The acceptability and efficacy of online clinical supervision for midwives: A mixed-methods study

PROBLEM: Clinical supervision has been shown to support midwives, but it is unclear whether online delivery would provide equivalent benefits or would require additional facilitation skills. BACKGROUND: Midwives have reported high levels of stress, burnout and moral distress, within a strained workforce. Clinical supervision can support reflection, professional development and wellbeing yet evidence on online delivery remains limited despite increased use of virtual platforms during the COVID-19 pandemic. AIM: To explore midwives' perceptions of the acceptability and efficacy of clinical supervision delivered via videoconferencing. METHODS: A mixed methods study was conducted with midwives from two regional New South Wales Local Health Districts. Three groups participated in monthly online group clinical supervision for six months. Post-intervention survey and interview data were collected informed by the Theoretical Framework of Acceptability. FINDINGS: Eleven of fifteen participants completed the survey and six were interviewed. Online clinical supervision was viewed positively across purpose, process and impact domains. Five themes were developed from the qualitative data: finding time and space, flexibility, valuing clinical supervision, feeling safe and the online experience. Participants described online sessions as accessible, supportive and safe, with flexibility particularly beneficial for regional and early-career midwives. DISCUSSION: Online delivery supported psychological safety and reflective practice, indicating that effective supervision can occur virtually. However, participation relied on protected time, private space and reliable technology - factors that limited engagement for some midwives. CONCLUSION: Online clinical supervision was acceptable and perceived as effective, providing a safe, flexible reflective space and improving access where in-person options were limited. Successful implementation requires organisational support, reliable technology, protected time and skilled facilitation.