advice to women. Using focus groups and questionnaires the study sought the views of three consecutive cohorts of final year midwifery students. The research focused on the students’ experiences of giving advice on contraception and sexual health to women in their care and on how they responded to proposed changes in the programme. Findings indicated that students wanted more practicebased educational methods. The study suggests that a model in which theoretical knowledge is reinforced practically, with practice based scenarios and mentor emulation as staging points, would help to develop confident practice. Keywords Midwifery; professional education; contraception; sexual health; theory-practice gap; curriculum. Introduction The ability of health care practitioners to incorporate theoretical learning into their professional practice, and the ways in which pre-registration curricula can best prepare students for practice, is much debated (Roberts and Johnson, 2009). We undertook a twelve month study to examine the extent to which the pre-registration midwifery curriculum prepares student midwives for one aspect of their professional practice, that of providing contraception and sexual health information and advice to women. We examined the students’ views on how confident they felt in giving contraceptive and sexual health (CaSH) advice, what they felt would increase their confidence and preparedness, and explored their suggestions for changes to the curriculum that would improve their ability to carry out this aspect of their role. Background Discussion of the link between theory and practice in health professional education has occurred across the international sector (Rolfe, 1998; Corlett, 2000; Smeby and Vågan, 2008; Davis, 2010; Sangestani and Khatiban, 2012). Concerns about the WALKER & DAVIS: LEARNING AT WORK AND UNIVERSITY: MIDWIFERY STUDENTS AND SEXUAL HEALTH ADVICE 64 theory-practice gap for health care practitioners (understood here as the disjunction between theoretical learning in a classroom setting and the requirements of practice), and discussion regarding the role of the pre-registration programme in preparing practitioners to undertake their role as registered practitioners, are two recurring themes in the literature. Of particular interest is the recognition that confidence plays a major role in embedding theory into the practice of registered health practitioners. One of the authors, who teaches about contraception and sexual health (CaSH) to pre-registration midwives, noticed that despite input about CaSH the midwifery students lacked confidence to use this knowledge. This observation was the impetus to undertake the study reported here. Corlett et al. (2003) state that the theory-practice gap is not reduced by simply gaining knowledge and skill. Changing the delivery of the curriculum to try to reduce the theory-practice gap is reported in a number of studies. Aiming to measure the effect of curriculum delivery factors on development of theoretical knowledge and practical skills, Corlett et al. (2003) report the value of the work-based preceptor in developing theoretical knowledge in students of nursing in the early stages of new learning but suggest that theory and practice learning occur separately rather than simultaneously. Gardner (2012), reflecting on the legacy of Benner (1984), suggests the need for a reflective culture that more clearly links theoretical knowledge to practice by thinking about practice issues and cases. She is critical of the notion of the expert who relies on tacit expertise which they cannot articulate, identifying this as a source of rift between theory and practice. The work of Eraut et al. (1995) and Eraut (1997) explored the development of personal knowledge of practitioners within their new profession, including newly qualified midwives. The literature suggests there is a transition from theoretical learning to effective knowledgeable practice (Benner, 1984; Eraut et al., 1995). However, Eraut’s more recent work (Eraut, 2004) emphasises the formal role of the mentor in supporting the link between theory and practice in the clinical setting and the importance of the Higher Education institution in helping students use knowledge and skills to fit new and unpredictable situations. A number of authors recommend problem-based learning, experiential learning and reflective practice as ways in which to reduce the theory-practice gap (Corlett, 2000; Rochester et al., 2005; Sangestani and Khatiban, 2012). Barry et al. (2012) confirm the use of the Objective Clinical Structured Examinations in developing midwifery practice and Phillips et al. (2012) have explored the use of virtual antenatal clinics in developing practice. These forms of learning have been reported to have a positive effect and to increase progress with learning, improving the application of theory to practice and increasing the motivation to learn for pre-registration health practitioners. Specific studies in sexual health education as part of the midwife’s role are limited although there are studies which focus on assessment and discussion of sexual health needs of the patient or client by nurses. Sung et al. (2010) and Dattilo and Brewer (2005) found a lack of confidence in undertaking assessment or initiating WALKER & DAVIS: LEARNING AT WORK AND UNIVERSITY: MIDWIFERY STUDENTS