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Original Article
Effects and Adequacy of High-Fidelity Simulation-Based Training for Obstetrical Nursing
Woo Sook Lee1, Miok Kim2
Journal of Korean Academy of Nursing 2011;41(4):433-443.
DOI: https://doi.org/10.4040/jkan.2011.41.4.433
Published online: August 12, 2011

1Associate Professor, Red Cross College of Nursing, Seoul, Korea

2Full-time Lecturer, Department of Nursing, Namseoul University, Cheonan, Korea

1Associate Professor, Red Cross College of Nursing, Seoul, Korea

2Full-time Lecturer, Department of Nursing, Namseoul University, Cheonan, Korea

Address reprint requests to : Kim, Miok Department of Nursing, Namseoul University, 21 Maeju-ri, Seonghwan-eup, Seobuk-gu, Cheonan 331-707, Korea Tel: +82-41-580-2716 Fax. +82-41-580-2931 E-mail: aprilsea@hanmail.net
• Received: November 2, 2010   • Revised: November 4, 2010   • Accepted: August 4, 2011

Copyright © 2011 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    Clinical training for nursing students is limited to rudimentary skills to avoid potential risks. Simulation-Based Training (SBT) can overcome the shortcomings of clinical training. We evaluated the educational effect of SBT for obstetrical nursing students using high-fidelity simulation courses.
  • Methods
    We developed a simulation program for obstetrical nursing students to practice nursing skills that are necessary to provide quality care. The program consisted of four sessions. 1st: An orientation and a preliminary test. 2nd: Learning core skills required in obstetrical nursing. 3rd: Testing each student with scenario. 4th: Providing a debriefing session. At the beginning of the program, students were surveyed about their self-confidence in obstetrical nursing care, and at the end of the program, they were surveyed about the adequacy of SBT as well as self-confidence.
  • Results
    Students’ self-confidence showed a significant difference before and after simulation. Mean adequacy of SBT was 7.15±1.35 (out of 10). Most students became more interested in Women’s Health Nursing after SBT.
  • Conclusion
    The results from evaluating the effects of simulation-based obstetrical nursing training show that SBT provides invaluable clinical experience for obstetrical nursing students by overcoming the lack of actual clinical involvement in clinical training programs.
  • Keywords: Obstetrical nursing; Simulation-based training
Figure 1.
Running process of the simulation-based training.
jkan-41-433f1.jpg
Table 1.
General Characteristics of Participants (N=138)
Variables Mean±SD n (%)
Age (yr) 21.3±2.7
Gender
  Female 125 (90.6)
  Male 13 (9.4)
Simulation experience
  Yes 106 (76.8)
  No 31 (22.4)
Satisfaction with the obstetric clinical experience
  Very high 22 (15.9)
  High 41 (29.7)
  Middle 34 (24.6)
  Low 31 (22.5)
  Very Low 10 (7.2)
Table 2.
Self-confidence about Clinical Practices for Obstetric Nursing (N=138
Sub-domain Items Before simulation
 After simulation
 p
Mean±SD Mean±SD
Knowledge about clinical situation Preparation of clients for Leopold’s maneuver 3.17±0.90 3.80±0.75 <.001
Correct understanding of the relationship between uterine contraction and fetal heart rates 2.87±0.85 3.46±0.92 <.001
Correct interpretation of fetal monitoring results 2.46±0.83 3.09±0.94 <.001
Thorough understanding of process of labor 3.01±0.83 3.25±0.82 .003
Understanding of the clients reaction during labor 2.98±0.81 3.30±0.90 <.001
Thorough understanding of postpartum changes (Height of fundus, etc.) 3.41±0.86 3.70±0.77 .001
Sub-total 2.98±0.63 3.43±0.64 <.001
Precise assessment Appropriate assessment of clients (physical examination, pain assessment, etc.) 2.92±0.76 3.32±0.85 <.001
Appropriate intervention Proper performance for each step of Leopold’s maneuver 3.06±0.94 3.70±0.83 <.001
Check fetal heart rate at correct location and correct interpretation 3.01±0.86 3.67±0.84 <.001
Clear explanation to client about clients’ medical status 2.67±0.82 3.30±0.78 <.001
Right position change for the condition of the client 3.02±0.88 3.68±0.86 <.001
Appropriate breathing technique according to the clients’ status 2.78±0.87 3.58±0.84 <.001
Nursing interventions for anxiety 3.15±0.91 3.60±0.85 <.001
Client education for postpartum management 3.28±0.86 3.64±0.78 <.001
Proper comfort care for clients 3.25±0.78 3.60±0.89 <.001
Privacy protection for the client in all the possible situations 3.88±0.82 3.76±0.97 .208
Correct judgement and report on clients’ condition 2.27±0.79 3.21±0.81 <.001
Providing nursing care calmly 3.07±0.78 3.33±0.92 .003
Sub-total 3.08±0.60 3.55±0.60 <.001
Prioritization Priority nursing care plan according to clients’ condition 2.68±1.06 3.16±0.90 <.001
Appropriate communication Appropriate communication with clients and colleagues 3.28±0.71 3.53±0.83 .001
Total 3.03±0.58 3.48±0.60 <.001
Table 3.
Adequacy of Simulation-based Training (N=138
Sub-domain Items Mean±SD
Relevance of the simulation learning process
Simulation-based training increased confidence in nursing 7.31±1.74
Simulations were realistic 7.38±1.84
Simulation helped to establish nursing goals for clients 7.27±1.74
Simulation-based training increased students’ interest in women’s health nursing 8.33±1.26
Simulation-based training may help nursing practice in the future 8.01±1.90
Total 7.17±1.38
Adequacy of simulation-based training in each session
Orientation & Preliminary test Orientation helped in understanding the simulation program 7.09±1.91
The goal of the simulation program was made clear 7.44±1.84
The simulation scenarios were easily understood 6.79±1.72
7.10±1.52
Learning core skills Open Lab was properly used for simulation preparation 6.30±2.39
Simulation test Students could confirm abnormal status of clients through simulation 7.01±1.68
Students could prioritize nursing interventions during the simulation 6.49±1.73
Students knew what should be done to resolve clients’ problems 6.32±1.79
Students could perform correct procedure for nursing skills 6.30±1.76
6.52±1.48
Debriefing Constructive feedback was given after simulation 7.75±1.78
Debriefing helped the student identify his or her strength 7.29±1.85
Debriefing helped to identify the weakness of the student 8.12±1.71
7.72±1.55
Total 6.99±1.36
Relevance of the simulation learning environment
The installation and equipment of the simulation program were appropriate 7.95±1.83
The duration of the simulation tests were appropriate 7.61±1.81
The simulation tests were interesting enough to hold students’ attentio 7.53±1.95
Appropriate nursing information was provided during the simulation program 7.33±1.67
Total 7.60±1.60
Total 7.15±1.35
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        Effects and Adequacy of High-Fidelity Simulation-Based Training for Obstetrical Nursing
        J Korean Acad Nurs. 2011;41(4):433-443.   Published online August 12, 2011
        DOI: https://doi.org/10.4040/jkan.2011.41.4.433
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      Effects and Adequacy of High-Fidelity Simulation-Based Training for Obstetrical Nursing
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      Figure 1. Running process of the simulation-based training.

      Figure 1.

      Effects and Adequacy of High-Fidelity Simulation-Based Training for Obstetrical Nursing
      Variables Mean±SD n (%)
      Age (yr) 21.3±2.7
      Gender
        Female 125 (90.6)
        Male 13 (9.4)
      Simulation experience
        Yes 106 (76.8)
        No 31 (22.4)
      Satisfaction with the obstetric clinical experience
        Very high 22 (15.9)
        High 41 (29.7)
        Middle 34 (24.6)
        Low 31 (22.5)
        Very Low 10 (7.2)
      Sub-domain Items Before simulation
      		 After simulation
      		 p
      Mean±SD Mean±SD
      Knowledge about clinical situation Preparation of clients for Leopold’s maneuver 3.17±0.90 3.80±0.75 <.001
      Correct understanding of the relationship between uterine contraction and fetal heart rates 2.87±0.85 3.46±0.92 <.001
      Correct interpretation of fetal monitoring results 2.46±0.83 3.09±0.94 <.001
      Thorough understanding of process of labor 3.01±0.83 3.25±0.82 .003
      Understanding of the clients reaction during labor 2.98±0.81 3.30±0.90 <.001
      Thorough understanding of postpartum changes (Height of fundus, etc.) 3.41±0.86 3.70±0.77 .001
      Sub-total 2.98±0.63 3.43±0.64 <.001
      Precise assessment Appropriate assessment of clients (physical examination, pain assessment, etc.) 2.92±0.76 3.32±0.85 <.001
      Appropriate intervention Proper performance for each step of Leopold’s maneuver 3.06±0.94 3.70±0.83 <.001
      Check fetal heart rate at correct location and correct interpretation 3.01±0.86 3.67±0.84 <.001
      Clear explanation to client about clients’ medical status 2.67±0.82 3.30±0.78 <.001
      Right position change for the condition of the client 3.02±0.88 3.68±0.86 <.001
      Appropriate breathing technique according to the clients’ status 2.78±0.87 3.58±0.84 <.001
      Nursing interventions for anxiety 3.15±0.91 3.60±0.85 <.001
      Client education for postpartum management 3.28±0.86 3.64±0.78 <.001
      Proper comfort care for clients 3.25±0.78 3.60±0.89 <.001
      Privacy protection for the client in all the possible situations 3.88±0.82 3.76±0.97 .208
      Correct judgement and report on clients’ condition 2.27±0.79 3.21±0.81 <.001
      Providing nursing care calmly 3.07±0.78 3.33±0.92 .003
      Sub-total 3.08±0.60 3.55±0.60 <.001
      Prioritization Priority nursing care plan according to clients’ condition 2.68±1.06 3.16±0.90 <.001
      Appropriate communication Appropriate communication with clients and colleagues 3.28±0.71 3.53±0.83 .001
      Total 3.03±0.58 3.48±0.60 <.001
      Sub-domain Items Mean±SD
      Relevance of the simulation learning process
      Simulation-based training increased confidence in nursing 7.31±1.74
      Simulations were realistic 7.38±1.84
      Simulation helped to establish nursing goals for clients 7.27±1.74
      Simulation-based training increased students’ interest in women’s health nursing 8.33±1.26
      Simulation-based training may help nursing practice in the future 8.01±1.90
      Total 7.17±1.38
      Adequacy of simulation-based training in each session
      Orientation & Preliminary test Orientation helped in understanding the simulation program 7.09±1.91
      The goal of the simulation program was made clear 7.44±1.84
      The simulation scenarios were easily understood 6.79±1.72
      7.10±1.52
      Learning core skills Open Lab was properly used for simulation preparation 6.30±2.39
      Simulation test Students could confirm abnormal status of clients through simulation 7.01±1.68
      Students could prioritize nursing interventions during the simulation 6.49±1.73
      Students knew what should be done to resolve clients’ problems 6.32±1.79
      Students could perform correct procedure for nursing skills 6.30±1.76
      6.52±1.48
      Debriefing Constructive feedback was given after simulation 7.75±1.78
      Debriefing helped the student identify his or her strength 7.29±1.85
      Debriefing helped to identify the weakness of the student 8.12±1.71
      7.72±1.55
      Total 6.99±1.36
      Relevance of the simulation learning environment
      The installation and equipment of the simulation program were appropriate 7.95±1.83
      The duration of the simulation tests were appropriate 7.61±1.81
      The simulation tests were interesting enough to hold students’ attentio 7.53±1.95
      Appropriate nursing information was provided during the simulation program 7.33±1.67
      Total 7.60±1.60
      Total 7.15±1.35
      Table 1. General Characteristics of Participants (N=138)

      Table 2. Self-confidence about Clinical Practices for Obstetric Nursing (N=138

      Table 3. Adequacy of Simulation-based Training (N=138

      Table 1.

      Table 2.

      Table 3.

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