Clinical Information for Students and Preceptors

Students usually begin a clinical apprenticeship in the second year of Mercy In Action College of Midwifery's community-based distance program, while continuing to complete their academic work through our online classroom. In many cases, students may choose to apprentice with a midwife in their home community, or they may relocate to complete their clinical apprenticeship at a site approved by our college.

This page contains information for students and clinical preceptors regarding the clinical training requirements at Mercy In Action College of Midwifery.

Download the CLINICAL HANDBOOK FOR STUDENTS AND PRECEPTORS for more information as well as student clinical forms and records.

If you are a licensed midwife interested in applying to be a clinical preceptor for Mercy In Action College of Midwifery, please download the Clinical Handbook and read the Clinical Preceptor Qualifications; Roles, Responsibilities and Rights of Clinical Preceptors; Clinical Site Guidelines; and Preceptor and Clinical Site Application Process.

Download the STUDENT HANDBOOK AND COURSE CATALOG at THIS PAGE for detailed information on clinical requirements.

See our Professional Licensing page for information specific to each state.

Clinical Handbook

Potential Preceptor Inquiry Form

Submit this form if you are interested in applying to become a clinical preceptor for Mercy In Action College of Midwifery. Information about preceptor and clinical site requirements can be found in our Clinical Handbook.

Name

First Name

Last Name

Email

Credentials

CPM, CNM, LM, MD, etc

Number of years in clinical practice from initial midwife certification

Note: the requirement is 3 years from date of certification OR NARM Preceptor approval

State(s) where you are licensed to practice midwifery:

State(s) where you practice clinically:

Only list the States in which you would involve a student in clinical experiences

Have you ever been a preceptor for Mercy In Action College of Midwifery in the past?

Yes

No

If you were ever a past Preceptor for our College, please tell us the year(s) and any other names you might have used

Clinical Site

Please check if you work in a solo practice, group practice, or both

Solo Practice

Group Practice

Clinical Site Name

Write the name of the Clinical Site/Practice. If there are multiple clinical sites, follow the name of each practice with a dash (-) and whether they are solo or group. Separate each practice with a comma.

Student Name

Write the name of the Mercy In Action Student interested in apprenticing with you.

Have you ever had any disciplinary action against your license, or had your membership revoked from a midwifery organization? If yes, please explain.

Comments:

Clinical Placement Concern Form

Before submitting this form, please carefully review the Preceptor Complaint Procedure in the Clinical Handbook. Mercy In Action College of Midwifery endeavors to use a communication model such as the one outlined in Crucial Conversations: Tools for Talking When Stakes are High, and to seek collaborative solutions between individuals. In the event that a clinical preceptor or student has a concern or complaint that needs to be resolved, the first recommended step is a direct conversation with the concerned party. If this has not been effective or is not applicable, the next or first step is for the preceptor or student to submit this form to request a meeting with the Clinical Director. Please note that you may be contacted via email first to set up a time to meet.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Time zone you are located in:

Select your role:

Student

Clinical Preceptor

For the following, please list only factual information related to the incident of concern.

Date of Incident/Conflict (If multiple incidents or a pattern of conflict, please enter an approximate range of dates when the incidents or issues occurred):

Please list the other person(s) involved:

Please describe the incident in detail:

Please describe your efforts to address this issue with the other person(s) involved (please refer to the Clinical Complaint Procedure, in which we recommend first seeking to resolve the issue with the involved party whenever possible):

Do you have any additional comments?

I verify that all information in this submission is true and accurate (type name):

Mercy In Action College of Midwifery Grievance Form

For clinical placement concerns, please utilize the separate Clinical Placement Concern form above.

Before submitting this form, please carefully review the Preceptor Complaint Procedure in the Clinical Handbook, or the Student Complaint and Grievance Policy in the Student Handbook, as applicable to the situation.

To submit a grievance is to engage in a formal process where the concern must be made in writing, with details on dates, individuals involved and other pertinent information.

Every effort will be made to protect the person submitting the complaint (preceptor, student, faculty, or staff) from any discrimination as a consequence of making a complaint or filing a grievance.

This form will be submitted to the Director of Education, who will determine appropriate follow-up. If this complaint or grievance involves the Director of Education, please submit an email to info@mercyinaction.com and you will be put in touch with a college leader or board member as applicable to the situation.