The Maternal‐Newborn Assessment Study: Can Simulation Replicate the Clinical Learning Experience in Undergraduate Nursing Education?

Paper Presentation Objective To compare high‐fidelity simulation and practice in the clinical laboratory to hospital‐based clinical learning on the ability of undergraduate nursing students to assess, intervene, and critically think in the obstetric setting. Design Quasi‐experimental, nonequivalent comparison groups, post test only; power analysis for three variables, medium effect size required 76 in each comparison group for a total of 152 participants; alpha level .05 and power of .8. Setting Private university in the Pacific Northwest. Sample Undergraduate, senior nursing students (80) in the maternal‐child course: 39 in an obstetric hospital rotation and 41 in a pediatric clinical rotation voluntarily participated and comprised the two comparison groups. Methods Each student demonstrated simulated postpartum and newborn assessments, whereas an obstetric faculty member trained as an observer evaluated performance using check‐off forms. Following and prior to debriefing, students provided written responses to questions designed to assess critical thinking during the simulation. Questions and items on check‐off forms were assigned points to obtain assessment, written, and total scores. Scores t Tests were used to compare scores of students completing an obstetric hospital rotation versus those in a pediatric clinical rotation, and frequencies for passing assessments were calculated. Results No significant difference was detected between students in the pediatric clinical rotation who only practiced assessments in the laboratory setting and students completing a hospital‐based obstetric rotation related to ability to assess, intervene, or critically think. The p ‐value for comparisons ranged from .41 to .93 (all nonsignificant); less than one third of students passed either assessment. Conclusion/Implications for Nursing Practice Simulation is a widely used teaching strategy. Researchers have found simulation increases undergraduate nursing students' knowledge, skills, self‐efficacy, and confidence. Our findings indicate that simulation was as effective as clinical practice in terms of students' performance outcomes. Well‐designed simulations can replace part of nursing students' hands‐on clinical time with positive learning outcomes. Evaluating individual student performance facilitates design of remediation activities targeting identified areas of weakness. Future researchers should combine simulation with hospital‐based clinical experience to determine if student competency improves.