Practice learning in nursing and midwifery education: an independent rapid review

Educating and training enough new nurses, midwives and nursing associates with the right skills, knowledge and experience is critical for meeting the current and future staffing needs of our health and care services. 

Students in these professions complete hands-on “practice learning” hours as part of their training. This report, conducted in partnership with the Florence Nightingale Foundation and commissioned by the Nursing and Midwifery Council (NMC), examines the current regulations and standards for practice learning in the UK and explores the factors that contribute to a positive learning environment, including practice supervision and assessment. 

Key findings in brief

• We did not find clear evidence to determine the optimal number of practice hours needed to ensure safe and effective practice or support the current requirement of 2,300 hours.
• There was consensus among stakeholders that the quality of practice learning mattered more than its duration, and that current requirements need revisiting to better assure quality and reduce inconsistencies in experience. 
• There was also limited evidence and mixed stakeholder views on what number of births, assessments and other learning objectives should be required as part of midwifery training standards.
• Students and registrants were often confused about what counts as a practice learning hour and what counts as theory. Many felt that there was insufficient protection of students’ ‘supernumerary status’ and protected learning time.
• In many cases the specific practice learning requirements are leading to anxiety for students. More task-orientated care is sometimes being promoted over continuity of care.

We recommend that the NMC do more to communicate its standards and fill in evidence gaps around how factors such as assessment approaches and simulation learning contribute to the competency of new registrants. At a national policy level, we also call for dedicated national strategies to ensure an appropriately broad range of high-quality learning placements, and reviews into how placements are incentivised and funded and how to better protect the value of supervisors and assessors in clinicians’ job plans and via pay and progression.