Changes in maternity services and the role of the midwife mean that the midwife must provide flexible, evidence-based, woman-centred care. As the lead professional, the midwife must use a high level of professional judgement, clinical reasoning and decision-making to enable choice while ensuring the safety and wellbeing of mother and infant. Delayed development of these cognitive skills is suggested by the continuing theory-practice gap, suboptimal practice and students requiring to conform to non-evidence-based practice. The purpose of this research was to explore midwifery students' understanding and experience of the development of cognitive skills. The research employed analysis of undergraduate midwifery programme documentation and a focus group discussion with student midwives from second and third year of the programme. Document analysis and thematic analysis of the interview data indicated a lack of emphasis on cognitive skill development and a sense that these skills improve naturally through exposure to clinical practice. The findings suggest a need to change our approach to learning in clinical practice and to conduct further research to improve understanding of mechanisms to support the development of cognitive skills.
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