INTRODUCTION:

Nursing is a profession where practical and theoretical knowledge needs to be highly integrated, and clinical practice is significant for the professional development of undergraduate nursing students. The shift from traditional instructional methods toward student-centered teaching challenges nursing faculty to create learning experiences that will develop safe and competent graduates. Going out into the clinical field can be stressful for nursing students. They know that mistakes can seriously affect a patients’ outcome. Therefore, failure is not an option.

Students may end up being overly cautious and unsure of decisions or they might be disastrous Nursing faculties are always looking for more effective teaching methods that enhance student performance and improve his development of self-confidence [1].

Demonstration as a traditional lab training refers to the visual presentation of the action and activities or practical work related to the facts and principles of a delivered lesson by the teacher in the classroom [2]. Traditional teaching methods usually don't meet students' requirements to be active learner, as they don't allow time for independence, critical thinking, this require nursing educators to shift from a teacher centered to student – centered approach, which can foster independence in learning, creative problem- solving skills, a commitment to life- long learning and critical thinking[3].

Technological innovations are advancing practice across all domains of education and industry, and the same is true in nursing education. Sim-lab or Simulation is gaining popularity as a means to provide innovative learning experiences and foster a richer understanding of didactic content. Simulation activities involve controlled representations of actual clinical events. As a strategy - not a technology –to mirror, anticipate, or amplify real situations with guided experiences in a fully interactive way[4][13].

Sim-lab or Simulations in health professional education take the forms of role play, videotaped interactions, case studies, demonstrations, computer-based learning modules, online activities, standardized patients, virtual reality applications, and mannequins or plastic body parts. Simulations are often discussed in terms of low fidelity vs. high fidelity, a distinction that appears to be closely linked to the level of technological sophistication they demonstrate[5]. High fidelity refers to sophisticated computerized simulation of whole patients (patient simulators) or various anatomical parts[6]. Fidelity is the term utilized in the simulation domain to describe the degree of accuracy of the system being used. The purpose of simulation is to be realistic in a manner adequate to convince the user that the scenario performed resembles real-life. High-fidelity simulation is a relatively new area in nursing education and utilizes high technology simulation monitors and computers. This technology offers new avenues for teaching student nurses scenarios as well as critical thinking and reflection on lived experience and practice[7][14].

The opportunity for students to deliver care in a safe manner in today’s high-risk, complex health care environment is limited. Situations involving high-risk patients are not ideal for student learning experiences. Simulation allows students to practice skills and apply nursing knowledge in a safe environment [7]. In the simulated environment, simulations using human patient simulators are student-centered and provide students with opportunities to practice decision making, problem solving, and team member skills in a non-threatening way [8]. According to [9], simulation is useful for teaching and valuating specific clinical skills and provides a way to increase safety, decrease errors, and improve clinical judgment. Use of simulation can support students‟ competency development, moving them further along the continuum toward competent performance and the ability to evaluate and reflect on the activities in a non-threatening area these competencies will positively affect students' performance and enhance their level of self-confidence[3][15].

Student performance with learning is defined as the degree to which students believe they have opportunity to be involved in a learning activity and to receive feedback about their learning. Student Self-confidence is defined as “confidence in oneself and in one's powers and abilities”. People with self-confidence believe themselves to have the ability to handle a situation or deliver nursing care in a correct, appropriate and an effective way. This process occurs in an environment that respectfully challenges students as they participate in the learning experience, The role of the clinical teacher in enhancing student performance is associated with “pacing the student to professional competency," which involves diagnosis of readiness, selection of clinical problems, supervision, and evaluation. These categories, although not exhaustive or exclusive, provide a useful framework for considering the functions of the clinical teacher that may enhance student performance by using effective clinical teaching strategies that are appropriate for student needs and enhance their development [10].

PROBLEM JUSTIFICATION:

The largest health discrepancy in the world is maternal mortality with most deaths occurring around the labor, delivery and postpartum period. The presence of skilled qualified competent nurses, optimal student Learning for high quality maternity care is a leading factor in averting maternal death and disability[11]. The ultimate goal for nursing faculty is to produce nursing graduates that think critically and apply technical skills in complex patient care situations. Given the increasing complexity in the health care environment, realistic educational experiences that give students the chance to hone their skills before interacting with real patients are more important than ever. The demands for change in curricula have escalated in the last decades, its’ a widely a knowledge that a nursing curricula should overtly and systematically foster the development of the behaviors and skills that graduates will require to fulfill the societal expectations of the health care professionals. In nursing, there is limited research on the effectiveness and outcomes when using simulators and simulations on students' performance regarding clinical teaching methods and its consequences[12].

PURPOSE OF THE STUDY:

Evaluate the effect of sim-lab versus traditional lab training on maternity nursing students' performance. This aim will be achieved through:

1. Assess students' performance by using traditional lab and sim- lab

2. Compare between students' performance using traditional lab and using sim-lab

RESEARCH HYPOTHESIS:

Sim-lab as a teaching strategy has a positive effect on maternity nursing students' performance than traditional laboratory training.

POPULATION, SAMPLE, AND SETTING:

The convenience sample was recruited from third-year nursing students N = 36 were involved in the study divided into two equal groups (study/simulated and control/traditional). The study was conducted at Maternity clinical Lab in faculty of Nursing, Hail University during the course entitled maternity and gynecological nursing. Data was collected at the beginning of the second semester in the academic year 2016/2017. Exclusion criteria are previous experience with sim-lab. None of the students in either group had been exposed to simulation previously.

PROTECTION OF HUMAN SUBJECTS:

This study will be submitted to the Institutional Review Board (IRB of Nursing).The rights of the subjects will be protected at all times. Participation will be strictly voluntary with implied consent assumed with return of the completed questionnaires. No names will be used for data collection. There are no risks identified for being included in this study. Benefits from this study will include identification of characteristics of clinical faculty which are effective to student learning outcomes in the clinical setting. Findings about characteristics of those in instructional roles will be of value in devising a valid and reliable evaluation tool to assess the effectiveness of clinical teachers. Permission to use the instrument will be obtained from the authors.

RESEARCH DESIGN:

A comparative quasi-experimental posttest design was used. The research compared the effect of Sim-lab versus traditional lab training on performance of nursing students.

TOOLS OF DATA COLLECTION:

Self-administered questionnaire the researchers constructed a questionnaire sheet after reviewing the related literature. It was divided in 2 parts.

First part: included assessment of student personal data and past clinical experience (questions: 1- 8).

Second part: Performance Evaluation format for intrapartum assessment.

Scoring system:

All items were rated using a Likert-type scale with 1 being low and 5 being high. Total scores could range from 12 to 36 and it divided into two parts:

1. Total score for student performance:

Total score of 6 to 15 is considered as satisfied

Total score of 0 to 5 is considered as unsatisfied

VALIDITY AND RELIABILITY:

These tools were reviewed by jury of 7 expertises in the field of maternity and gynecological nursing to test its contents and face validly. Reliability was done by Cronbach's Alpha coefficient test which revealed r = 80.2.

PROCEDURE:

Three steps were involved in the development of this study

Step 1-Data Collection

Step 2-Approval of Human Research Review Committee

Step 3-Approval of Dean, HODs and Class coordinator’s

PLAN FOR DATA ANALYSIS:

Prior to data collection, Pilot study was conducted for students. It was conducted to evaluate the efficiency and content validity of the tool, to find the possible obstacles and problems that might be faced during data collection. Students included in the pilot study were excluded from the sample, to avoid contamination of research sample. A data collection for this study was carried out in the period from the beginning of the second semester in the academic year 2016/2017. The researchers first explained the aim of the study to the participants and reassure the students that information collected would be treated confidentiality and that would be used only for the purpose of the research without implication for their course grade Implementation phase was divided into two stages: Educational and Training phase, student evaluation.

CONCLUSION:

This study aimed to evaluate the effect of sim-lab versus traditional lab training on maternity nursing students' performance. A comparative quasi experimental study was utilized.

REFERENCES:

1. Alfes, C. M. (2011). Evaluating the use of simulation with beginning nursing students. Journal of Nursing Education, 50(2), 89-93.

2. Alinier, G., Hunt, B., Gordon, R., and Harwood, C. (2006). Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Nursing, 54(3), 359-369.

3. Bandura, A. (2007). Social learning theory. New York: General Learning Press.Bearnson, C. S., and Wilker, K. M. (2005). Human patient simulators: Anew face in baccalaureate nursing education at Brigham Young University. Journal of Nursing Education, 44(9), -425.

4. Pamela G., (2010) Simulation in Nursing Education: A Review of the Research, Nova Southeastern University, Fort Lauderdale, Florida, USA. The Qualitative Report Volume 15 Number 4 July 1006-1011.

5. Maran, N. J., and Glavin, R. J. (2003). Low- to high-fidelity simulation - A continuum of medical education? Medical Education, 37(s1), 22-28.

6. Good, M. L. (2003). Patient simulation for training basic and advanced clinical skills. Medical Education, 37(s1), 14-21.

7. Piscotty, R., Grobbel, C., and Tzeng, H. (2011). Integrating quality and safety competencies into undergraduate nursing using student-designed simulation. Journal of Nursing Education, 50(8), 429-436.

8. Billings, D. M., and Halstead, J. A. (2009). Teaching in Nursing: A guide for faculty (3rd ed.). Saint Louis: Elsevier.

9. Bearnson, C. S., and Wilker, K. M. (2005). Human patient simulators: A new face in baccalaureate nursing education at Brigham Young University. Journal of Nursing Education, 44(9), 421-425.

10. Benner, P. (2014). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Publishing Co., Nursing Division.

11. Adamson, K.A., Kardong-Edgren, S., and Willhaus, J. (2013). An Updated Review of Published Simulation Evaluation Instruments. Clinical Simulation in Nursing, 9(9), e393-e400.

12. Linder LA, and Pulsipher N.(2008); Implementation of Simulated learning experiences for baccalaureate pediatric nursing students. Clinical Simulation in Nursing.;4(3):e41–e47.

13. Harris MA. (2011); Simulation-enhanced pediatric clinical orientation. J Nurs Educ.; 50(8):461–5.

14. Smith, S. J. and Roehrs, C. J. (2009). High-fidelity simulation: factors correlated with nursing student performance and self-confidence. Nursing Education Perspectives, 30(2). 74-78.

15. Parker RA, McNeill JA, Pelayo LW, Goei KA, Howard J, Gunter MD.(2011); Pediatric clinical simulation: a pilot project. J Nurs Educ.; 50(2):105–11.

Received on 10.10.2016 Modified on 25.11.2016

Int. J. Nur. Edu. and Research. 2017; 5(2): 175-178.

DOI: 10.5958/2454-2660.2017.00036.9