Improving Retention Rates in Midwifery Education Programs

FEBRUARY 2013 Enews Articles


Improving Retention Rates in Midwifery Education Programs
by Marla Hicks and Gerri Ryan

Whether a school is new or established, student retention as a measure of institutional success is a concern to every midwifery education program. In this article, we would like to share with you some measures that have dramatically improved student retention at Nizhoni Institute of Midwifery.

During the first few years of our program, we found student retention to be a significant problem. In addressing this issue, personal interviews and program evaluations revealed that our students were generally very satisfied with their midwifery education but were frequently beset by personal challenges. Sometimes students experienced unanticipated changes, such as a spouse’s job transfer out of state or a personal or family illness that required the student to withdraw from the program. More often, however, our students’ reasons for withdrawal centered around three key areas: time, money, and commitment. Specifically, students most often left the program due to an inability to pay school-related expenses or because of misunderstandings regarding the time and energy needed to successfully complete the academic and clinical requirements of our program.

To address this situation, the Executive Directors began exploring potential pitfalls with applicants very directly prior to enrollment. Applicants are now asked to express their understanding of the midwifery lifestyle and the time and energy commitment required for midwifery practice. The Directors discuss specific stressors inherent to midwifery practice and their effect on both the student and the student’s family members. Applicants are asked to identify potential challenges to completing their education as well as possible solutions and the Directors provide feedback. We have noted with interest that, once they truly understand the depth and breadth of knowledge and clinical acumen required for midwifery practice, family members typically express even greater support for their student.

The Directors also speak frankly with program applicants and their family members about specific plans for funding their midwifery education. Each applicant details a primary financial plan, but is also asked to formulate a viable and specific “Plan B” in case the primary plan fails or requires adjustment. Because Nizhoni Institute does not participate in federal or state student loan programs, this level of financial planning and transparency is important to student success and retention.

Notes from these interviews are retained in student files so that the directors can refer to them periodically (e.g., during student evaluations) and provide students with assistance as necessary. Students are also strongly encouraged to come to the Directors regarding developing problems so that they can be addressed well before the student finds it necessary to withdraw from the program.

Nizhoni has implemented policies and procedures regarding student financial accountability that all students receive and sign along with their enrollment agreement. They are, therefore, aware of the steps they are expected to take if their financial situation changes. The first step is open communication between the student and the Directors. We can also make special contractual arrangements to accommodate specific circumstances for a limited period of time. These arrangements allow the student time to regroup, catch up financially, and move forward with their education.

Another significant pathway for improving student retention has been to foster communication and camaraderie between our midwifery cohorts. Nizhoni students are admitted to the program annually and progress together as a cohort over a three-year period. This system promotes solidarity within the group but also creates the potential for a gulf between each of the cohorts. We realized that our most senior students had experience and coping skills that the newer students did not yet have, and so we now hold regular activities that create community between members of the three cohorts that are in session at any given time. Students report that this has helped them to gain perspective and has also provided access to problem-solving skills and solutions that were not available elsewhere. Faculty members also participate in these activities and are regularly very accessible, providing helpful support to the students.

Public recognition of the work of our students and their supporters occurs annually at Nizhoni Graduation where faculty, administrators, alumni, current students, the Nizhoni Board of Trustees, and the midwifery community gather with graduates, family, and friends to celebrate our newest midwives. Each graduate chooses one special person to speak about the experience of supporting a student through the midwifery program. The culmination of the graduation event is a pinning ceremony in which loved ones present the Nizhoni School pin to their new graduates. The pinning ceremony is a beautiful way to acknowledge the years of concerted joint effort and growth that have transformed the graduates from students to midwives.

Since implementing these changes, Nizhoni Institute has seen significant improvement in student retention. Students report that they value the personalized assistance that they receive over the course of the program and family members often tell us that they feel truly appreciated for their contributions. We have been pleased with these results and will continue to examine ways in which we can improve our admission processes and student services. When our students succeed, our schools succeed and our profession is strengthened. We need more midwives!

Marla Hicks, RN-BC, CPM is Executive Director, Chief Academic Officer, and a faculty member of Nizhoni Institute of Midwifery, located in San Diego, California. She has been practicing midwifery for 35 years.

Gerri Ryan, LM, CPM, CDE is the Executive Director, Chief Operating Officer, and a member of the faculty of Nizhoni Institute of Midwifery. She maintains an active midwifery practice in San Diego and assists in developing continuing education opportunities for practicing doulas, midwives, and health professionals.

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