Effect of Scenario-Based Simulation Training on the Obstetrics and Gynecology Nursing Clinical Practicum

10.1097/jnr.0000000000000417

Ayten ŞENTÜRK ERENEL；Şengül YAMAN SÖZBİR；Mehtap UZUN AKSOY；Esra ARSLAN GÜRCÜOĞLU；Sıdıka PELİT AKSU；Filiz ÜNAL TOPRAK；Canan UÇAKCI ASALIOĞLU

nursing ； students ； simulation ； self-confidence ； clinical stress

The Journal of Nursing Research

29卷2期（2021 / 04 / 01）

1 - 9

英文

Background: Simulation practices in obstetrics and gynecology (OB-GYN) nursing are used in education, practice, assessment, and the investigation of interventional and behavioral skills related to both routine and emergency conditions. Purpose: This study was conducted in an OB-GYN nursing course to determine the effect of simulation practices on clinical practice satisfaction, clinical stress, and self-confidence in nursing students. Methods: A cluster randomized controlled experimental trial was conducted on 122 students (experimental group, n = 58; control group, n = 64). After theoretical training, all of the students applied six scenarios in the OB-GYN nursing simulation laboratory. The students in the experimental group began clinical practice after simulation training, whereas their peers in the control group began clinical practice without prior simulation training. Data in this study were collected using a personal information form, the Pagana Clinical Stress Questionnaire, a self-confidence scale, and a satisfaction subscale from the Clinical Learning Environment Scale on, respectively, the first day and final day of clinical practice. Results: At the end of the clinical practice, average clinical stress in the control group was higher than that in the experimental group (p = .001). No intergroup difference was found in self-confidence levels (p ＞ .05). For the control group, at posttest, the average satisfaction with the clinical learning environment was higher (p = .046) and the average satisfaction with the clinical learning environment was lower (p = .05). In contrast, no mean pretest-posttest differences were found in clinical stress and self-confidence levels in the experimental group (p ＞ .05). In the control group, no mean pretest-posttest difference was found for the clinical learning environment (p ＞ .05), whereas mean clinical stress (p ＜ .001) and self-confidence (p = .012) levels were higher at posttest (p ＜ .05). Conclusions/Implications for Practice: The findings of this study indicate that simulation training interventions reduce clinical satisfaction and stress in students but do not influence self-confidence. Nursing educators may provide scenario-based simulation training to students taking OB-GYN courses to enhance their preparedness for clinical practice.

1. Akın, A.(2007).The development and psychometric characteristics of the self-confidence scale.Bolu Abant Izzet Baysal University Journal of Faculty Education,7(2),167-176.
2. Akyuz, A.(2011).Innovative applications in nursing skills training.Clinical and Communication Skills and Trainings Congress in Health Sciences,Ankara, Turkey:
3. Cronenwett, L.,Sherwood, G.,Barnsteiner, J.,Disch, J.,Johnson, J.,Mitchell, P.,Sullivan, D. T.,Warren, J.(2007).Quality and safety education for nurses.Nursing Outlook,55,122-131.
4. Demir, Y.,Ak, B.,Bilgin, N. Ç.,Efe, H.,Albayrak, E.,Çelikpençe, Z.,Güneri, N.(2012).Barriers and facilitating factors to research utilization in nursing practice.Journal of Contemporary Medicine,2(2),94-101.
5. Dunn, S. V.,Burnett, P.(1995).The development of a clinical learning environment scale.Journal of Advanced Nursing,22(6),1166-1173.
6. Eyikara, E.,Baykara, Z. G.(2018).Effect of simulation on the ability of first year nursing students to learn vital signs.Nurse Education Today,60,101-106.
7. Gardner, R.,Raemer, D. B.(2008).Simulation in obstetrics and gynecology.Obstetrics and Gynecology Clinics of North America,35,97-127.
8. Germain, M.,O'Leary-Kelley, C.,Goyal, D.,Anand, S.(2018).Can clinical simulation increase confidence levels in performing postpartum care in a diverse group of baccalaureate nursing students?.Nursing Education Perspectives,39(2),94-95.
9. Işık, B.,Kaya, H.(2014).The effect of simulation software on learning of psychomotor skills and anxiety level in nursing education.Procedia-Social and Behavioral Sciences,116,3864-3868.
10. Jeffries, P. R.,Rodgers, B.,Adamson, K.(2015).NLN Jeffries simulation theory: Brief narrative description.Nursing Education Perspectives,36(5),292-293.
11. Karadağ, G.,Kılıç, S. P.,Ovayolu, N.,Ovayolu, Ö.,Kayaaslan, H.(2013).Difficulties encountered by nursing students in practices and their views about nurses.TAF Preventive Medicine Bulletin,12(6),665-672.
12. Khalaila, R.(2014).Simulation in nursing education: An evaluation of students' outcomes at their first clinical practice combined with simulations.Nurse Education Today,34,252-258.
13. Kim-Godwin, Y. S.,Livsey, K. R.,Ezzell, D.,Highsmith, C.,Winslow, H.,Aikman, A. N.(2013).Students like peer evaluation during home visit simulation experiences.Clinical Simulation in Nursing,9(11),e535-e542.
14. Korkmaz, Ö. G.(2011).Professionalism and nursing in Turkey.Journal of Hacettepe University Faculty of Nursing,18(2),59-67.
15. Küçük, E. Ö.,Çakmak, S.,Kapucu, S.,Meltem, K. O. C.,Kahveci, R.(2017).Determination of nursing students' awareness of evidence-based nursing practice.Journal of Hacettepe University Faculty of Nursing,4(2),1-12.
16. Kuznar, K. A.(2007).Associate degree nursing students’ perceptions of learning using a high-fidelity human patient simulator.Teaching and Learning in Nursing,2,46-52.
17. Labrague, L. J.,McEnroe-Petitte, D.M.,Bowling, A. M.,Nwafor, C. E.,Tsaras, K.(2019).High-fidelity simulation and nursing students' anxiety and self-confidence: A systematic review.Nursing Forum,54(3),358-368.
18. Luctkar-Flude, M.,Wilson-Keates, B.,Larocque, M.(2012).Evaluating high-fidelity human simulators and standardized patients in an undergraduate nursing health assessment course.Nurse Education Today,32,448-452.
19. Maas, N. A.,Flood, L. S.(2011).Implementing high fidelity simulation in practical nursing.Clinical Simulation in Nursing,7,229-235.
20. Mete, M.,Gümüş, F.,Zengin, L.,Erkan, M.,Arda Sürücü, H.,Yiğitalp, G.,Evinç, E.,Duman, M.,Durgun Ozan, Y.(2017).Evaluation of the effect of simulation method applied in occupational ability laboratory on the students' ability to solve problems.Jaren,3(2),92-96.
21. Oh, P. J.,Jeon, K. D.,Koh, M. S.(2015).The effects of simulation based learning using standardized patients in nursing students: A meta-analysis.Nurse Education Today,35(5),e6-e15.
22. Öner Altıok, H.,Üstün, B.(2013).The stress sources of nursing students.Educational Sciences: Theory & Practice,13(2),760-766.
23. Pagana, K. D.(1989).Psychometric evaluation of the clinical stress questionnaire (CSQ).The Journal of Nursing Education,28(4),169-174.
24. Pınar, G.,Abay, H.,Akalın, A.(2016).The effect of scenario-based simulation training technology on knowledge and skills of maternity nursing students in Turkey.International Journal of Development Research,6(6),8096-8101.
25. Pınar, G.,Doğan, N.(2013).Improving perinatal patient safety among Turkish nursing students using simulation training.Procedia - Social and Behavioral Sciences,83,88-93.
26. Pınar, G.,Knight, C. C.,Gaioso, V. P.,Watts, P. I.,Dailey, K. D.,Britt, S. E.,Catron, K. S.,Zengul, F. D.(2015).The effects of high fidelity simulation on nursing students' perceptions and self-efficacy of obstetric skills.International Archives of Nursing and Health Care,1(1),1-7.
27. Rhodes, M. L.,Curran, C.(2005).Use of the human patient simulator to teach clinical judgment skills in a baccalaureate nursing program.Computers, Informatics, Nursing,23(5),256-262.
28. Robertson, B.,Kaplan, B.,Atallah, H.,Higgins, M.,Lewitt, M. J.,Ander, D. S.(2010).The use of simulation and a modified Team STEPPS curriculum for medical and nursing student team training.Simulation in Healthcare,5(6),332-337.
29. Sarı, D.(2001).T. R. Ege University.
30. Schoening, A. M.,Sittner, B. J.,Todd, M. J.(2006).Simulated clinical experience: Nursing students' perceptions and the educators' role.Nurse Educator,31(6),253-258.
31. Şendir, M.(2013).Use of simulation in women's health nursing education.Florence Nightingale Journal of Nursing,21(3),205-212.
32. Şendir, M.,Acaroğlu, R.(2008).Reliability and validity of Turkish version of clinical stress questionnaire.Nurse Education Today,28(6),737-743.
33. Skrable, L.,Fitzsimons, V.(2014).Simulation in associate degree nursing education: A literature review.Teaching and Learning in Nursing,9,120-125.
34. Smith, R.,Gray, J.,Raymond, J.,Catling-Paull, C.,Homer, C. S.(2012).Simulated learning activities: Improving midwifery students' understanding of reflective practice.Clinical Simulation in Nursing,8(9),e451-e457.
35. Terzioğlu, F.,Kapucu, S.,Ozdemir, L.,Boztepe, H.,Duygulu, S.,Tuna, A. Z.,Akdemir, N.(2012).Nursing students' opinions about simulation method.Hacettepe University Faculty of Health Sciences Nursing Journal,19(1),16-23.
36. Terzioğlu, F.,Yücel, C.,Koç, G.,Şimşek, Ş.,Yaşar, B. N.,Şahan, F. U.,Akın, R.,Öçal, S. E.,Akdağ, C.,Elçin, M.,Mert, M.,Yıldırım, S.(2016).A new strategy in nursing education: From hybrid simulation to clinical practice.Nurse Education Today,39,104-108.
37. Tosterud, R.,Hedelin, B.,Hall-Lord, M. L.(2013).Nursing students' perceptions of high- and low-fidelity simulation used as learning methods.Nurse Education in Practice,13(4),262-270.
38. Woda, A.,Hansen, J.,Paquette, M.,Topp, R.(2017).The impact of simulation sequencing on perceived clinical decision making.Nurse Education in Practice,26,33-38.
39. World Health Organization(2013).WHO nursing and midwifery progress report 2008-2012.
40. Yuan, H. B.,Williams, B. A.,Fang, J. B.,Ye, Q. H.(2012).A systematic review of selected evidence on improving knowledge and skills through high-fidelity simulation.Nurse Education Today,32(3),294-298.

1. Ruey-Hsia WANG,Li-Min WU,Hui-Chen TSENG,Hsun-Kuei KO,Hsiu-Hung WANG(2022).Psychometric Evaluation of the Capstone Core Competency Scale on Nursing Students in Taiwan.The Journal of Nursing Research,30(5),1-8.
2. (2024).The Efficacy of High-Fidelity Telesimulation in Preparing Nursing Students for Emergency and Critical Patient Care: A Prospective Study.The Journal of Nursing Research,32(5),1-9.