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© Borgis - New Medicine 2/2013, s. 55-61
*Eszter Borján1, Zoltán Balogh1, Judit Mészáros2
Evaluating the effectiveness of two simulation courses for midwifery students
1Department of Nursing, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Head of Department: Zoltán Balogh, PhD
2Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Dean of the Faculty of Health Sciences: Prof. Judit Mészáros, PhD
Summary
Aim. The aim of this study was to evaluate the effectiveness of two simulation courses for midwifery students.
Material and methods. There were 30 midwifery students enrolled in the study at Semmelweis University, the Faculty of Health Sciences between February and May 2011. The descriptive study examined the effectiveness of a common compulsory course: “Clinical simulation” and a special course following it: “Case studies in simulation” using the METI Simulation Effectiveness Tool (SET). Students completed the SET after the common compulsory course and also after the special course, by rating its statements. Results were compared by the authors.
Results. The common compulsory course: “Clinical simulation” was effective. After the special course: “Case studies in simulation” we realized remarkable improvement in assessment skills, in the skill of critical thinking and self-confidence.
Conclusion. METI SET is a useful tool for evaluating our students’ perception; however, more objective assessment tools should be used for the evaluation of our students’ development in simulation.



INTRODUCTION
The worldwide use of high-fidelity human patient simulators in nursing and midwifery education programs has increased in the past ten years. Universities are faced with increased student intakes, decreased clinical placements and a shortage of patient availability (1, 2). Nevertheless students require innovative and successful learning strategies in order to be prepared for real clinical practice in a more effective way. Simulation is an efficient method because it provides multiple learning objectives in a realistic clinical environment without harming patients (1).
We started to integrate simulation into the curriculum in 2008 when we received our first METI (Medical Education Technologies, Inc.) Emergency Care Simulator (ECS). Since 2011 we have also obtained a METIman Nursing and a METI Baby Sim.
The curriculum development has been a four-year long process we have not finished yet. Simulation has been integrated into the curriculum for all undergraduate students. Each of our students has the opportunity to practice basic assessment and technical skills with a simulator. The name of the common compulsory course is: “Clinical simulation”. This course includes elementary level scenarios for all students in different fields of health care. The prerequisite of this course is to cover the subject: “Basics of Health Sciences” which provides general knowledge and practice in the fields of nursing (3). After completing the “Clinical simulation” course the nursing and midwifery students have more possibilities to practice on the simulator by using the METI PNCI (Program for Nursing Curriculum Integration) learning package (4). We have developed two special programs for nursing and midwifery students. The name of this special course is: “Case studies in simulation”. Although we don’t have a special birth simulator yet we can use the METI ECS and METIman Nursing simulators for midwifery students as well. As we were planning the simulation program for midwifery students we chose the most appropriate scenarios (simulated clinical experiences – SCEs) from the METI PNCI learning package considering the midwife’s role in different clinical fields (tab. 1). The prerequisite of this course is to cover the subject: “Basics of Nursing” which includes the basic knowledge and skills for nursing and midwifery students.
Table 1. Scenarios from the METI PNCI learning package.
Title of the scenarioReasons for the choice of scenarios
Hyperemesis Gravidarumobstetric scenario
Pregnancy Induced Hypertensionobstetric scenario
Postpartum Hemorrhageobstetric scenario
Amniotic Fluid Embolismobstetric scenario
Postop Ileuscommon complication after operation
Postop DVTcommon complication after birth or operation
While using human patient simulators we have experienced most of the advantages of this new teaching and learning strategy but we have also realized that we have to measure the effectiveness of our work in order to ensure the best way of teaching our students. We can find many evaluation instruments in literature but in most cases their validity and reliability is unknown. Further use and development of simulation evaluation instruments are of highest importance (5).
AIM
The first aim of this study was to evaluate the effectiveness of the special simulation course for midwifery students by comparing the results measured after a common compulsory course: “Clinical simulation” with the ones measured after the special course: “Case studies in simulation”. The second aim of this study was to analyse the fields of students’ development after the two courses. For the comparison we used the METI Simulation Effectiveness Tool (SET).
The research questions of this study were as follows:
1. Was the common compulsory “Clinical simulation” course effective?
2. Did we experience any improvement after the special course?
3. Can we improve all fields of knowledge and all skills during one course?
MATERIAL AND METHODS

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Piśmiennictwo
1. Wilford A, Doyle TJ: Integrating simulation training into the nursing curriculum. Br J Nurs 2006; 15(11): 604-607. 2. Brown D, Chronister C: The effect of simulation learning on critical thinking and self-confidence when incorporated into an electrocardiogram nursing course. Clin Simulation Nurs 2009; 5(1): e45-e52. 3. Csóka M, Vingender I: A szimulátoros oktatás módszertana. Nővér 2010; 23(6): 22-39. 4. Borján E, Balogh Z, Mészáros J: Three-year teaching experience in simulation education. New Medicine 2011; 15(4): 138-142. 5. Kardong-Edgren S, Adamson KA, Fitzgerald C: A Review of Currently Published Evaluation Instruments for Human Patient Simulation. Clin Simulation Nurs 2010; 6(1): e25-e35. 6. Elfrink Cordi VL, Leighton K, Ryan-Wenger N et al.: History and Development of the Simulation Effectiveness Tool (SET). Clin Simulation Nurs 2012; 8(6): e199-e210. 7. Smith-Blair N, Neighbors M: Use of the critical thinking disposition inventory in critical care orientation. J Contin Educ Nurs 2000; 31(6): 251-256. 8. Kaddoura MA: New graduate nurses’ perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence. J Contin Educ Nurs 2010; 41(11): 506-516. 9. Ravert P: Patient simulator sessions and critical thinking. J Nurs Educ 2008; 47(12): 557-562. 10. Benner P: From Novice to Expert. Excellence and Power in Clinical Nursing Practice, Addison-Wesley Publishing Company, Inc. 1984. 11. Tulkán I: Ápolói kompetenciák mérése különös tekintettel a területi gyakorlatokra. PhD értekezés, Semmelweis Egyetem 2010. 12. Brannan JD, White A, Bezanson JL: Simulator effects on cognitive skills and confidence levels. J Nurs Educ 2008; 47(11): 495-500. 13. Jeffries PR: A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nurs Educ Perspect 2005; 26: 96-103.
otrzymano: 2013-05-08
zaakceptowano do druku: 2013-06-03

Adres do korespondencji:
*Eszter Borján
Semmelweis University, Faculty of Health Sciences, Department of Nursing
1085 Budapest, Vas u. 17, Hungary
tel.: +36 (1) 4865930; fax: 4865931
e-mail: eborjan@gmail.com

New Medicine 2/2013
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