AND SEXUAL HEALTH ADVICE 65 discussion of sexual health issues by nursing students in the practice setting. Sung and Lin (2012) identify the value of an education programme in sexual health in increasing nursing students knowledge and attitudes to sexual health. The literature clearly recognises the importance of a pre-registration curriculum which allows development of good practice, but there is little material on students’ views about how knowledge and skills might be best developed to minimise the theory-practice gap. There is only very limited research about theory and practice for midwifery students in the field of CaSH advice. For our study, we sought pre-registration midwifery students’ views on whether the curriculum sufficiently supported the development of knowledge and skills to enable them to provide sexual health information and advice to women, and enquired how students considered that the curriculum could be altered to improve their ability to translate theory into effective practice. The study specifically explored the role of confidence in reducing the theory- practice gap. Research project The research project as a whole had two aims, the first of which is pursued in this paper. This aim was to ascertain the views of three cohorts of final year midwifery students regarding: · How confident they felt in giving advice on contraception and sexual health. · What they felt would increase their confidence and knowledge in this area. · How they would prefer to receive sexual health education. A second aim, to estimate competence in delivery of CaSH, is not reported in this paper. The research was carried out within a higher education institution in England which educates pre-registration midwifery students. It was funded by an internal grant. The participants were a convenience sample of three consecutive cohorts of final year midwifery students (N=86). The participants undertook theoretical aspects of their programme on two separate campuses of one university, with practice placements across a wide geographical area within the East of England. All final year student midwives in these cohorts were invited to participate. This project was carried out in accordance with ethical guidelines of the British Educational Research Association (BERA, 2011). The project was approved by the University research ethics committee. Fully informed written consent was obtained from all focus group participants. Participant information was supplied on the first sheet of the questionnaire and consent to use of the questionnaire was implied by its completion and return. The study, informed by Newby (2010) and Parahoo (2006) used an exploratory ‘case study’ approach to analyse what happens in the current delivery of contraception and sexual health education within the midwifery curriculum, regarding what works well and what is less effective from the perspective of the students. It explored the WALKER & DAVIS: LEARNING AT WORK AND UNIVERSITY: MIDWIFERY STUDENTS AND SEXUAL HEALTH ADVICE 66 student midwives’ ideas for feasible changes to the delivery of the programme with the potential to have a positive effect on their practice as a midwife. This study was designed to evaluate both processes (what the student midwives thought about the teaching and learning) and outcomes (what was the confidence of the student midwives). Three successive cohorts of final year midwifery students were invited to complete anonymously a questionnaire asking about their experiences of and attitudes to giving advice on contraception and sexual health (CaSH) to women in their care, and receiving education on contraception and sexual health (CaSH) in the midwifery curriculum. Participants were recruited by verbal invitation from one of the researchers at the beginning of a class, and questionnaires were returned anonymously in a ‘drop-box’ at the end of the class, thus enabling potential participants to choose whether or not they participated. The questionnaire was designed to obtain data to address all three elements of the research question; the level of confidence in giving advice, how that confidence could be increased, and preferences for the delivery of sexual health education during the pre-registration midwifery programme. The questionnaire contained both quantitative and qualitative sections. This paper reports the analysis of comments written in the ‘free text’ boxes of the questionnaire, and triangulates and enriches these by analysis of themes from the focus groups. Three focus groups were convened, one from each cohort, of third year midwifery students over a twelve month period from July 11 to June 12. The focus group was run by a researcher who did not know the participants. Participants had the right to withdraw without penalty. These procedures ensured that students were able to exert their freedom to choose whether to participate and to express their views freely, and ensured anonymity and confidentiality. The focus group was facilitated using an aide memoire which explored three main themes (a) the participants views on the role of midwives regarding sexual health and contraception (b) how and to what extent the midwifery undergraduate curriculum has prepared participants for delivering advice on contraception and sexual health, (c) participants’ views on how contraception and sexual health