Common problems of clinical performance examination in breastfeeding instruction for nursing baccalaureate students.

The purpose of this study was to investigate the problems commonly seen in the clinical breastfeeding practice of undergraduate nursing students. The criterion for clinical performance examination was the instructional ability index for breastfeeding determined from the competency-based clinical performance examination in maternity nursing, a model developed by Chung et al. (2001). Simple random sampling was used to access 60 participants from the 213 baccalaureate students from the second year of a nursing department who had completed obstetric nursing education. The average age of the subjects was 20.73 years. Most subjects did not have experience either in breastfeeding or in instructing others about breastfeeding. The pass rate in the clinical examination was 26.67 % (n=16), and the difference was only in obstetrics nursing practicum scores and days of practice between pass and fail, with no significant difference in demographic data. The most common mistakes found during breastfeeding instruction by students included distinguishing the infant consciousness state fit for feeding, knowing when to stop feeding, identifying when the baby is hungry or satisfactied via behavioral cues, maternal posture (cradle and football holds, and side-lying), latching on techniques, assisting mother to correctly remove infant from the breast, and overriding test categories such as sepsis, interpersonal relationship, health teaching, physical jeopardy, and bonding. The results of this study can be used by instructors to improve their teaching design in breastfeeding education, as well as by undergraduate students of nursing departments to advance their ability to instruct others about breastfeeding.