Buddy Model in Midwifery Training Builds Confidence, Study Finds

A quiet revolution is unfolding in the delivery wards of one of Thailand’s largest hospitals, and it does not involve new machines, new drugs, or new surgical techniques. Instead, it rests on something far older and more human: pairing inexperienced student midwives with practicing nurse-midwives who guide them, step by step, through the realities of clinical care. A new qualitative study from Siriraj Hospital in Bangkok, published in BMC Nursing, offers one of the most detailed portraits yet of how this so-called buddy model actually feels to the people living it, and its findings carry important lessons for midwifery education far beyond Thailand’s borders.

The research, led by Antita Kanjanakaew and colleagues at Mahidol University’s Faculty of Nursing together with nurse educators at Siriraj Hospital, emerged from a pressing global problem. Health systems worldwide face a shortage of qualified nurse-midwifery educators, the specialized faculty members who traditionally supervise students during clinical placements. When there are not enough educators to go around, students can find themselves watching from the sidelines rather than learning by doing. The buddy model was developed as a collaborative response, pairing students with experienced bedside nurse-midwives who act as day-to-day guides within authentic clinical settings, allowing experiential learning to continue even when formal educator supervision is stretched thin.

To understand whether the model works, the researchers turned to the people at its center. Twenty-six nurse-midwifery students participated in online focus group discussions, while fifteen nurse-midwives took part in in-depth individual interviews. Participants were recruited through purposive sampling, a technique that deliberately selects individuals with direct experience of the phenomenon under study. The team then applied qualitative content analysis, a systematic method for identifying patterns and themes within textual data, to distill hundreds of pages of conversation into a coherent account of what the buddy model delivers, and what it demands.

Four major themes emerged from the students’ side of the relationship. The first was apprehension toward interacting with unfamiliar nurses, a reminder that stepping onto a busy maternity ward as a student is an inherently vulnerable act. Students described initial anxiety about approaching nurses they did not know, worrying about being judged or turned away. Yet this apprehension typically gave way to the second theme: hands-on learning. Once relationships formed, students reported that working alongside buddy nurses enhanced their confidence, accelerated their professional identity formation, and helped them integrate classroom theory with the messy, unpredictable realities of patient care. There is a qualitative difference, the students suggested, between reading about labor management and standing beside a woman in labor with a trusted mentor at your shoulder.

The third and fourth themes revealed the model’s internal complexity. Students described a dichotomy between two types of buddies, and correspondingly different challenges of learning from each. Some buddy nurses were engaged, generous teachers who actively created learning opportunities; others were passive, offering little direction and leaving students to fend for themselves. Busy clinical environments compounded the problem, reducing learning engagement when workloads overwhelmed even the most willing mentors. In other words, the buddy model is not a self-executing mechanism. Its educational value depends heavily on the disposition, availability, and teaching capacity of the individual nurse to whom a student is assigned.

The nurse-midwives’ perspective, captured in the individual interviews, added a second, equally textured layer. Four themes again emerged. The nurse-midwives saw the buddy nurse role as multifaceted, encompassing mentor, emotional supporter, and professional role model simultaneously. They described holding the line between teaching and care, a delicate balancing act in which patient safety must always take priority even as students need room to practice. They also spoke of growth, from self to system, suggesting that serving as buddies prompted reflection not only on their own practice but on the broader structures of the clinical environment. Finally, they identified barriers to effective teaching, including heavy workloads, the constant demands of patient safety, and limited opportunities to carve out genuine learning moments within packed shifts.

When the researchers integrated both sets of perspectives, a striking picture emerged. The buddy model, they concluded, functions as a reciprocal relational learning process rather than a simple one-way transfer of knowledge. The relationship begins with approach and engagement, as students overcome initial apprehension and nurses open their practice to observation and participation. It progresses through support and professional role modeling, as buddies demonstrate not just technical skills but the emotional and ethical dimensions of midwifery. And it culminates in shared learning and professional outcomes, with students gaining competence and confidence while nurse-midwives themselves report renewed professional growth. Learning, in this framing, is not delivered but co-constructed.

That reciprocity may explain why the model appears to support psychological safety, a concept that has attracted growing attention in health professions education. Students who feel emotionally secure are more likely to ask questions, admit uncertainty, and attempt challenging procedures, all of which are essential to developing clinical judgment. The buddy relationship, built on repeated daily contact with a consistent mentor, seems to create precisely the conditions under which such vulnerability becomes productive. The study’s authors suggest this supportive relational quality is central to the model’s perceived benefits for both experiential learning and professional development.

Yet the findings come with candid caveats. The study’s participants perceived the buddy model as valuable, but its successful implementation depended on adequate engagement of buddy nurses, manageable workloads, and sufficient clinical learning opportunities. Where any of these conditions failed, the model’s benefits eroded quickly. Passive buddies and overwhelmed wards turned a potentially rich learning relationship into a hollow formality. The authors are careful to note that their findings offer preliminary, context-specific support, drawn from a single hospital and a particular academic-practice partnership, rather than a universal prescription. Generalizing to other institutions will require further research in different settings and health systems.

Even so, the implications are significant at a moment when midwifery education faces mounting pressure. Shortages of clinical educators are not unique to Thailand; they are a structural feature of nursing and midwifery training in many countries, and they threaten the pipeline of skilled birth attendants precisely when maternal health services need reinforcement. The buddy model offers a pragmatic pathway: it mobilizes the clinical workforce already in place, transforms routine care into a teaching platform, and does so without requiring large new investments in faculty. The Bangkok study suggests the approach can work, but only if institutions treat buddy nurses as educators in their own right, protecting their time, recognizing their teaching role, and selecting for the engaged, supportive disposition that students so clearly valued. The alternative, the study quietly warns, is a buddy system in name only, in which students stand beside nurses too busy to teach and learn far less than they might.

Subject of Research: Experiences of nurse-midwifery students and nurse-midwives with the buddy model of clinical education in Thailand

Article Title: Experiences of the buddy model in midwifery clinical practice: a qualitative exploration of students and nurse-midwives

Article References: Experiences of the buddy model in midwifery clinical practice: a qualitative exploration of students and nurse-midwives. (n.d.). https://doi.org/10.1186/s12912-026-05378-1

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05378-1

Keywords: buddy model, midwifery education, clinical learning, nurse-midwifery students, nurse-midwives, qualitative study, experiential learning, clinical teaching, professional identity, psychological safety, Thailand, nursing education