References
Impact of immediate vs delayed feedback in a midwifery teaching activity with a simulated patient
Abstract
Background:
Literature on evidence-based midwifery demonstrates a lack of simulation in antenatal consultation.
Aims:
This study aims to explore whether immediate individual feedback (IIFB) is more effective than delayed group feedback (DGFB) following a teaching activity for midwifery students, and evaluate students' satisfaction.
Methods:
A teaching activity with simulated patients was developed to improve midwifery students' competence in conducting a holistic antenatal session. Clinical and communication skills were evaluated using a validated grid adapted from the Calgary-Cambridge Referenced Observation Guide on communication. Students (n = 51) were randomly separated into two groups, IIFB or DGFB.
Findings:
Non-parametric tests showed that students who received IIFB significantly improved their competence in conducting history-taking in comparison to the students who received DGFB (P = 0.034), including higher satisfaction (P < 0.001).
Conclusions:
Competence in leading holistic antenatal care sessions is essential for midwives. Students' clinical and communication skills, as well as satisfaction, improve with opportunities to work with simulated patients. Students who received IIFB showed a greater improvement of clinical skills and reported higher satisfaction with the timing of feedback than those who had DGFB.
Simulation is defined as ‘a technique, not a tech nology, to replace or amplify real experi ences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner’ (Gaba, 2004: 1). Simu lation in midwifery provides learners with a unique opportunity to practise hands-on skills and competencies and allow them to learn from mistakes in repeated teaching activities, integrating new knowledge rapidly and without putting a woman or infant at risk (Scholes et al, 2012). The use of simulation in midwifery predominates in obstetric emergencies such as shoulder dystocia and cord prolapse emergencies (Merién et al, 2010; Cooper et al, 2012), rather than more routine training such as how to perform a full antenatal consultation.
The antenatal consultation is of particular interest because it is a major part of midwifery, incorporating elements of bio-psychosocial screening, prevention, health promotion and professional skills. However, its teaching is sometimes underestimated, and educators tend to favour training in obstetric complications (Pairman, 2006; Klima et al, 2009; Fullerton et al, 2016). In nursing and medical science, authors advocate that simulated learning encompasses the cognitive, psychomotor and affective domains of learning to accommodate the preferences of all nursing students and enable them to provide holistic care (Ricketts, 2011; Vyas et al, 2011). A standardised approach to simulated learning in nursing education, with the development of clinical scenarios linked to relevant theory and lectures, would offer measurable learning outcomes to meet professional and regulatory requirements (May et al, 2009). Simulation in midwifery education with simulated patients (SPs) is useful when psychomotor and cognitive skills are taught in an integrative manner with communication and relationship competencies (Cooper et al, 2012). There is a clear benefit of simulation in terms of communication and relationship skills.
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