BACKGROUND:
Competency in labor management is a cornerstone of effective midwifery practice and essential for reducing maternal and neonatal morbidity. In Zambia, the shift toward competency-based education aims to better prepare graduates for real-world practice. However, gaps in the clinical performance of pre-service midwifery students—particularly in high-stakes labor management—remain a concern. This study employs Miller’s Pyramid of Clinical Competence to assess the preparedness of final-year midwifery students and generate evidence for education reform.

OBJECTIVES:
To comprehensively assess clinical competencies in labor management among third-year pre-service midwifery students in Zambia and to explore the implications for midwifery curriculum, mentorship, and clinical learning environments. Methods

METHODS:
This ongoing mixed-methods study uses a cross-sectional design across selected public midwifery training institutions. Quantitative data collection includes: Structured knowledge assessments (Knows), Clinical vignettes (Knows How), OSCEs (Shows How), and Real-time clinical performance evaluations using standardized checklists (Does). Qualitative components include focus group discussions with students and interviews with educators, mentors, and clinical supervisors to explore enablers and barriers to competency development. Data collection is scheduled for completion by October 2025.

RESULTS:
Preliminary observations suggest discrepancies between knowledge and hands-on clinical performance, with variability across institutions. Anticipated findings will provide insight into how curriculum content, mentorship quality, and clinical placement opportunities impact competence in labor management. Full analysis will be completed and ready for presentation at the time of the conference.

CONCLUSIONS:
This study is expected to generate actionable recommendations to strengthen midwifery training in Zambia, enhance clinical readiness, and align education with ICM global standards for competent midwifery care.

KEY MESSAGE:
Midwifery education; clinical competence; labor management; Miller’s Pyramid; Zambia; competency-based education. Poster session 3 (Group B)