From New Doula to Experienced Professional: Building Competence Through Deliberate Practice

By Birth & Baby University · Last updated: October 2026 · 4 min read

Doulas often hear that experience is the best teacher. Research suggests it is a teacher who needs help. This article looks at the debate about deliberate practice, the evidence that years in practice do not automatically mean better care, and what simulation research says about feedback and repetition. It then proposes a way to practice specific doula skills, with the caveat that none of this has been tested in doula practice.

Key takeaways

• A meta-analysis found deliberate practice explained 26% of performance variance in games, 21% in music, 18% in sports, 4% in education and less than 1% in professions, leading the authors to say it is important but less so than argued.
• A reanalysis by the original proponent argued that the meta-analysis used a looser definition and that, with a stricter one, practice explained considerably more variance.
• A systematic review of 62 evaluations in medicine found 52% reported decreasing performance with increasing years in practice for all outcomes assessed, and only 2% reported increasing performance with experience across outcomes.
• A meta-analysis of 14 studies found simulation-based education with deliberate practice superior to traditional clinical education for skill acquisition (effect size 0.71).

What the research says

The deliberate practice debate

Deliberate practice means structured activity designed to improve specific aspects of performance, with feedback. The 2014 meta-analysis found it explained 26% of the variance in performance for games, 21% for music, 18% for sports, 4% for education and less than 1% for professions, and concluded it is important but not as important as argued. A 2019 response by Ericsson argued the original definition requires individualized goals, concentration and feedback, that the meta-analysis counted looser structured practice, and that a reanalysis excluding such data estimated that duration of practice explained 29% and, after correction, 61% of variance. The authors disagree, and both analyses concern domains such as music and sport, not doula work.

Experience is not the same as improvement

A systematic review of experience and quality of health care examined 62 evaluations in physicians. Thirty-two (52%) reported decreasing performance with increasing years in practice for all outcomes, 13 (21%) decreasing for some outcomes, 13 (21%) no association, and 1 (2%) increasing for all outcomes, and results did not change with the most objective measures. The authors suggested longer-serving physicians may need quality improvement interventions. This review concerns physicians’ knowledge and care outcomes, not doulas, and reflects 2004 searches.

What helps practice work

A 2011 meta-analysis of 14 studies found simulation-based medical education with deliberate practice produced better skill acquisition than traditional clinical education (effect size 0.71, 95% CI 0.65 to 0.76), while noting the small number of reports. A BEME review of 109 studies found high-fidelity simulation facilitates learning under the right conditions, with feedback (47% of articles) and repetitive practice (39%) named as key features, and rated overall research quality as generally weak. These are procedural skills in medical training. Doula skills are relational and variable, so translation is an inference.

What doulas say about learning

Doulas themselves point to apprenticeship and mentorship. A 2026 interview study of 29 doulas listed real-life examples and practice and extending learning after training through apprenticeship and mentorship as themes. DONA’s birth certification page requires parent evaluations and self-reflection for each of three births, a built-in form of feedback.

What this means for doulas

• Do not assume experience equals improvement. Years help only if you also get feedback and keep learning.
• Choose specific skills. Examples are explaining a decision to a family neutrally, offering a comfort measure, speaking with a charge nurse or ending a hard conversation.
• Practice with feedback. A mentor, peer or recorded role-play gives you information you cannot see yourself.
• Stay within scope. Practice communication, support and referral skills, not clinical procedures.

Putting the evidence into practice

• Pick one skill each quarter and write what good looks like in two or three observable behaviors.
• Practice it away from clients through role-play with a peer or mentor, repeating short scenarios and changing one thing each time.
• After a real use, write what happened and ask for specific feedback from a mentor or, with consent, from a client or colleague.
• Track it: date, scenario, what you changed, what you will try next.
• After three months, decide whether to continue, extend or move to a new skill, and revisit your skills list yearly.

The bottom line

Research does not show that experience alone makes professionals better, and the deliberate practice evidence is disputed. Feedback, repetition and a clear target are the features that appear most often in studies of effective practice, so build them in deliberately, and be honest that this is not yet tested for doulas.

Related reading: Reflective Practice for Doulas: How to Evaluate and Improve Your Professional Skills; Why Mentorship Matters for New Doulas: Exploring Research on Professional Learning; How Continuing Education Helps Doulas Maintain Evidence-Based Practice.

This article is for professional education. It is not medical, legal, financial or tax advice. Check the standards of your certifying organization and the rules where you work.

Sources and further reading

• Macnamara BN, et al. Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis. Psychological Science 2014. Read the source
• Ericsson KA. Deliberate Practice and Proposed Limits on the Effects of Practice on the Acquisition of Expert Performance: Why the Original Definition Matters and Recommendations for Future Research. Frontiers in Psychology 2019. Read the source
• Choudhry NK, et al. Systematic review: the relationship between clinical experience and quality of health care. Annals of Internal Medicine 2005. Read the source
• McGaghie WC, et al. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine 2011. Read the source
• Issenberg SB, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher 2005. Read the source
• Shklarski L, et al. “We’re not clinicians, but we see it”: doulas’ roles in supporting clients with perinatal mood and anxiety disorders. Midwifery 2026. Read the source
• DONA International. Birth Doula Certification (page read October 2026). Read the source

Deliberate practice needs feedback, which is easier with a mentor. Birth & Baby University’s mentorship for doulas is described on the For Doulas page, alongside training and recertification options. Choose skills to practice that fit your certifier’s scope and ask your mentor how they give feedback.

More for professionals: the Professionals Blog.