Completed
IPE-Initial Prenatal Exams
#6
*Assistant under Supervision
3
#7
* Primary under Supervision
20
BO- Birth Observes
Home
Birth Center
Hospital
#8
*Silent Observer
10
#9
*Assistant under Supervision
20
BM-Births Managements
#10
Home
Birth Center
Hospital
*Primary under Supervision
50
NB-Newborn
#11
*Assistant under Supervision
20
*Primary under Supervision
#12
PP- Postpartum Exams
30
*Assistant under Supervision
10
#13
*Primary under Supervision
#14
CC-Continuity of Care
40
#15
*Full Continuity of Care
05
#16
Date
*Partial Continuity of Care
10
Total Points Possible 150
Total Earned Points
Reviewed by
FSTM Preceptor Manual
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VI
Clinical Skills Check-Off
Documentation
FSTM Preceptor Manual
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39
YEAR 1 – TERM 1
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th edition
Skills with a check mark have been signed off by a FSTM Instructor and/or Approved FSTM
Preceptor in Practical Skills Guide for Midwifery 5th edition.
Lecture:
 1121 Healthcare Skills I
Check Off
1st
2nd
Review & Practice:
• 1121 Healthcare Skills I
• 1241 Midwifery Practicum IA
• 1002CL Clinical Lab / 1003CL Clinical Lab
Skill
Page #
HEALTHCARE SKILLS I
Sterile Technique
Hand Washing
I-5
I-3
Gloving/Ungloving
I-4
Use of Stethoscope
Use of Otoscope
I-9
I-9
Use of Ophthalmoscope
Maternal Blood Pressure
Auscultation of BP with Stethoscope--------------------Palpation of BP--------------------------------------------Maternal Pulses
Radial Pulse-------------------------------------------------Carotid Pulse------------------------------------------------Apical Pulse-------------------------------------------------Six-second Pulse-------------------------------------------Maternal Temperature Assessment
Oral Temp with a Glass Thermometer--------------------Oral Temp with a digital Thermometer -----------------Maternal Respiratory Assessment
Observation of Maternal Respirations--------------------Auscultation of Maternal Respirations / Stethoscope---Maternal Skin Assessment
I-10
Oxygen Setup and Preparation of the Bag-Valve-Mask
Universal Precautions / OSHA Training
I-20
I-21
I-17
I-17
1-17
1-18
I-14
I-15
I-18
I-19
I-20
I-12 & IV-18 ( for
baby)
I-13
Basic Treatment of Shock
I-22
Adv. Treatment of Shock
II-26
General Lifting Technique
I-11
Two Person Sheet Lift
Preparation of the Birth Room
I-12
IV-3
Sterile Technique
I-5
Hand Washing
I-3
Gloving/Ungloving
Use of Stethoscope
I-4
I-9
Use of Otoscope
I-9
FSTM Preceptor Manual
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Use of Ophthalmoscope
Maternal Blood Pressure
Auscultation of BP with Stethoscope--------------------Palpation of BP--------------------------------------------Maternal Pulses
Radial Pulse-------------------------------------------------Carotid Pulse------------------------------------------------Apical Pulse-------------------------------------------------Six-second Pulse-------------------------------------------Maternal Temperature Assessment
Oral Temp with a Glass Thermometer--------------------Oral Temp with a digital Thermometer -----------------Maternal Respiratory Assessment
Observation of Maternal Respirations--------------------Auscultation of Maternal Respirations / Stethoscope----
I-10
I-20
I-21
I-17
I-17
1-17
1-18
I-14
I-15
I-18
I-19
CPR TRAINING
Advanced 02 Admin to Mother/Mouth to Mouth
II-24 / CPR
Oxygen Therapy via Bag-valve-mask
II-25 / CPR
Pulse Oximeter: adult and newborn
Basic Emergency Neurological Evaluation
ABC’s of Emergency carel-28 Use of automated external
I-24 / CPR Training
defibrillator ( AED)
I-27 / CPR Training
I-27/ CPR
ABC’s of Emergency Care
Basic Emergency Neurological Evaluation
Use of Automated External Defibrillator 9AED)
Maternal Oral Suctioning
FSTM Preceptor Manual
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I-26/ CPR Training
I-26/ CPR
I-28 / CPR
11-33 / CPR
41
YEAR 1 – TERM 2
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th Edition
Skills with a check mark have been signed off by a FSTM Instructor and/or FSTM Approved
Clinical Preceptor in Practical Skills Guide for Midwifery 5th edition.
Lecture:
 1222 Healthcare Skills II
 1260 Microbiology for Midwives
Check Off
1ST
Review & Practice:
• 1222L Healthcare Skills II Lab
• 1260L Microbiology for Midwives Lab
• 1342 Midwifery Practicum IB
• 1002 CL Clinical Lab (with Preceptors)
• 1003 CL Clinical Lab (with Preceptors)
Skill
2ND
Page #
1222/1222L HEALTHCARE SKILLS II
Sterilization of Instruments
Pressure Cooker----------------------------------------------Oven Method------------------------------------------------Boiling Method----------------------------------------------Autoclave Method------------------------------------------Cold Chemical Sterilization-------------------------------Obtain a clean catch of urine
Urinalysis via dipstick
Glucose Analysis
Glucometer---------------------------------------------------Dextrostix-----------------------------------------------------Hematocrit Analysis
Hemoglobin Analysis
Basic Physical Exam
I-6
I-7
I-7
I-8
I-8
III-14
III-14
III-12
III-13
II-13
III-10
III-13
S.O.A..P. Charting
Auscultation of Fetal Heart rate
Fetoscope-----------------------------------------------------Doppler-------------------------------------------------------Pinard Horn--------------------------------------------------Draw Medication from Ampule
I-25
III-45
III-45
III-46
II-3
Draw Medication from Multidose Vial
Intramuscular Injections
IM Injection for the Mother--------------------------------IM Injection for the Newborn------------------------------Intradermal Injections
II-3
Subcutaneous Injections
II-9
Venipuncture with Syringe
II-10
II-4
II-6
II-7
Venipuncture with Vacutainer
Allergic Reaction/Mother
II-12
VII-18
Urinary Catheterization
Input and Output during Labor
II-20
IV-6
Oral Client History
III-9
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1222/1222L HCS II - IV Training
Changing and Discontinuing IV
Changing Fluid Bag-------------------------------------Discontinuing (D/C) IV---------------------------------Administration of IV Fluids
Attaching a Saline Lock
II-14
II-15
II-13
II-15
Administration of IV Antibiotics
Administration of IV Pitocin for PP Hemorrhage
II-16
II-17
FSTM GYN/ BREAST Exam Training
Breast Exam & Assessment for Breastfeeding
GYN Pelvic Exam
Speculum Exam----------------------------------------------Assessment of Uterus Ovaries & Cervix-----------------Exam of Vulva, Vagina, Cervix, Perineum & Anus----- Pelvic
Measurements ------------------------------------------
Endocervical Brush Device and spatula technique
Broom like device technique
1260/1260L Microbiology for Midwives & Lab
Wet mount Slide-Use of Microscope
 Preparing a Wet Mount Slide
 How to use a Microscope
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FSTM Training III-18-20
FSTM Training
III-26
III-28
III-30
III-38
III-34
III-35
II-19
II-19
43
YEAR 2 – TERM 1
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th edition
Skills must be signed off by a FSTM Instructor and/or Approved FSTM Clinical Preceptor
Lecture:
 1330 Antepartum
 1350 Diagnostic Testing
Check Off
1st
2nd
Review & Practice:
 2143 Midwifery Practicum IIA
 2001CL Clinical Lab (with Preceptors)
 2002CL Clinical Lab (with Preceptors)
 2003Cl Clinical Lab (with Preceptors)
Skill
General Counseling for the Antepartum Period
Procedure #1---------------------------------------------------
Page #
III-4
Specific Counseling & Education for the Antepartum Period
Procedure #2--------------------------------------------------Routine Prenatal Exam
Assessment of Edema
Fundal Height Measurement
Procedure #1--------------------------------------------------Procedure #2 -------------------------------------------------Procedure #3--------------------------------------------------Procedure #4--------------------------------------------------Costovertebral Angle Tenderness (CVAT)
Deep Tendon Reflexes of the Knee
Clonus
Determining Estimated Due Date (EDD)
Leopold’s Maneuvers
Obstetrical Abdominal Evaluation –Woman not less than 28 weeks gestation
Assessment-Other than Vertex Presentation
Fetal Activity Testing
Ectopic Pregnancy
Assessment of Pre-Eclampsia / Toxemia
External Version
Pre-Term Labor
Uterine Size & Fetal Age according to bi-manual exam
Urinary Tract Infection/ UTI
Asymptomatic Bacteriuria
Cystitis
Post Dates Pregnancy
Care of Woman who has Miscarried
Maternal Hypertension/Mild after 20 weeks
Severe Maternal Hypertension
Bishop Score of the Cervix
Maternal Seizures
Amnios/Chorionitis
Pulmonary Embolism
Supine Hypotensive Syndrome
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III-50
III-47
III-42
III-43
III-43
III-44
III-22
III-22
III-23
III-3
III-39
III-40
III-41
III-48
III-56
III-61
VII-9
III-62
III-27
III-15
III-17
II-21
III-52
III-57
III-59
III-60
III-53
11-37
IV-49
V-23
III-51
44
YEAR 2 – TERM 2
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th Edition
Skills must be signed off by a FSTM Instructor and/or FSTM Clinical Preceptor
Lecture:
 2120 Intrapartum
Check Off
1st
2nd
Review & Practice:
•
2244 Midwifery Practicum IIB
•
2100-2300CL Clinical Lab
Skill
Basic Intrapartum exam
Intrapartum Pelvic Exam
Evidence of Ruptured Membranes
Sterile Digital Exam------------------------------------------Sterile Speculum Exam---------------------------------------Artificial Rupture of Membranes
Assessment of Contractions
Basic Comfort Measures
Monitoring Fetal Heart Tone (FHT)
Assessment of Meconium Staining
Enema
Hand Maneuvers to Assist Delivery
Ritgen Maneuver
Placenta Abruptio
Placenta Previa
Abnormal Changes in Maternal Vitals
Abnormal FHT and Patterns
Abnormal Intrapartal Bleeding
Intrapartal Bleeding Assessment----------------------------Abnormal Intrapartal Bleeding when Birth is Imminent-Management of Nuchal Cord
Management of Nuchal Hand/Arm
Cord Prolapse
Cord Prolapse-------------------------------------------------Cord Prolapse when Birth is Imminent -------------------Shoulder Dystocia
McRoberts Maneuver----------------------------------------Gaskin Maneuver--------------------------------------------Face and Brow Presentation
Breech Delivery
Delivery of Twins
Emergency Manual Dilation
Episiotomy
Induction/Augmentation of Labor
Intradermal sterile Water Injection
Orgastric Tube Insertion
Dehydration in Labor
Uterine Inversion
Uterine Rupture
Cervical Rimming
Cervical Ripening Balloon
Non- pneumatic Auto Shock Garmet: (Apply NASG & monitor the woman who has
hemorrhaged after giving birth & delivery of placenta)
Modified Active Management if the Third Stage of Labor
(AMTSL)
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IV- 8
IV-10
IV-11
IV-12
IV-13
IV-14
IV-15
IV-19
IV-20
IV-21
IV-25
IV-26
III-69
III-70
VII-16
IV-31
IV-47
IV-48
IV-27
IV-28
IV-43
IV-43
IV-29
IV-30
IV-35
IV-36
IV-37
IV-45
IV-34
IV-5
II-8
VII-48
IV-7
V-23
IV-42
III-53
III-54
I-23
IV-39
45
YEAR 2 – TERM 3
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th Edition
Skills must be signed off by a FSTM Instructor and/or FSTM Clinical Preceptor
Lecture:
 2220 Newborn
 2250 Suturing for Midwives
 2210 Postpartum
Check Off
1st
Review & Practice:
 2345 Midwifery Practicum IIC 2003CL
Clinical Lab (with Preceptors)
 2220 Newborn
 2250 Suturing for Midwives
 2210 Postpartum
Skill
2nd
Page #
NEWBORN Skills
Immediate Care of Newborn
Clamping & Cutting the Cord
Newborn Temperature Assessment
Axillary Temperature with glass thermometer-------------Axillary Temperature with Digital thermometer-----------Rectal Temperature with glass thermometer ---------------Rectal Temperature with Digital thermometer-------------Tympanic Temperature ---------------------------------------Temperature regulation of the Newborn
Newborn Pulses
Respiratory & Cardiac Assessment of the Newborn
Scoring Respiratory Assessment
APGAR Assessment
Assessment of Newborn Reflexes
Newborn Eye Prophylaxis
Gestational Age Assessment
Initial Newborn Exam
Administering Free Flow Oxygen to Newborn
24-Hour Newborn Exam
Routine Newborn Exam
Newborn Metabolic Screen
Use of Icterometer
Jaundice in Newborn
Newborn Seizures
Birth of the Premature Infant
Newborn Suction Techniques
Bulb Syringe-----------------------------------------------------De Lee-----------------------------------------------------------Res-Q-Vac or Electrical Device-----------------------------Allergic Reaction / Baby
Gastroschisis
Determine Blood Type and Factor in the Newborn
Choanal Artesia
Immediate Care of Newborn
Clamping & Cutting the Cord
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VI-7
VI-9
VI-9
VI-10
VI-11
VI-12
VI-8
VI-13
VI-14
V-10
VI-15
VI-16
VI-17
VI-18
VI-20
VI-4
VI-23
VI-28
VI-25
VI-26
VI-27
II-36
IV-41
VI-5
VI-5
VI-6
III-29
IV-50
V-5
VI-33
VI-3
VI-7
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Newborn Temperature Assessment
Axillary Temperature with glass thermometer-------------Axillary Temperature with Digital thermometer-----------Rectal Temperature with glass thermometer ---------------Rectal Temperature with Digital thermometer-------------Tympanic Temperature ---------------------------------------Temperature regulation of the Newborn
Newborn Pulses
Congenital Diaphragmatic Hernia (CDH)
Pierre Robin Syndrome
Downs Syndrome
Cleft Lip Palate
Recognition of RDS and Infection
Newborn Oropharyngeal Airway
Newborn Intubation
Newborn Resuscitation (NRP Certification)
VI-9
VI-9
VI-10
VI-11
VI-12
VI-8
VI-13
VI-34
VI-34
VI-35
VI-36
VI-31 / NRP
II-29 / NRP
II-29 / NRP
II-31/ NRP
POSTPARTUM Skills
Immediate Postpartum Maternal Care
Specific Counseling & Education, PP/Newborn Period
Obtaining Cord Blood Sample
Collecting in a Tube------------------------------------------Collecting with Syringe and Needle-----------------------Facilitating Delivery of Placenta
Postpartum Bleeding
Estimation of Blood Loss
Assessment of Placenta
Bathing Mother and Baby
Mother/Baby Together
Baby separately
General Postpartum Exam
Six-week Postpartum Exam
Manual Removal of Placenta
Placenta---------------------------------------------------------Placental Fragments-------------------------------------------Bi-Manual Compression
Postpartum Hemorrhage
V-3
V-14
V-4
V-4
V-6
V-7
V-8
V-9
V-13
V-13
V-16
V-17
V-20
V-21
V-19
V-22
SUTURING Skills
Basic Suturing
Assessment & Repair of Lacerations
Infiltration of Local Anesthetic ( suturing )
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V-10
II-21
47
YEAR 3
Clinical Skills Documentation Check Off
Text: Practical Skills Guide for Midwifery, 5th Edition
Skills must be signed off by a FSTM Instructor and/or Clinical FSTM Preceptor
Lecture:
 3110 & 3110L GYN & Women’s Health - Lab
Check Off
1st
Review & Practice:



Skill
3001CL Clinical Lab
3002CL Clinical Lab
3003CL Clinical Lab
Page #
2nd
Papanicolaou / PAP Test
Pap Smear
Endocervical Brush, Spatula Technique
Broom-like Device Technique
GYN Cultures
III-32
III-32
III-34
III-35
III-37
YEAR 3 TERMS 1, 2 & 3
During the third year of the program Student Midwives should review skills which have not
received 2 signatures and focus on obtaining signatures. Skills must be completed and the
signatures pages from Practical Skills Guide for Midwifery, 5th Edition will be turned into the
Administrative Coordinator for the student’s permanent file.
Topics that will be covered/conducted in the third year of the program
 3146 Midwifery Practicum IIIA – Protocols
 3247 Midwifery Practicum IIIB – FSTM Clinical Skills Exam
 3348 Midwifery Practicum IIIC – NARM Review
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VII
FSTM Curriculum
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DIRECT ENTRY MIDWIFERY PROGRAM CURRICULUM
YEAR 1
YEAR 3
Year 1, Term 1
1101
Anatomy and Physiology I
1101L Anatomy and Physiology Lab
1102L Student Success Lab
1103
Healthcare Skills I
1104
Research Evaluation
1105
History of Midwifery
1106
Basic Communication Skills
1107
Florida Law and Rule
Total Credits
Credits
3
1
1
2
1
1
1
1
11
Year 1, Term 2
1201
Anatomy and Physiology II
1201L Anatomy and Physiology II Lab
1202
Midwifery Practicum I A
1203
Healthcare Skills II
1203L Healthcare Skills II Lab
1204
Female Sexuality for Midwives
1205
Breastfeeding
1200CL Clinical Lab
Total Credits
Credits
1
2
1
2
1
2
2
1
12
Year 3, Term 1
3101
Gynecology and Women's Health
3102
Writing Protocols
3103
NARM Review
3104
Collaborative Management
3100CL Clinical Lab
Total Credits
Credits
2
1
1
1
4
9
Year 3, Term 2
3201
Establishing/Maintaining a Practice
3202
Clinical Skills Practicum
3203
Traditional Healing Modalities III
3204
Issues in Professional Midwifery
3200CL Clinical Lab
Total Credits
Credits
2
1
1
1
4
9
Year 3, Term 3
3300CL Clinical Lab
Total Credits
Credits
4
4
YEAR 3 TOTAL CREDITS
Year 1, Term3
Credits
1301
Reproductive A&P
3
1301L Reproductive A&P Lab
1
1302
Midwifery Practicum I B
1
1303
Antepartum
3
1304
Traditional Healing Modalities I
1
1305
Diagnostic Testing
1
1306
Interpersonal Communication Skills
1
1300CL Clinical Lab
1
Total Credits
12
YEAR 1 TOTAL CREDITS
35
YEAR 2
Year 2, Term 1
Credits
2101
Nutrition for the Childbearing Years
2
2102
Midwifery Practicum II A
1
2103
Intrapartum
3
2104
Fetal Monitoring
1
2105
Psychology for Midwives
2
2106
Professional Communication Skills
1
2100CL Clinical Lab
3
Total Credits
13
Year 2, Term 2
2201
Microbiology for Midwives
2201L Microbiology for Midwives Lab
2202
Midwifery Practicum II B
2203
Postpartum
2204
Suturing for Midwives
2205
Herb Workshop
2206
Newborn
2200CL Clinical Lab
Total Credits
Credits
2
1
1
1
1
1
2
3
12
Year 2, Term 3
2301
Public Health
2302
Midwifery Practicum II C
2303
Pharmacology
2304
Traditional Healing Modalities II
2300CL Clinical Lab
Total Credits
Credits
2
1
2
1
3
9
22
General Program
Requirements:
Semester Credit Conversion Formula:
15:1 Theory
30:1 Theory Lab
60:1 Clinical Lab
Actual Contact Hours:
Theory: 915
Theory Lab: 210
Clinical Lab: 1380
Total Program Contact Hours: 2505
Total Program Credits: 91 (Semester Credits)
Cost per Credit Hour: $364.00*
Total Program Cost: $33,124.00
Clinical Requirements**
Total Clinical Credits: 23***
Prenatal Exams: 80
Initial Prenatal Exams: 23
Birth Observations: 30
Birth Managements: 50
Postpartum Exams: 50
Newborn Exams: 50
Continuity of Care: 15
Required Home Births: 5
Required Hospital Births: 2
*All program credits, clock hours, tuition, and feesare sub ject to
change. Average anticipated tuition increase is 4% per academic year.
**These Requirements meet or exceed all mandates as defined b y the
Chapter 467 Florida Statutes, the North American Registry of
Midwives (NARM), and the Midwifery Education Accreditation Council
(MEAC), and are sub ject to change at any time.
***Senior students who have completed their academic requirements
b ut have not finished their clinicalrequirements must continue to
register for Clinical Lab using course codes 4100CL, 4200CL, and
YEAR 2 TOTAL CREDITS
FSTM Preceptor Manual
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4300CL until all clinical requirements have b een met.
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VIII
Appendix
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Clinical Observation
Clinical Lab
The student midwife’s responsibilities as a silent observer are outlined below.
As an Observer the student should remain quiet and unobtrusive. A great deal of learning
is gained as a silent witness.
Student midwives: Please modify the outline below to meet the needs of the setting where the
birth observe is taking place. Always adhere to the requests, directions and instruction of the
attending midwife or physician.
Prerequisites for observations:
1. Obtain permission from the preceptor and the school.
2. Receive orientation to clinical site, location of supplies and procedure and protocol
policies.
3. Students must be CPR and NRP certified.
The Role of the Observer:
 An observer’s role is silent.
 Other than introducing oneself to parents and family, the observer does not get drawn
into the conversation unless specifically requested to participate by the preceptor. For
example “labor coaching” as requested.
 Please take notes regarding questions you may have and save them until you can meet
with the preceptor privately. Never question procedure or policy in front of the client.
 Observe and note the interactions between the clinical staff and family.
 Observe and note your own reactions and feelings to what you are observing.
 Note the time of delivery of the baby, Apgar score at 1minute and 5minutes and time
of the delivery of the placenta.
 Observe the Newborn assessment.
If permitted be prepared to assist in the following possible ways.
 Demonstrate the ability to accurately assess vital signs.
 Be prepared to obtain supplies should the midwife/clinician request.
 Be prepared to participate in labor coaching upon the request of the midwife/clinician.
 Be prepared to correctly make an emergency phone call upon request.
 Stay for 2-4 hours (or longer as needed) postpartum as designated by the
midwife/clinician to observe the immediate postpartum period.
 Help to clean the environment after the birth (i.e., assist with laundry, washing and
restocking supplies etc.)
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Continuing Education LM
Provider Number: 50-1981
Title of CEU Presentation: Precepting FSTM Midwifery Students
Number of CEU’s offered: 3
Location of seminar: Self Study
Name of Preceptor: _____________________________________
Learning Objectives:
Section One: The Preceptor will be able to: Identify the Roles and Expectation of the
Preceptor, Accepting & Placement of a Midwifery Student, Developing Critical Thinking Skills
in the Midwifery Student and Evaluating Student Progress.
Section Two: The Preceptor will be able to: Understand the roles of the student regarding:
Clinical Requirement and Documentation, Midwifery Clinical Lab and Clinical Notebooks.
Reference:
FSTM Preceptor Manual
Section One: Please circle your answer.
1. Who should a Preceptor contact when they need a consult regarding a student?
A. FSTM Executive Director
B. FSTM Clinical Director
C. A good friend
2. How often are Preceptors required to evaluate student(s) progress?
A. once a year
B. Never
C. Once each semester
3. Are FSTM Preceptors considered Clinical Faculty at FSTM?
Yes / No
4. Is it in the best interest of the student to be on call 24/ 7?
Yes / No
5. Is it helpful to give constructive feedback to the student?
Yes / No
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Section Two: Please circle your answer.
1. How many Birth Observes are required for a midwifery student to complete in order to
graduate?
A. 10
B. 15
C. 30
2. How many Birth Managements are required for a midwifery student to complete in order to
graduate?
A. 40
B. 50
C. 100
3. When a new student is attending a birth as a Silent Observer they should be performing the
newborn exam.
True / False
4. Students must submit documentation of clinical experience forms within one month of the
date of the experience.
True / False
5. Preceptors are encouraged to review and approve clinical experience forms within two weeks
of receiving from the student.
True/False
6. What text does the student midwife use to have clinical skills signed off in?
A. Varneys by Helen Varney
B. Practical Skills Guide to Midwifery by Weaver & Evans
C. Suturing for Midwives by Anne Frye
7. Student Midwives are required to create client identification (ID) number to use on clinical
experience forms, instead of writing the clients name.
True / False
8. How many continuity of care cases are Students required to document?
A. 10
B. 15
C. 30
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The Florida School of Traditional Midwifery
810 East University Avenue
Gainesville, Florida 32601
Telephone: 352-338-0766
Fax: 352-338-2013
www.midwiferyschool.org
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