Comparing the effects of simulation-based training, blended, and lecture on the simulated performance of midwives in preeclampsia and eclampsia

Enhancing the competencies of obstetrical nurses and midwives in high-risk pregnancy management through simulation-based training in Lao people's democratic republic: A pilot study

BACKGROUND

Simulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited.

AIM

To examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives' knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting.

METHOD

During September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared.

FINDINGS

Workshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills.

CONCLUSIONS

The simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.

Effectiveness of Simulation-Based Training of Undergraduate Medical Students Regarding the Management of Eclampsia: A Randomized Controlled Educational Trial

Introduction Obstetric emergencies, like eclampsia, need a quick and accurate response from the treating physician coming into first contact with the patient. Therefore, all doctors, even primary care physicians, interns, and resident doctors, need training to handle such cases proficiently, leaving minimal chances of error. Providing training for the management of these critical conditions on actual patients is not practically feasible. Clinical simulation in obstetrics can be used for the improvement of these skills for undergraduate and postgraduate students. We conducted a non-blinded randomized controlled trial with the primary aim of developing and implementing a module for training undergraduate medical students on the assessment and management of eclampsia and to evaluate and compare it with traditional didactic lectures or case-based learning. Methods The present randomized controlled educational trial was conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India. The undergraduate medical students (Phase 3, Part 1) posted in the department during their clinical postings or tutorials were randomized into two groups. A total of 62 students were randomly divided into two groups, Group A and Group B, each consisting of 31 students. However, only 24/31 (77.42%) in Group A and 19/31 (61.3%) in Group B finally agreed to participate in the study. One group (Group A, with 24 participants) was taught the diagnosis and management of antepartum eclampsia through simulation-based training, and the other group (Group B, with 19 participants) was taught the same topic through conventional teaching, which consisted of didactic lectures through PowerPoint presentations and case-based discussion. Learning objectives were kept identical for both groups. Pre- and post-test scores were compared for both groups. Results The mean pre-test score of the simulation group was 6.13 ± 1.39, and that of the conventional teaching group was 6.05 ± 1.54. The post-test score of the simulation group was 9.17 ± 1.34, and that of the conventional teaching group was 7.37 ± 1.70. The simulation group showed an extremely significant (two-tailed p < 0.0001) improvement in their post-test scores when compared to their scores before the module was taught. The difference in the scores of simulated teaching (Group A) and conventional teaching (Group B) was also statistically significant (p = 0.005). Simulation-based learning was found to be more interactive, helpful in providing real-life-like experiences, led to better retention and understanding, and motivated the students for self-directed learning. Conclusion Although both conventional and simulation-based teaching were useful, simulation-based training was more effective in teaching undergraduate medical students regarding the diagnosis and management of eclampsia. Simulation-based learning is more interactive, provides real-life-like experiences, leads to better retention and understanding, and motivates the students for self-directed learning.

Utilizing Simulation-Based Training to Increase Preeclampsia Recognition in Undiagnosed Patients

Research suggests that simulation in nursing education is a learning strategy that promotes critical thinking and utilization of clinical judgment in a safe environment without fear of retribution if errors are made. Senior nursing students in a small liberal arts university participated in a complex simulation that involved a pregnant patient with preeclampsia. The students were charged with doing a complete assessment of the patient and unborn baby. Upon completion of the assessment, the students utilized their critical thinking skills to determine the best treatment for the patient and baby that rendered the best outcomes. The goal of the exercise was to provide the students with a realistic scenario that advanced quickly into an emergent situation. The majority of students will not work in labor and delivery, but they will experience situations in their respective units that require quick thinking and critical decision-making. This simulation was a strategy to help facilitate these students into their transition to practice.

A comparison of the effects of teaching through simulation and the traditional method on nursing students' self-efficacy skills and clinical performance: a quasi-experimental study

Introduction

Simulators in a clinical environment provide a space where students can acquire skills and experience under the supervision of their professors without any worries or inflicting any harm on their patients. The current study aimed to compare the effects of teaching through simulation and the traditional method on nursing students' self-efficacy skills and clinical performance.

Method

The current study was quasi-experimental and adopted a pre-test & post-test design. The population consisted of 122 students of nursing, out of whom 100 students were selected as the sample. Then, they were randomly divided into an experimental and a control group. A questionnaire assessed the students' self-efficacy skills and clinical performance before and after implementing the instructional programs. The data were analyzed using descriptive and inferential statistical techniques in SPSS 23.

Findings

The mean of the participants' self-efficacy scores increased significantly after the intervention (from 87.57 to 142.13). Moreover, the mean of the participants' clinical performance increased significantly after the intervention (from 2.16 to 4.57). The findings indicated that simulation teaching significantly affects nursing students' self-efficacy and clinical performance.

Conclusion

Simulation was recommended as an effective teaching methodology, particularly in nurses' internship wards. In other words, acquiring the essential skills through applying the simulation method is recommended before entering real-world environments.

The effectiveness of simulation training in obstetric emergencies: A meta-analysis

Role of clinical skill training in the formation of skills and professional competencies of midwifery students is important. Hence, the use of "training new methods are essential in clinical settings." This study aimed at determining the effectiveness of simulation training in obstetric emergencies. In this meta-analysis study, international databases of Web of Science, Scopous, Proquest, and PubMed and Iranian databases such as Irandoc, Magiran, and SID were searched for studies published between 2000 and 2020 using related keywords. Based on the consortium checklist, the full text of the selected articles was reviewed and in case of a specific score, the article was analyzed. The results show that, out of 420 studies after applying the inclusion and exclusion criteria, only nine clinical trial articles were reviewed. Studies were conducted in Iran, the United States, France, China, and Chicago. The results of meta-analysis showed that the simulation training method can be effective in managing midwifery emergencies. Hence, the use of simulation training method can be effective in various areas of learning related to obstetric emergencies.

The effects of simulation training on learning of health information systems: A scoping review

One of the most commonly used methods for training is simulation. It is important to examine the effects of simulation training of health information systems on the knowledge, attitude, and skill in trainees. This review provided a summary of relevant literature on how simulation training affects the learning of health information systems and determine the features and functional capabilities of existing simulators. Studies and websites using simulation training to teach health information systems were included. Studies were searched through Medline (via PubMed), Scopus, and ISI Web of Science and websites through Google search by the end of 2019. The characteristics of studies, features, and functional capabilities of simulators and effects on learning outcomes were extracted. The included studies and websites were categorized according to different characteristics including simulation types, learning outcome categories, and the effects of simulation training on learning outcomes. The learning outcomes were categorized into four groups: knowledge, attitude, skill, and satisfaction. The effects of interventions on outcomes were categorized into statistically significant positive, positive without statistical argument, no effect (not statistically significant), negative without statistical argument, or statistically significant negative. Ten studies and eight websites that used simulation training to teach health information systems (mainly electronic health record [EHR]) were included. EHR simulation was performed in 80% of the included studies and trainees in 70% of studies were physicians and nurses. All studies were conducted in three developed countries. In the included studies, four learning outcomes (i.e. skill, attitude, knowledge, and satisfaction) were assessed. Ninety percent of the included studies assessed skill-related outcomes, with more than half mentioning significant improvement. Thirty percent of the included studies assessed outcomes-related knowledge and attitude, all of which reported the positive effects of simulation training. The simulators offered a variety of functional capabilities, while all of which simulated the clinical data entry process. In teaching health information systems, especially EHRs, simulation training enhances skill, attitude, knowledge, and satisfaction of health-care providers and students.

Development, Implementation, and Outcomes of a Global Infectious Disease Training Course

BACKGROUND

Skilled healthcare professionals are critical for providing quality healthcare for children with cancer globally. Training curricula addressing the knowledge needs in infection care and prevention (ICP) in cancer are scarce.

PROGRAM DESCRIPTION

We implemented a 10-week blended course in ICP. The distance learning had four 2-week modules: Infectious Complications, Quality in Infection Care, Quality in Infection Prevention, and Sustainability, Research, and Dissemination. Each module had pre- and post-tests and weekly webinars. The 2-week in-person learning had lectures, group exercises, clinical observations, hospital and laboratory tours, and ended in an annual conference. An individual project developed during the distance learning was presented in the in-person workshop. Course attendance criteria were English language proficiency and participants' role in ICP at their institutions.

PROGRAM EVALUATION AND RESULTS

Twenty-two students from 17 hospitals in 10 countries completed the course, developed a project, and answered surveys covering knowledge assessments and satisfaction, and 6-month course and 1-year project follow-ups. Pretest and post-test scores revealed knowledge improvement (P < .001). Participants rated the distance learning as outstanding (63%) or good (28%); and the in-person as outstanding (87%). In the follow-up survey, graduates felt more comfortable at managing infections and participated more in quality improvement and academics at their institutions. Seventeen participants (77%) took steps to implement their study projects, and 9 were successful. Collaboration and networking of trainees were notable outcomes.

DISCUSSION

The ICP course is a resource to improve knowledge, engage graduates in network collaborations, and a reliable model to develop other thematic healthcare global training programs.