A number of participants believed that some of their clinical instructors couldn’t express supportive behavior because they had low confidence in clinical situations. There are some possible explanations in this regard. Firstly, as described previously in this paper, clinical instructors in Iran are employees of the universities and are not hospital midwives. Some of them are academic individuals without having the experience of working in the clinical practice. As a result, they do not have enough confidence to carry out clinical jobs simultaneously as well as supporting students. Bringing midwifery teachers in the clinical area to work alongside students and staff has been regarded as an advisable approach in the literature. Bridging the theory-practice gap, teaching the care of women to students in a more realistic approach, and providing a more accurate assessment of students, are among the advantages that have been described in this regard.7,29 However, as articulated in the ICM education standards, it is essential that universities use experienced midwives for this objective.1 Moreover, maternity care in nearly all hospitals where students completed their placements was medical-led and very restrictive of autonomous midwifery practice. This condition limited the power of clinical instructors so that students felt they are low in confidence. Other studies also showed physician’s dominance as the limitation of clinical training of midwifery trainers.7,30