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Midwifery academic educators' experiences and knowledge on managing students' moral distress and psycho-emotional trauma during clinical placement: A qualitative study protocol

  • Published: 26 June 2026
  • While growing attention has been given to moral distress and work-related psycho-emotional trauma among practicing midwives, few researchers have explored how midwifery academic educators understand, identify, and manage these phenomena in students. This paper presents a study protocol on the exploration of midwifery academic educators' experiences and knowledge in managing students' moral distress and psycho-emotional trauma related to clinical placement. A qualitative research design using focus group interviews with academic educators involved in undergraduate and postgraduate midwifery education will be adopted. Participants will be purposively recruited according to predefined inclusion and exclusion criteria. Focus groups will consist of 6–8 participants. Two focus group discussions will initially be conducted in each country in the host country's native language. Following preliminary data analysis and identification of major- and subcategories, a second round of focus group confirmatory discussions will be conducted with the same participants. Data will be collected through semi-structured discussions focusing on participants' direct or indirect experiences regarding midwifery students' moral distress and trauma, pedagogical approaches academic educators' use to address these issues, strategies for identifying and managing students' distress, and practices that facilitate students' disclosure and psychological safety. Data will be analysed using the inductive content analysis approach. The study is expected to provide insight into current educational practices, perceived challenges, and gaps in academic educators' preparedness to address moral distress and psycho-emotional trauma among midwifery students. Findings are anticipated to inform the development of targeted pedagogical strategies, continuing education initiatives, and supportive interventions aimed at enhancing students' well-being and resilience during clinical placement. By highlighting academic educators' perspectives, this study seeks to contribute to the advancement of midwifery education through the promotion of psychologically safe learning environments and evidence-informed approaches to managing moral distress and maternity care-related trauma in academic and clinical training contexts.

    Citation: Maria Karanikola, Virginia Koutroubas, Nicos Middleton, Anne Griese, Eleni Hadjigeorgiou, Veronika Christodoulides, Ourania Kolokotroni, Julia Leinweber. Midwifery academic educators' experiences and knowledge on managing students' moral distress and psycho-emotional trauma during clinical placement: A qualitative study protocol[J]. AIMS Public Health, 2026, 13(3): 706-724. doi: 10.3934/publichealth.2026038

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  • While growing attention has been given to moral distress and work-related psycho-emotional trauma among practicing midwives, few researchers have explored how midwifery academic educators understand, identify, and manage these phenomena in students. This paper presents a study protocol on the exploration of midwifery academic educators' experiences and knowledge in managing students' moral distress and psycho-emotional trauma related to clinical placement. A qualitative research design using focus group interviews with academic educators involved in undergraduate and postgraduate midwifery education will be adopted. Participants will be purposively recruited according to predefined inclusion and exclusion criteria. Focus groups will consist of 6–8 participants. Two focus group discussions will initially be conducted in each country in the host country's native language. Following preliminary data analysis and identification of major- and subcategories, a second round of focus group confirmatory discussions will be conducted with the same participants. Data will be collected through semi-structured discussions focusing on participants' direct or indirect experiences regarding midwifery students' moral distress and trauma, pedagogical approaches academic educators' use to address these issues, strategies for identifying and managing students' distress, and practices that facilitate students' disclosure and psychological safety. Data will be analysed using the inductive content analysis approach. The study is expected to provide insight into current educational practices, perceived challenges, and gaps in academic educators' preparedness to address moral distress and psycho-emotional trauma among midwifery students. Findings are anticipated to inform the development of targeted pedagogical strategies, continuing education initiatives, and supportive interventions aimed at enhancing students' well-being and resilience during clinical placement. By highlighting academic educators' perspectives, this study seeks to contribute to the advancement of midwifery education through the promotion of psychologically safe learning environments and evidence-informed approaches to managing moral distress and maternity care-related trauma in academic and clinical training contexts.



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    Authors' contributions



    Conceptualization, M.K; methodology, M.K, N.M, J.L; literature review A.G, M.K, V.S.K; resources, A.G, J.L, M.K; data curation, M.K, A.G, J.L, V.S.K,; writing—original draft preparation, M.K, V.S.K; review and editing, M.K, V.C, V.S.K, E.H, and N.M.; table preparation, M.K, V.S.K ; discussion & interpretation: All co-authors. All co-authors have read and agreed to the published version of the manuscript.

    Conflict of interest



    The authors declare no conflicts of interest.

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