https://menj.journals.ekb.eg
Print ISSN: 2735-3974
Online ISSN: 2735-3982
DOI: -------------------------------------
MNJ
Menoufia Nursing Journal
Faculty of Nuring
Menoufia University
Effect of Simulation on Students' Achievement in Normal
Labor Modules
Noha H. AbdElfattah , Galal A. EL-Kholy, Amal A. Hassan
Omran, Hanan E. Hassan
Abstract: Simulation is a potentially powerful teaching approach that engages nursing
students and requires them to use critical thinking and clinical reasoning, and provides
an opportunity for reflective learning and integration of the student’s knowledge.
Purpose: evaluate the effect of simulation on students' achievement in labor modules.
Design: A Quasi experimental study (study and control) Setting: This study was
conducted at maternity nursing lab and lecture class in the Faculty of Nursing at Benha
University. Sample: A convenient samples of 60 students’ were received simulation
based teaching and 60 students were included in the control group. Instruments: The of
data collection were Self-administered questionnaire sheet, Observational checklist,
Students’ satisfaction with learning method and Media for the module of labor (Noelle
mannequin& videos).Result: There was a highly statistical difference regarding
students’ practical skills during process of labor including perineal care, abdominal
examination, vaginal examination, handling, assessment of fundus, placental
examination and newborn physical assessment of both phase of assessment. Conclusion:
Simulated delivery room classes were an effective training approach; they were
equipped the students with practices that result in a significantly higher practical
achievements and higher satisfaction scores compared to the conventional training.
Recommendations: The study recommended that Maternity nursing students ‘should be
provided by variety of simulation-based education on maternity nursing skills to increase
level of performance, satisfaction, and self-confidence.
Key words: Simulation; Achievement satisfaction.
INTRODUCTION
Traditional pedagogical techniques
resulting in a serious time lag
are still very much the norm within
between
higher education. Student learning
applying new knowledge so, it
remains
upon
attributed to simulations relates to
extracting knowledge from texts
the suggested improvements in
and lectures. This style of teaching
overall student learning. For much
rarely
of the literature has stressed the
largely
gives
based
students
the
students
of
and
opportunity to apply their newfound
increased
knowledge to actual situations,
learning, it have the power to
MNJ, Vol. 4, No. 1, May 2019, PP: 87-103
levels
learning
cognitive
87
Effect of Simulation on Students' Achievement in Normal Labor Modules
recreate complex, dynamic political
realistic,
safe
Processes in the lecture, allowing
students
to
students
the
development of the teacher role.
motivations, behavioral Constraints,
This manuscript provides ideas for
resources and interactions among
planning, implementation, and
institutional actors(Raymond 2010).
suggestions
Simulation is a potentially powerful
technology use in the training of
teaching approach that engages
nurse educators for their role in
nursing students and requires them
clinical teaching (Shellenbarger,
to use critical thinking and clinical
T., & Edwards, 2012).
reasoning,
HYPOTHESIS:
to
examine
and
provides
an
opportunity for reflective learning
and integration of the student’s
knowledge (Peisachovich, Gal, &
Johnson, 2016). Simulation is an
educational strategy that can be
used to support the process of
clinical education. It can help in
improving
students’
self-esteem
environment
for
practice
the
for
simulation
Students’ who received simulation
based teaching (study group) will
have higher level of knowledge and
practices than students who receive
routine academic (control group)
post intervention.
PURPOSE
through provide an opportunity to
The purpose of the study is to
practice in a risk-free environment.
evaluate the effect of simulation on
Simulation is the imitation of the
students' achievement in normal
operation of a real-world process or
labor modules.
system over time (Montagna&
Omicini, 2016).
Simulation use continues to
expand
in
nursing
education,
specifically at the undergraduate
level. Graduate nursing students can
also
benefit
from
simulation
METHODE
Research
design:
A Quasi
experimental (Study and control),
was used
Setting: This study was conducted
at Maternity Nursing Laboratory
and classroom in the Faculty of
Nursing Benha University.
teaching issues may be limited;
Sampling: A convenient sample
composed of 120 students’ were
included
All available third year 2nd semester
therefore, simulation provides a
nursing students' at the obstetrics
activities. Graduate nurse educator
students’
88
exposure
to
clinical
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect of Simulation on Students' Achievement in Normal Labor Modules
and gynecology department were
symptoms of labor, characteristic
recruited in this study during the
of uterine contraction, definition
academic
of
year
convenience
(2016-2017),
sample
of
A
(120)
first
stage
of
labor,
components of labor, diagnosis
nursing students was divided into
of
equal groups, study and control
definition of partogram, mention
group(60 students per each group),
value of partogram, definition of
applying
two
teaching
second stage of labor, sign of
methods.
Using
traditional
second stage of labor, duration
clinical
the
labor,
method for half of students (60) as a
of
control
mechanism
group,
while
using
stages
second
stage
of
of
of
labor,
labor,
delivery,
simulation (Noelle mannequin &
definition of third stage, sign of
videos) for another half of students
placenta separation, mechanism
(60) as a study group.
of
INSTRUMENTS
definition of fourth stage of
The study tools which had been
labor.
used for data collection was divided
into four tools which included the
separation
and
Scoring system
Adequate
knowledge
---
≥75%.
following:
Instrument one knowledge of
students’
placental
structured
interview
Inadequate knowledge ---<75%.
questionnaire
Instrument two students’ practice
This instrument contains two parts:-
observational checklist.
Part one: It was concerned with
It was developed by the researcher
demographic characteristic as
to assess students’ practices
name,
immediately, after and at the end of
age,
occupation
and
educational level).
labor. It contain the procedures that
Part two: knowledge of student
regarding
contain
normal
labor.
knowledge
It
about,
were done for the women such as.
Perineal care, abdominal
examination, vaginal examination,
definition of labor, difference
handling, assessments of fundus,
between true and false labor
Placental examination and newborn
pain,
physical assessment.
premonitory
sign
and
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
89
Effect of Simulation on Students' Achievement in Normal Labor Modules
Validity: The developed tool was
the skills and obtaining the required
reviewed for content validity by a
knowledge to perform necessary
jury consisting of a group of
tasks in a clinical setting. Help in
5experts specialized in the obstetric
understanding the concepts covered
nursing field.
in the simulation.
Reliability: The reliability of the
Scoring system
Satisfactory -----------
tool were tested using Cronbach’s
>75%.
Alpha test
Scoring system
Highly
satisfactory
----
<85%
-Media
Unsatisfactory------------
methods structured interview
It was developed to assess
student satisfaction with modules
that included, The teaching methods
used in this simulation were helpful
The
simulation
provide student with a variety of
learning materials and activities to
allow learners to attain knowledge,
in
environment,
modules
of
labor(Noelle mannequin &Video
about simulated videos about labor
procedures Perineal care, abdominal
questioner.
effective,
for
This tool used for training students
satisfaction with learning
safe
The
controlled
teaching
materials used in this simulation
were motivating student to learn,
The method of simulation was
suitable to the way of learning,
simulation covered critical content
necessary for learning. Developing
90
Satisfactory practice-----75-
Instrument three Students’
skills
75%.
<60%.
85%
and
Uncertain -------------- 60-
examination, vaginal examination,
handling, assessments of fundus,
Placental examination and newborn
physical assessment.
Ethical considerations:
The aim of the study was
explained to students' before data
collection
to
gain
their
confidence and trust.
An oral consent was obtained
from each student to participate
in the study they were informed
that they could withdraw at any
time when they need.
The
researcher
maintaining
assured
anonymity
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
and
Effect of Simulation on Students' Achievement in Normal Labor Modules
confidentiality
of
each
the study and methods of data
collection
participant.
They were assured that the study
2. Data was collected from the
was not having any physical,
study and control groups at the
social or psychological risk.
same time instruments one and
Written approval was obtained
two (an explanation was done for
from the dean faculty of nursing
students about filling instruments
and
one
Head
of
maternal
and
and
two.
After
wards
nursing
instrument were distributed, It
department Benha University, to
took minutes to fill instruments).
newborn
health
explain the purpose of the study.
This
design
included
the
preparatory phase, pilot study, the
actual field work (implementation
and
evaluation
phases),
and
3. Students’ in
control
Pilot study:
A pilot study was carried out on
10% of the total sample it included
(12 students). It was done to assess
efficiency
of
the
clarity
and
Instruments,
estimate the time needed for data
collection, and test the feasibility of
conducting
the
received
theoretical lecture about normal
labor,
including
definition,
terms, stages, sign & symptoms
and
applicability,
groups
and mechanism of labor; sign
associated limitation.
the
the study and
study.
No
modification were done, students’
who shared in the pilot study were
included in sample.
symptoms
separation;
placental
of
placental
mechanism
delivery
of
and
care
during 4th stage of labor in the
same groups.
4. Students’ in the study group
were divided in to four equal
groups. Each group contained 15
students.
5. Students in the control group
were divided in to four equal
groups. Each group contained 15
students.
Procedure:
1. A written approval was obtained
from the dean of the Faculty of
Nursing and Head of Maternity
after explaining the purpose of
6. Students in the study group were
subject
to
stimulated
experience
using
simulator
and
delivery
Noelle
videos
doll
(The
Program implementation through
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
91
Effect of Simulation on Students' Achievement in Normal Labor Modules
(7) sessions, (3) for theoretical
them to remonstration, programs
session and
were implemented as study group
(4)
for
practical
session. the theoretical session
about
normal
labor, including
but without videos.
8. The
researcher
started
the
definition, terms, stages, sign &
evaluation phase at the end of re-
symptoms
of
demonstration for all students in
labor; sign and symptoms of
the study and control groups.
placental separation; mechanism
Each
of placental delivery and care
3time and the mean was taken.
and
mechanism
th
student
was
during 4 stage of labor) and each
Observation
session implemented in (45) min
required
through using learning material
instrument two.
(lecture – group discussion). The
with
one.
vaginal examination, perianal care,
for
each
using
9. Knowledge for each student was
reassessed
examination,
done
procedure
practical session were concerned
(Abdominal
evaluated
using
instruments
4-Statistical design:
assessment of fundus, handling,
placental
examination,
and
Data analysis was performed using
newborn physical assessment) and
IBM
also each session implemented in
version 22. Mean and standard
(45) minutes and conducted in the
deviation were done for quantitative
affiliated
data frequency distribution was
laboratory
department
of
this
including
done;
SPSS
(t)
statistical
test
was
software
used
for
demonstration, videos and re-
qualitative data (X2). A correlation
demonstration.
Implementation
coefficient (r) was used to evaluate
phase for each group of study took
the relationship between the study
about two weeks)
variable. A statistical significant
7. Students’ in the control group
difference was considered if p-value
received routine training in the
≤ 0.05 and a highly statistical
laboratory
significant was considered when p-
(demonstration)
by
traditional mannequin and allowing
value ≤ 0.001.
RESULT:
92
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect of Simulation on Students' Achievement in Normal Labor Modules
Table (1): Distribution of studied sample according their personal
characteristics (N=120).
Study group
Control group
(N=60)
(N=60)
Personnel characteristics
No
%
No
%
26
43.3%
32
53.3%
34
56.7%
28
46.7%
(21.04 ± 1.46)
Chi
square
Test
P value
Age in (years)
20-21
22-23
Mean ±SD
(21.43 ± 1.98)
1.20
>0.05
0.135
>0.05
0.040
>0.05
Educational level
Secondary school
28
46.7%
26
43.3%
32
53.3%
34
56.7%
43
71.7%
42
70.0%
17
28.3%
18
30.0%
Technical health institute & nursing
institute
Residence
Rural
Urban
NB: :ns p >0.05.
Table (2): Distribution of studied sample according their pre intervention
knowledge about labor (N=120).
Study group
(N=60)
Incorrect
Correct
Item
Definition of normal labor
Factors affecting labor
Control group
(N=60)
Incorrect
Correct
P
value
No
%
No
%
No
%
No
%
54
90.0
6
10.0
49
81.7
11
18.3
1.71
>0.05
45
75.0
15
25.0
41
68.3
19
31.7
0.657
>0.05
50
83.3
10
16.7
53
88.3
7
11.7
0.617
>0.05
47
78.3
13
21.7
52
86.7
8
13.3
1.44
>0.05
43
71.7
17
28.3
45
75.0
15
25.0
0.170
>0.05
52
86.7
8
13.3
55
91.7
5
8.3
0.776
>0.05
Differences between True
and False Labor Pains
Premonitory Symptoms and
Signs of Labor
Sure signs of labor
Characteristic of uterine
contraction
NB: ns p >0.05
Cont’d)
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
93
Effect of Simulation on Students' Achievement in Normal Labor Modules
Table (3): Distribution of studied sample according their pre intervention knowledge
about labor (N=120).
Study group
(N=60)
Incorrect
Correct
Item
Control group
(N=60)
Incorrect
Correct
P
value
No
%
No
%
No
%
No
%
54
90.0
6
10.0
57
95.0
3
5.0
1.08
>0.05
53
88.3
7
11.7
55
91.7
5
8.3
0.370
>0.05
55
91.7
5
8.3
56
93.3
4
6.7
0.120
>0.05
46
76.7
14
23.3
44
73.3
16
26.7
0.178
>0.05
labor
37
61.7
23
38.3
36
60.0
24
40.0
0.035
>0.05
Duration of the second stage
47
78.3
13
21.7
45
75.0
15
25.0
0.186
>0.05
Definition of third stage of labor
45
75.0
15
25.0
42
70.0
18
30.0
0.376
>0.05
Duration of third stage of labor
43
71.7
17
28.3
41
68.3
19
31.7
0.159
>0.05
placental separation
52
86.7
8
13.3
46
76.7
14
23.3
2.00
>0.05
Signs of placental separation
54
90.0
6
10.0
52
86.7
8
13.3
0.323
>0.05
42
70.0
18
30.0
46
76.7
14
23.3
0.682
>0.05
Stages of normal labor
Definition of first stage of labor
Duration of first stage of labor
Definition of second stage of
labor
Mechanism of second stage of
Mechanism of the third stage of
Mechanisms of placenta
examination
NB: ns p >0.05
Table (4): Distribution of studied sample according their pre intervention knowledge
about practical skills of labor stages (N=120).
Control group
(N=60)
(N=60)
Incorrect
Item
Correct
Incorrect
P
Correct
value
Aim of perineal care
Aim of vaginal examinations
Aim of abdominal
examinations
Definition of the partogram
94
Study group
No
%
No
%
No
%
No
%
52
86.7
8
13.3
51
85.0
9
15.0%
0.069
>0.05
43
71.7
17
28.3
45
75.0
15
25.0%
0.170
>0.05
43
71.7
17
28.3
42
70.0
18
30.0%
0.040
>0.05
49
81.7
11
18.3
45
75.0
15
25.0%
0.786
>0.05
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect of Simulation on Students' Achievement in Normal Labor Modules
Value of the partogram
Components of the
partogram
Signs of fetal distress
45
75.0
15
25.0
40
66.7
20
33.3%
1.00
>0.05
43
71.7
17
28.3
40
66.7
20
33.3%
0.352
>0.05
44
73.3
16
26.7
46
76.7
14
23.3%
0.178
>0.05
P > 0.05
Table (5): Distribution of studied sample according their knowledge post intervention
(N=120).
Post-intervention
Study group
Control group
(N=60)
(N=60)
Incorrect
Correct
Incorrect
Correct
Knowledge
Definition of normal labor
Factors affecting labor
Chi
square
test
P value
No
%
No
%
No
%
No
%
14
23.3
47
78.3
46
76.7
13
21.7
36.31
<0.001**
24
40.0
37
61.7
36
60.0
23
38.3
5.63
<0.05*
7
11.7
53
88.3
53
88.3
7
11.7
70.53
<0.001**
10
16.7
50
83.3
50
83.3
10
16.7
53.33
<0.001**
14
23.3
45
75.0
46
76.7
15
25.0
32.04
<0.001**
5
8.3
55
91.7
55
91.7
5
8.3
83.33
<0.001**
Differences between True and False
Labor Pain
Premonitory Symptoms and Signs of
Labor
Sure signs of labor
Characteristic of uterine contraction
P<0.001**
Table (6): Distribution of studied sample according their knowledge about practical skills
of stages of labor at post intervention (N=120).
Study group
(N=60)
Incorrect
Correct
Knowledge
Aim of perinea care
Aim of vaginal examination
Control group
(N=60)
Incorrect
Correct
Chi
square
test
P value
No
%
No
%
No
%
No
%
0
0.0
38
63.3
60
100.0
22
36.7
55.61
<0.001**
7
11.7
43
71.7
53
88.3
17
28.3
44.43
<0.001**
12
20.0
34
56.7
48
80.0
26
43.3
17.06
<0.001**
2
3.3
42
70.0
58
96.7
18
30.0
57.41
<0.001**
2
3.3
38
63.3
58
96.7
22
36.7
48.60
<0.001**
5
8.3
35
58.3
55
91.7
25
41.7
33.75
<0.001**
0
0.0
45
75.0
60
100.0
15
25.0
72.00
<0.001**
Aim of abdominal
examination
Definition of the partogram
Value of the partogram
Components of the partogram
Signs of fetal distress
P <0.001**
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
95
Effect of Simulation on Students' Achievement in Normal Labor Modules
Table (7): Distribution studied sample according their practical skills of stages of labor at
pre &post intervention (N=120).
Time of evaluation
Study group
Adequate
Inadequate
Adequate
Inadequate
Chi
square
test
P value
No
%
No
%
No
%
No
%
8
13.3
52
86.7
10
16.7%
50
83.3
0.796
>0.05
56
93.3
4
6.7
30
50.0%
30
50.0
27.74
<0.001**
Pre-intervention
Post-intervention
Control group
P. >0.05
P<0.001**
Table (8): Distribution of mean score of studied sample practice regarding labor
procedures immediately at the re demonstration phase (N=120).
First trial
Procedure
Study group
(N=60)
Control group
(N=60)
Independent
t test
P
value
Mean ±SD
Mean ±SD
Perineal care
25.1200±.57159
24.0417±1.20483
6.26
<0.001**
Abdominal examination
13.4478±2.12201
12.5733±.71376
3.02
<0.001**
Vaginal examination
28.2350±1.85059
27.6167±1.07501
2.23
<0.001**
Handling
17.9850±.65686
17.4250±.72384
4.43
<0.001**
Assessment of fundus
23.4850±.61142
22.3333±.62887
10.17
<0.001**
Placenta examination
14.5667±.94091
13.6250±.93711
5.49
<0.001**
Newborn physical assessment
18.6667±.42850
17.4917±.96766
8.60
<0.001**
P <0.001**
Table (9): Distribution of mean score of studied sample regarding average practice score
about labor procedures of both phases of assessment (N=120).
Average score of the two different trials
Study group
Procedure
(N=60)
Mean ±SD
Perineal care
25.1567±.54907
Abdominal examination
13.4903±2.11541
Vaginal examination
28.4017±1.31204
Handling
18.1117±.50727
96
Independe
nt
t test
P
value
24.2125±1.17154
5.85
<0.001**
12.7517±.58149
2.60
<0.001**
27.7458±.87272
3.22
<0.001**
17.4958±.70934
5.47
<0.001**
Control group
(N=60)
Mean ±SD
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect of Simulation on Students' Achievement in Normal Labor Modules
Assessment of fundus
23.5425±.55722
Placenta examination
14.7042±.75981
Newborn physical assessment
18.7250±.33096
142.1320±3.52868
Total practice sore
22.3958±.63495
10.51
<0.001**
13.7250±.87781
6.53
<0.001**
17.6250±.73430
10.57
<0.001**
135.9517±2.40333
11.21
<0.001**
P <0.001**
Table (10): Distribution of studied sample regarding satisfaction score about simulation
method (N=60).
Satisfaction
Agree
Uncertain
Disagree
No
%
No
%
No
%
44
73.3
12
20.0
4
6.7
47
78.3
9
15.0
4
6.7
motivating student to learn.
36
60.0
22
36.7
2
3.3
4. The method of simulation was suitable to the way of learning
39
65.0
16
26.7
5
8.3
41
68.3
15
25.0
4
6.7
41
68.3
13
21.7
6
10.0
1. The teaching methods used in this simulation were helpful
and effective
2. The simulation provide student with a variety of learning
materials and activities to promote the learning curriculum
3. The teaching materials used in this simulation were
5. Simulation covered critical content necessary for learning.
6. developing the skills and obtaining the required knowledge to
perform necessary tasks in a clinical setting
7. Help in understanding the concepts covered in the simulation.
39
65.0
19
31.7
DISCUSSION
Nowadays simulation is taking an
solving
important place in training and
differential,
education of healthcare professionals
mastery learning (Guy et al , 2015)&
.Simulations have been shown to be
(Koh et al., 2010).
an
effective
tool
in
traditional
learning environments. Innovative
advances
in
technology
have
introduced a variety of tools to
enhance learning in higher education.
Among these, simulations have been
used to support a variation of
cognitive learning styles, to facilitate
higher-order thinking and problem
skills,
and
to
augment
collaborative,
and
Several factors drive the increase of
using simulation in nursing and
health
professional
Inadequate
clinical
education.
placement
opportunities. Patient safety issues,
as simulation allow health care
practitioners to acquire the skills and
experience required to protect patient
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
97
2
3.3
Effect of Simulation on Students' Achievement in Normal Labor Modules
safety (Richardson
&
Claman,
inaccurate
assessment.
or
slow
2014).
clinical decision making, the student
Simulation is a teaching and learning
has the opportunity to learn from the
strategy that is increasingly used in
experience. The primary aim of
nursing education to prepare students
simulation is to help the student
for the clinical workplace. Simulation
nurse. Achieve competence, linking
is a practice that resembles reality. It
their theoretical knowledge with
has existed in nursing education in
clinical practice (Ricketts, 2011).
many forms and the first healthcare
Simulation is an innovative and
simulation manikins were introduced
technologically advanced teaching
in the early 1960s (Jeffries, 2007).
and learning approach that combines
As science, technology and education
a
have
has
experiential learning. The student
and
learns
progressed;
become
a
simulation
sophisticated
problem-based
approach
through
with
‘doing’
and
innovative learning and teaching
‘experiencing’,
approach
vast
knowledge base, psychomotor skills
spectrum of educational modalities.
and clinical decision making based
These ranges from computer games,
on the information before them.
role plays and skills-based trainers to
(Kim, et al, 2016).
patient manikins or human patient
The present study is significantly
simulation (Edgecombe, et al, 2013).
supported
The purpose of simulation is to
hypothesis,
achieve specific goals related to
attention to stress the importance and
learning or evaluation. Simulation
utilization
does not replace the need for learning
education for improvement students'
in the clinical practice setting, but
achievement
allows the student to develop their
regarding
assessment, critical thinking and
enhancement of the students' clinical
decision-making skills in a safe and
skills. The aim of this work is to
supportive
encompassing
environment
a
(Valler-
study
utilizing
through
which
of
simulation
labor
Jones et al., 2011). This also allows
students'
for the assessment and evaluation of
labor modules.
of
the student demonstrates a mistake,
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
in
our
the
performance
process
and
simulation
achievement
the student performance, whereby if
98
research
directing
and
effect
their
in
on
normal
Effect of Simulation on Students' Achievement in Normal Labor Modules
The discussion of the current study
scenarios on the pediatric nursing
was categorized in to three sections:
students" and reported that there was
characteristics,
a significant difference between the
knowledge
and
satisfaction of the study sample
pretest
regarding simulation methods.
scores.
Regarding
characteristic
of
the
This
and
posttest
knowledge
may be due to lack of
students, the findings of the present
knowledge related to labor because
study revealed that nursing students
students’ did not study this content in
for both groups were in age ranged
the previous curriculum.
from 20:23 years with mean age
Simulation is potential tools that help
(21.43±1.98)
(21.04±1.46)
this
the nursing students to practice in a
accordance
with
real environment. It's a teaching
Oh,(2015) who conducted a study to
strategy that provides students with
determine the effects of simulation
artificial representation of a complex
based
learning
real life for enabling them to learn in
outcome of nursing students and
a safe environment. it offers the
founded that the mean age was
opportunity for students to improve
21.44years old; more than half
the intended learning outcomes such
65.27% of the students were aged
as
21years old.
knowledge
There was no statistically significant
reasoning
difference between study and control
satisfaction(Bezyack,2007).
group regarding their knowledge
Regarding
about labor lecture contents pre
practical skills of stages of labor, the
intervention as definition of normal
present study revealed that there was
labor, difference between true and
no statistically significant difference
false
premonitory
between study and control groups
of
labor,
regarding the aim of abdominal,
mechanism of labor and signs of
vagina and perineal care, definition,
labor and characteristic of uterine
value and components of partogram
contractions.
in addition to signs of fetal stress.
finding
is
an
training
labor
symptoms,
in
pain,
stages
This
the
finding
was
clinical
skill
performance,
acquisition,
ability
and
knowledge
clinical
student
related
to
supported with Saied, (2017) who
This
conducted a study to "evaluate the
Podlinski, (2016) who conducted a
effect of using a simulation based
study
finding
to
is
supported
"evaluate
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect
by
of
99
Effect of Simulation on Students' Achievement in Normal Labor Modules
Simulation
Training
on
Nursing
learning strategy",
who indicated
Students' Content Exam Scores", and
that there was
found that may limit the nursing
satisfaction with learning by the
student’s ability to learn and develop
clinical simulation and that learner’s
the necessary skills.
confidence in their skills.
This
The current study revealed a highly
may be due to lack of
high knowledge
knowledge about practical skills of
statistical
labor modules.
between study and control group
The present study indicated that
regarding knowledge about practical
studied
skills
groups
statistical
achieved
significant
highly
difference
significant
during
process
difference
of
labor
including aim of abdominal, vaginal
regarding their knowledge about
examination,
labor lecture contents as definition of
definitions, values and components
normal labor, difference between true
of partogram and signs of fetal
and false labor pains, stages of labor,
distress. This may be due to students
mechanism
of the simulation group had given a
of
labor
and
and
perineal
care,
characteristic of uterine contractions.
chance for demonstration and make a
This result was matched with Omer,
mistake and re-demonstration and
(2016), who conducted a study to
correction of their mistakes that had
"explore the perception of 117
led
nursing students on their satisfaction
improving practical skills.
and self-confidence after clinical
In this respect, Pantelidis1, et al
simulation experience", who reported
(2016), who conducted study for
Improvement of knowledge because
evaluate
methods used in simulation were
environment of the course, as well as
effective and gave them clear ideas
the skills and knowledge acquired by
of what is expected from them. These
the participants , who founded that
knowledge
Students
acquisition
abilities
to
gaining
the
confidence
general
improved
of
educational
their
clinical
knowledge and their ability to take
improve their self-confidence.
was
action by diagnosing and intervening.
al,
As demonstrated by the pre- and
(2015),who conducted a study to
post- MCQs tests, students performed
"evaluate
better after the completion of the
In
addition
congruent
this
with
findings
Agha
medical
,
et
students’
satisfaction with simulation based
100
seminar.
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
Effect of Simulation on Students' Achievement in Normal Labor Modules
The present study illustrated that the
This
distribution of mean score of studied
Zarifcanaiey, et al, (2016), who
sample
conducted study
practice
procedures
regarding
immediately
labor
at
re-
results
effect
of
supported
by
to compare the
integrated
demonstration phase, had more a
(simulation
highly
significant
strategies) and the simulation based
difference regarding their practical
training on performance level at
skills
labor
critical thinking ability of nursing
including perineal care, abdominal
students, who founded that the
examination, vaginal examination,
experimental group obtained higher
handling
performance
statistical
during
process
,assessment
of
of
fundus,
and
training
critical
score
thinking
significantly
placenta examination and newborn
difference than control group due to
physical assessment this may be due
positive effect of using integrated
to improve student knowledge and
methods on critical practice, problem
retain
solving
information
lecturer
and
gained
from
practical
re-
skills,
clinical
efficacy,
academic achievement, and clinical
competence.
demonstration of the labor skill.
the
Regarding students satisfaction about
distribution of mean score of studied
simulation method, the result of this
sample
labor
study showed that slightly more than
procedures post intervention, had a
three quarter of students of the
highly
significant
studied sample agree with" the
difference regarding their practical
simulation provide student with a
skills
labor
variety of learning materials and
including perineal care, abdominal
activities to promote the learning
examination, vaginal examination,
curriculum". While minority of them
handling
disagree with "help in understanding
The
current
revealed
practice
regarding
statistical
during
that
process
,assessment
of
of
fundus,
placenta examination and newborn
the
physical assessment. This may be
simulation. This may be attributed to
due to the students’ performance
the
level
sessions
was
increased
by
the
concepts
students
take
converted
in
the
in
the
simulation
opportunity
procedures
for
application of integrated training
performing
on
(stimulation videos and Noelle doll).
mannequins in a simulation lab and
seeing videos about labor procedures
Menoufia Nursing Journal, Vol.4, No. 1, May 2019
101
Effect of Simulation on Students' Achievement in Normal Labor Modules
(abdominal
vaginal
enables nursing students to gain new
exanimation, perineal care, placental
knowledge and build upon previous
examination, and newborn physical
skill.
assessment).
provides self-paced learning and
Hall , (2013) supporting the present
affords
study finding, by evaluating the
opportunity to make mistakes and
effect of simulation based education
learn from them, which cannot be
on baccalaureate nursing students’
accomplished in the clinical setting.
satisfaction and reporting that the
Moreover, simulation training can
students were very satisfied with the
provide
simulation learning activity.
experiences to all nursing students by
The
examination,
result
of
this
study
was
Simulation
nursing
training
also
students
standardized
the
learning
enabling active experience. This
congruent with Mould, et al, (2011),
guides
who assess the effect of simulation
simulation for students in education.
on
student
satisfaction
and
our
attention
to
utilize
confidence, who reported that a
CONCLUSION
Students who received simulation
higher
with
based teaching acquired higher level
learning by clinical simulation and
of knowledge and practice than
the learner confidence in their skills.
students
In addition to that omer, (2016), who
academic teaching.
reported that using simulation as a
education
RECOMMENDATION
Simulation based teaching should be
promote student satisfaction with
integrated in the practice training for
their learning and improve self-
students before their contact with
confidence. Simulations prepare the
actual woman in the labor unit.
learner
strategy
for
satisfaction
clinical
student to for real-life experience and
speed the transition to professional
career.
who
received
routine
Research should be done to compare
between simulation based teaching
and other methods of teaching.
The current study emphasized that,
utilized of simulation on students’
achievement on labor modules as
simulation
training
provides
the
nursing student with opportunities for
active
102
involvement
in
learning,
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