Understanding Clinical Teaching in Midwifery Education: Validation of the MidPaACT Tool in the Italian Context

Abstract

Introduction. Midwifery education integrates theoretical instruction with clinical practice, in which supervisory relationships are pivotal. The quality of mentorship substantially influences students’ competence, confidence, and professional identity, and is largely determined by midwives’ awareness of their role as preceptors and how this is enacted in practice. This study aims to provide a valid instrument for evaluating clinical teaching in midwifery education by translating, culturally adapting, and psychometrically validating the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool in the Italian context. Methods. The MidPaACT questionnaire was translated and culturally adapted following established international guidelines. The process included forward translation, synthesis, back translation, expert panel review, and pilot testing. Data were collected through an online survey completed by preceptor midwives involved in undergraduate midwifery education. Construct validity was assessed using confirmatory factor analysis using a Diagonally Weighted Least Squares estimator. Model fit was evaluated using RMSEA, SRMR, CFI, and TLI indices. Internal consistency reliability was assessed using Cronbach’s alpha coefficients. Results. A total of 168 preceptor midwives participated. Confirmatory factor analysis supported the original two-factor structure (‘Supporting students to learn’ and ‘Safety in learning’) and indicated acceptable model fit (RMSEA = 0.08; SRMR = 0.105; CFI = 0.973; TLI = 0.971). Internal consistency was satisfactory for both subscales (α = 0.88 and α = 0.77). Participants reported high levels of engagement in supporting student learning and ensuring safety in clinical practice, while highlighting areas for improvement in academic–clinical collaboration and culturally responsive supervision. Discussion. The Italian version of the MidPaACT demonstrates satisfactory psychometric properties and provides a valid tool for the systematic evaluation of clinical teaching in midwifery education. Its use can support the development of targeted faculty development initiatives and strengthen evidence-informed approaches to improving the quality of clinical education.