Obstetrics and Gynaecological Nursing Division, Department of Nursing Siriraj Hospital, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
Department of Obstetric and Gynaecological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Midwifery. 2024 Oct;137:104132. doi: 10.1016/j.midw.2024.104132. Epub 2024 Aug 2.
Simulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited.
To examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives' knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting.
During September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared.
Workshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills.
The simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.
模拟培训已被广泛用作护理和助产学教育不同层次学习和评估临床技能的有价值策略。模拟培训对资源匮乏环境下高危妊娠的强化管理的影响有限。
检验基于低保真模型的模拟培训对资源匮乏环境中产科护士和助产妇高危妊娠管理的知识、态度和技能的影响。
2023 年 9 月，25 名在万象省五所三级公立医院工作的产科护士或助产士参加了为期三天的高危孕妇和新生儿强化管理培训研讨会，该研讨会采用了整合基于问题的学习的模拟培训方法。对知识、态度和技能评估标准的预测试和后测试得分进行了统计学比较。
工作坊学员在高危妊娠管理知识（p=0.012）、高危妊娠管理态度（p=0.000）和对模拟培训设计的态度（p=0.002）方面均有显著提高。临床技能应用于模拟表现检查表，总体表现得分的前后测试增益有统计学显著差异（p=0.000）。产后出血管理技能的平均得分为 11.48±2.23，是所有技能中得分提高最高的。
高危妊娠管理中的模拟培训提高了资源匮乏环境中护士和助产妇的知识、态度和技能。下一步包括直接观察学员在临床环境中的表现，以评估他们在确保患者安全、实现积极妊娠结局和提高满意度方面的能力。
