Background: The Association for Child Life Professionals (ACLP) requires those seeking to become a Certified Child Life Specialist (CCLS) complete a minimum of 480 hours of supervised clinical experience prior to the certification exam. Trainees’ skills are evaluated using the Evaluation Tool for Child Life Interns. This tool consists of 54 skill-based items scored with a 7-point Likert-based rating scale (with a Not Applicable (NA) option) and space for open-ended narrative feedback. Skill based items are within three separate domains: Assessment, Intervention and Professional Responsibility. There are no published research studies available to date on the use or effectiveness of the tool. Purpose: This study seeks to explore the educational impact of the tool using two sources of data: frequency of NA ratings across the three domains and narrative feedback from preceptors in comment sections of the tool. Methods: Using an explanatory sequential mixed methods design, quantitative data (proportion of NA ratings) and qualitative data (preceptors’ comments) from evaluation tools obtained from 45 learners spanning the academic years 2011 – 2016 at McMaster University’s Post Graduate Diploma Program in Child Life. Mean proportion of NAs was evaluated using a 2 (time: internship 1 and internship 2) x 3 (domain: assessment, intervention and professional responsibility) two-way repeated measures analysis of variance ANOVA. Qualitative data was explored using thematic analysis of preceptors’ narrative comments for skill-based items where at least 1 NA rating was selected. Results: Analyses of quantitative data revealed NA ratings to be substantially greater in the professional responsibility domain (22%) relative to both assessment (<1%) and intervention (3%) domains (p-value < 0.001). There was no main effect for time. Qualitative analyses showed that the use of NA was primarily due to the intern not having the opportunity to experience or demonstrate the skill being rated. Four themes emerged from the thematic analysis of narrative feedback (constructive feedback, action plans, clinical examples with patients and families, little to no opportunity for skill development). Conclusion: The Evaluation Tool for Child Life Interns offers quantitative and qualitative feedback to child life learners with benefits and challenges to its use. The subtasks in the assessment and intervention domains represent child life practice across various placement sites. Within the professional responsibility domain, skills being assessed require further review through stakeholder input to ensure they reflect current practice. The narrative feedback provided by preceptors is detailed and constructive. The tool is discouraged for use as a single summative assessment to make decisions of competency and is recommended for formative and summative use as one method of feedback within a program of assessment. / Thesis / Master of Science (MSc)

Bakgrund: Barnmorskans yrkesområde är inom sexuell, reproduktiv och perinatal hälsa. Detövergripande målet i barnmorskeutbildningen är att utveckla självständiga och kompetenta barnmorskor. Den verksamhetsförlagda utbildningen (VFU) motsvarar ungefär halva studietiden och är en viktig del i barnmorskeutbildningen. Förlossningsavdelningen är en viktig miljö för barnmorskestudenter att inhämta kunskaper om graviditet och förlossning. Motiv: VFU på förlossningsavdelning är en känslomässig och intensiv period för barnmorskestudenter. Barnmorskestudenters uppfattningar om vad som främjar utveckling behöver studeras vidare för att kunna optimera framtida verksamhetsförlagda utbildningar. Syfte: Det övergripande syftet var att belysa barnmorskestudenters upplevelser av verksamhetsförlagd utbildning på förlossningsavdelning.  Metod: En kvalitativ design med induktiv ansats har använts. Semistrukturerade intervjuer med sju barnmorskestudenter i Sverige genomfördes. Intervjuerna har analyserats genom en kvalitativ innehållsanalys. Resultat: Genom analysprocessen framkom ett tema, VFU på förlossningsavdelning – en känslomässig berg- och dalbana samt tre kategorier; Att både ge och ta emot stöd där en mängd faktorer som kan påverka mötet med kvinnan och stödpersonen beskrevs. Andra kategorin Att hålla ihop hela vägen beskrev hur barnmorskestudenternas hälsa varierade samt svårigheter i att gå från en trygg yrkesroll till en studentroll. Tredje kategorin Hinder i utvecklingsprocessen visade hur Covid-19-pandemin påverkade barnmorskestudenternas VFU, optimeringar inför framtida VFU samt tankar om den framtida yrkesrollen. Åtta subkategorier bildades. Konklusion: Barnmorskestudenterna upplevde sin VFU på förlossningsavdelning som en känslomässig berg- och dalbana. Flertalet faktorer som tidigare erfarenheter, relationen till handledaren och reflektionsmöjligheter påverkade barnmorskestudenters möte med kvinnan och stödpersonen. Att belysa dessa faktorer och inkludera barnmorskestudenter i den kvinnocentrerade vården kan leda till ökat självförtroende och kompetens hos barnmorskestudenter vilket i sin tur kan leda till optimeringar av den kvinnocentrerade vården. / Background: The midwife's profession is within the sexual, reproductive and perinatalhealth. The overall purpose of midwifery education is to develop independent and competent midwives. The clinical internship is an important part of the education. The labour ward is an important environment for midwifery students to acquire knowledge about pregnancy and childbirth. Motive: Clinical internship in the labour ward is an emotional and intense period for midwifery students. Midwifery student’s perceptions of what promotes development needs to be studied further, in order to optimise future clinical internships. Aim: The aim was to investigate midwifery students experiences of clinical internship at labour wards.  Methods: A qualitative design with an inductive approach was used. Semi-structured interviews with seven midwifery students in Sweden participated. The interviews were analysed with qualitative content analysis. Result: A theme emerged, Clinical internship at the labour ward - an emotional roller coaster and three categories; To both give and receive support where a number of factors that can affect the meeting with the woman and the support person were described. Second category Holding together all the way described how the midwifery student’s health varies as well as difficulties in the student role. The third category Obstacles in the development process showed how the Covid-19-pandemic affected midwifery student’s clinical internship, optimisations and thoughts about the future professional role.  Conclusion: The clinical internship at the labour ward was described as an emotional roller coaster. Previous experiences, the relationship with the supervisor and opportunities for reflection influenced the midwifery student's encounter with the woman and the support person. Elucidating these factors and including midwifery students in women-centered care can lead to increased self-confidence and competence among midwifery students, this couldlead to optimisations of the women-centered care.