https://menj.journals.ekb.eg Print ISSN: 2735-3974 Online ISSN: 2735-3982 DOI: ------------------------------------- MNJ Menoufia Nursing Journal Faculty of Nuring Menoufia University Effect of Simulation on Students' Achievement in Normal Labor Modules Noha H. AbdElfattah , Galal A. EL-Kholy, Amal A. Hassan Omran, Hanan E. Hassan Abstract: Simulation is a potentially powerful teaching approach that engages nursing students and requires them to use critical thinking and clinical reasoning, and provides an opportunity for reflective learning and integration of the student’s knowledge. Purpose: evaluate the effect of simulation on students' achievement in labor modules. Design: A Quasi experimental study (study and control) Setting: This study was conducted at maternity nursing lab and lecture class in the Faculty of Nursing at Benha University. Sample: A convenient samples of 60 students’ were received simulation based teaching and 60 students were included in the control group. Instruments: The of data collection were Self-administered questionnaire sheet, Observational checklist, Students’ satisfaction with learning method and Media for the module of labor (Noelle mannequin& videos).Result: There was a highly statistical difference regarding students’ practical skills during process of labor including perineal care, abdominal examination, vaginal examination, handling, assessment of fundus, placental examination and newborn physical assessment of both phase of assessment. Conclusion: Simulated delivery room classes were an effective training approach; they were equipped the students with practices that result in a significantly higher practical achievements and higher satisfaction scores compared to the conventional training. Recommendations: The study recommended that Maternity nursing students ‘should be provided by variety of simulation-based education on maternity nursing skills to increase level of performance, satisfaction, and self-confidence. Key words: Simulation; Achievement satisfaction. INTRODUCTION Traditional pedagogical techniques resulting in a serious time lag are still very much the norm within between higher education. Student learning applying new knowledge so, it remains upon attributed to simulations relates to extracting knowledge from texts the suggested improvements in and lectures. This style of teaching overall student learning. For much rarely of the literature has stressed the largely gives based students the students of and opportunity to apply their newfound increased knowledge to actual situations, learning, it have the power to MNJ, Vol. 4, No. 1, May 2019, PP: 87-103 levels learning cognitive 87 Effect of Simulation on Students' Achievement in Normal Labor Modules recreate complex, dynamic political realistic, safe Processes in the lecture, allowing students to students the development of the teacher role. motivations, behavioral Constraints, This manuscript provides ideas for resources and interactions among planning, implementation, and institutional actors(Raymond 2010). suggestions Simulation is a potentially powerful technology use in the training of teaching approach that engages nurse educators for their role in nursing students and requires them clinical teaching (Shellenbarger, to use critical thinking and clinical T., & Edwards, 2012). reasoning, HYPOTHESIS: to examine and provides an opportunity for reflective learning and integration of the student’s knowledge (Peisachovich, Gal, & Johnson, 2016). Simulation is an educational strategy that can be used to support the process of clinical education. It can help in improving students’ self-esteem environment for practice the for simulation Students’ who received simulation based teaching (study group) will have higher level of knowledge and practices than students who receive routine academic (control group) post intervention. PURPOSE through provide an opportunity to The purpose of the study is to practice in a risk-free environment. evaluate the effect of simulation on Simulation is the imitation of the students' achievement in normal operation of a real-world process or labor modules. system over time (Montagna& Omicini, 2016). Simulation use continues to expand in nursing education, specifically at the undergraduate level. Graduate nursing students can also benefit from simulation METHODE Research design: A Quasi experimental (Study and control), was used Setting: This study was conducted at Maternity Nursing Laboratory and classroom in the Faculty of Nursing Benha University. teaching issues may be limited; Sampling: A convenient sample composed of 120 students’ were included All available third year 2nd semester therefore, simulation provides a nursing students' at the obstetrics activities. Graduate nurse educator students’ 88 exposure to clinical Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules and gynecology department were symptoms of labor, characteristic recruited in this study during the of uterine contraction, definition academic of year convenience (2016-2017), sample of A (120) first stage of labor, components of labor, diagnosis nursing students was divided into of equal groups, study and control definition of partogram, mention group(60 students per each group), value of partogram, definition of applying two teaching second stage of labor, sign of methods. Using traditional second stage of labor, duration clinical the labor, method for half of students (60) as a of control mechanism group, while using stages second stage of of of labor, labor, delivery, simulation (Noelle mannequin & definition of third stage, sign of videos) for another half of students placenta separation, mechanism (60) as a study group. of INSTRUMENTS definition of fourth stage of The study tools which had been labor. used for data collection was divided into four tools which included the separation and Scoring system  Adequate knowledge --- ≥75%. following: Instrument one knowledge of students’ placental structured interview  Inadequate knowledge ---<75%. questionnaire Instrument two students’ practice This instrument contains two parts:- observational checklist.  Part one: It was concerned with It was developed by the researcher demographic characteristic as to assess students’ practices name, immediately, after and at the end of age, occupation and educational level). labor. It contain the procedures that  Part two: knowledge of student regarding contain normal labor. knowledge It about, were done for the women such as. Perineal care, abdominal examination, vaginal examination, definition of labor, difference handling, assessments of fundus, between true and false labor Placental examination and newborn pain, physical assessment. premonitory sign and Menoufia Nursing Journal, Vol.4, No. 1, May 2019 89 Effect of Simulation on Students' Achievement in Normal Labor Modules Validity: The developed tool was the skills and obtaining the required reviewed for content validity by a knowledge to perform necessary jury consisting of a group of tasks in a clinical setting. Help in 5experts specialized in the obstetric understanding the concepts covered nursing field. in the simulation. Reliability: The reliability of the Scoring system  Satisfactory ----------- tool were tested using Cronbach’s >75%. Alpha test  Scoring system  Highly satisfactory ---- <85%  -Media Unsatisfactory------------ methods structured interview It was developed to assess student satisfaction with modules that included, The teaching methods used in this simulation were helpful The simulation provide student with a variety of learning materials and activities to allow learners to attain knowledge, in environment, modules of labor(Noelle mannequin &Video about simulated videos about labor procedures Perineal care, abdominal questioner. effective, for This tool used for training students satisfaction with learning safe The controlled teaching materials used in this simulation were motivating student to learn, The method of simulation was suitable to the way of learning, simulation covered critical content necessary for learning. Developing 90  Satisfactory practice-----75- Instrument three Students’ skills 75%. <60%. 85% and Uncertain -------------- 60- examination, vaginal examination, handling, assessments of fundus, Placental examination and newborn physical assessment. Ethical considerations:  The aim of the study was explained to students' before data collection to gain their confidence and trust.  An oral consent was obtained from each student to participate in the study they were informed that they could withdraw at any time when they need.  The researcher maintaining assured anonymity Menoufia Nursing Journal, Vol.4, No. 1, May 2019 and Effect of Simulation on Students' Achievement in Normal Labor Modules confidentiality of each the study and methods of data collection participant.  They were assured that the study 2. Data was collected from the was not having any physical, study and control groups at the social or psychological risk. same time instruments one and  Written approval was obtained two (an explanation was done for from the dean faculty of nursing students about filling instruments and one Head of maternal and and two. After wards nursing instrument were distributed, It department Benha University, to took minutes to fill instruments). newborn health explain the purpose of the study. This design included the preparatory phase, pilot study, the actual field work (implementation and evaluation phases), and 3. Students’ in control Pilot study: A pilot study was carried out on 10% of the total sample it included (12 students). It was done to assess efficiency of the clarity and Instruments, estimate the time needed for data collection, and test the feasibility of conducting the received theoretical lecture about normal labor, including definition, terms, stages, sign & symptoms and applicability, groups and mechanism of labor; sign associated limitation. the the study and study. No modification were done, students’ who shared in the pilot study were included in sample. symptoms separation; placental of placental mechanism delivery of and care during 4th stage of labor in the same groups. 4. Students’ in the study group were divided in to four equal groups. Each group contained 15 students. 5. Students in the control group were divided in to four equal groups. Each group contained 15 students. Procedure: 1. A written approval was obtained from the dean of the Faculty of Nursing and Head of Maternity after explaining the purpose of 6. Students in the study group were subject to stimulated experience using simulator and delivery Noelle videos doll (The Program implementation through Menoufia Nursing Journal, Vol.4, No. 1, May 2019 91 Effect of Simulation on Students' Achievement in Normal Labor Modules (7) sessions, (3) for theoretical them to remonstration, programs session and were implemented as study group (4) for practical session. the theoretical session about normal labor, including but without videos. 8. The researcher started the definition, terms, stages, sign & evaluation phase at the end of re- symptoms of demonstration for all students in labor; sign and symptoms of the study and control groups. placental separation; mechanism Each of placental delivery and care 3time and the mean was taken. and mechanism th student was during 4 stage of labor) and each Observation session implemented in (45) min required through using learning material instrument two. (lecture – group discussion). The with one. vaginal examination, perianal care, for each using 9. Knowledge for each student was reassessed examination, done procedure practical session were concerned (Abdominal evaluated using instruments 4-Statistical design: assessment of fundus, handling, placental examination, and Data analysis was performed using newborn physical assessment) and IBM also each session implemented in version 22. Mean and standard (45) minutes and conducted in the deviation were done for quantitative affiliated data frequency distribution was laboratory department of this including done; SPSS (t) statistical test was software used for demonstration, videos and re- qualitative data (X2). A correlation demonstration. Implementation coefficient (r) was used to evaluate phase for each group of study took the relationship between the study about two weeks) variable. A statistical significant 7. Students’ in the control group difference was considered if p-value received routine training in the ≤ 0.05 and a highly statistical laboratory significant was considered when p- (demonstration) by traditional mannequin and allowing value ≤ 0.001. RESULT: 92 Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules Table (1): Distribution of studied sample according their personal characteristics (N=120). Study group Control group (N=60) (N=60) Personnel characteristics No % No % 26 43.3% 32 53.3% 34 56.7% 28 46.7% (21.04 ± 1.46) Chi square Test P value Age in (years) 20-21 22-23 Mean ±SD (21.43 ± 1.98) 1.20 >0.05 0.135 >0.05 0.040 >0.05 Educational level Secondary school 28 46.7% 26 43.3% 32 53.3% 34 56.7% 43 71.7% 42 70.0% 17 28.3% 18 30.0% Technical health institute & nursing institute Residence Rural Urban NB: :ns p >0.05. Table (2): Distribution of studied sample according their pre intervention knowledge about labor (N=120). Study group (N=60) Incorrect Correct Item Definition of normal labor Factors affecting labor Control group (N=60) Incorrect Correct P value No % No % No % No % 54 90.0 6 10.0 49 81.7 11 18.3 1.71 >0.05 45 75.0 15 25.0 41 68.3 19 31.7 0.657 >0.05 50 83.3 10 16.7 53 88.3 7 11.7 0.617 >0.05 47 78.3 13 21.7 52 86.7 8 13.3 1.44 >0.05 43 71.7 17 28.3 45 75.0 15 25.0 0.170 >0.05 52 86.7 8 13.3 55 91.7 5 8.3 0.776 >0.05 Differences between True and False Labor Pains Premonitory Symptoms and Signs of Labor Sure signs of labor Characteristic of uterine contraction NB: ns p >0.05 Cont’d) Menoufia Nursing Journal, Vol.4, No. 1, May 2019 93 Effect of Simulation on Students' Achievement in Normal Labor Modules Table (3): Distribution of studied sample according their pre intervention knowledge about labor (N=120). Study group (N=60) Incorrect Correct Item Control group (N=60) Incorrect Correct P value No % No % No % No % 54 90.0 6 10.0 57 95.0 3 5.0 1.08 >0.05 53 88.3 7 11.7 55 91.7 5 8.3 0.370 >0.05 55 91.7 5 8.3 56 93.3 4 6.7 0.120 >0.05 46 76.7 14 23.3 44 73.3 16 26.7 0.178 >0.05 labor 37 61.7 23 38.3 36 60.0 24 40.0 0.035 >0.05 Duration of the second stage 47 78.3 13 21.7 45 75.0 15 25.0 0.186 >0.05 Definition of third stage of labor 45 75.0 15 25.0 42 70.0 18 30.0 0.376 >0.05 Duration of third stage of labor 43 71.7 17 28.3 41 68.3 19 31.7 0.159 >0.05 placental separation 52 86.7 8 13.3 46 76.7 14 23.3 2.00 >0.05 Signs of placental separation 54 90.0 6 10.0 52 86.7 8 13.3 0.323 >0.05 42 70.0 18 30.0 46 76.7 14 23.3 0.682 >0.05 Stages of normal labor Definition of first stage of labor Duration of first stage of labor Definition of second stage of labor Mechanism of second stage of Mechanism of the third stage of Mechanisms of placenta examination NB: ns p >0.05 Table (4): Distribution of studied sample according their pre intervention knowledge about practical skills of labor stages (N=120). Control group (N=60) (N=60) Incorrect Item Correct Incorrect P Correct value Aim of perineal care Aim of vaginal examinations Aim of abdominal examinations Definition of the partogram 94 Study group No % No % No % No % 52 86.7 8 13.3 51 85.0 9 15.0% 0.069 >0.05 43 71.7 17 28.3 45 75.0 15 25.0% 0.170 >0.05 43 71.7 17 28.3 42 70.0 18 30.0% 0.040 >0.05 49 81.7 11 18.3 45 75.0 15 25.0% 0.786 >0.05 Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules Value of the partogram Components of the partogram Signs of fetal distress 45 75.0 15 25.0 40 66.7 20 33.3% 1.00 >0.05 43 71.7 17 28.3 40 66.7 20 33.3% 0.352 >0.05 44 73.3 16 26.7 46 76.7 14 23.3% 0.178 >0.05 P > 0.05 Table (5): Distribution of studied sample according their knowledge post intervention (N=120). Post-intervention Study group Control group (N=60) (N=60) Incorrect Correct Incorrect Correct Knowledge Definition of normal labor Factors affecting labor Chi square test P value No % No % No % No % 14 23.3 47 78.3 46 76.7 13 21.7 36.31 <0.001** 24 40.0 37 61.7 36 60.0 23 38.3 5.63 <0.05* 7 11.7 53 88.3 53 88.3 7 11.7 70.53 <0.001** 10 16.7 50 83.3 50 83.3 10 16.7 53.33 <0.001** 14 23.3 45 75.0 46 76.7 15 25.0 32.04 <0.001** 5 8.3 55 91.7 55 91.7 5 8.3 83.33 <0.001** Differences between True and False Labor Pain Premonitory Symptoms and Signs of Labor Sure signs of labor Characteristic of uterine contraction P<0.001** Table (6): Distribution of studied sample according their knowledge about practical skills of stages of labor at post intervention (N=120). Study group (N=60) Incorrect Correct Knowledge Aim of perinea care Aim of vaginal examination Control group (N=60) Incorrect Correct Chi square test P value No % No % No % No % 0 0.0 38 63.3 60 100.0 22 36.7 55.61 <0.001** 7 11.7 43 71.7 53 88.3 17 28.3 44.43 <0.001** 12 20.0 34 56.7 48 80.0 26 43.3 17.06 <0.001** 2 3.3 42 70.0 58 96.7 18 30.0 57.41 <0.001** 2 3.3 38 63.3 58 96.7 22 36.7 48.60 <0.001** 5 8.3 35 58.3 55 91.7 25 41.7 33.75 <0.001** 0 0.0 45 75.0 60 100.0 15 25.0 72.00 <0.001** Aim of abdominal examination Definition of the partogram Value of the partogram Components of the partogram Signs of fetal distress P <0.001** Menoufia Nursing Journal, Vol.4, No. 1, May 2019 95 Effect of Simulation on Students' Achievement in Normal Labor Modules Table (7): Distribution studied sample according their practical skills of stages of labor at pre &post intervention (N=120). Time of evaluation Study group Adequate Inadequate Adequate Inadequate Chi square test P value No % No % No % No % 8 13.3 52 86.7 10 16.7% 50 83.3 0.796 >0.05 56 93.3 4 6.7 30 50.0% 30 50.0 27.74 <0.001** Pre-intervention Post-intervention Control group P. >0.05 P<0.001** Table (8): Distribution of mean score of studied sample practice regarding labor procedures immediately at the re demonstration phase (N=120). First trial Procedure Study group (N=60) Control group (N=60) Independent t test P value Mean ±SD Mean ±SD Perineal care 25.1200±.57159 24.0417±1.20483 6.26 <0.001** Abdominal examination 13.4478±2.12201 12.5733±.71376 3.02 <0.001** Vaginal examination 28.2350±1.85059 27.6167±1.07501 2.23 <0.001** Handling 17.9850±.65686 17.4250±.72384 4.43 <0.001** Assessment of fundus 23.4850±.61142 22.3333±.62887 10.17 <0.001** Placenta examination 14.5667±.94091 13.6250±.93711 5.49 <0.001** Newborn physical assessment 18.6667±.42850 17.4917±.96766 8.60 <0.001** P <0.001** Table (9): Distribution of mean score of studied sample regarding average practice score about labor procedures of both phases of assessment (N=120). Average score of the two different trials Study group Procedure (N=60) Mean ±SD Perineal care 25.1567±.54907 Abdominal examination 13.4903±2.11541 Vaginal examination 28.4017±1.31204 Handling 18.1117±.50727 96 Independe nt t test P value 24.2125±1.17154 5.85 <0.001** 12.7517±.58149 2.60 <0.001** 27.7458±.87272 3.22 <0.001** 17.4958±.70934 5.47 <0.001** Control group (N=60) Mean ±SD Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules Assessment of fundus 23.5425±.55722 Placenta examination 14.7042±.75981 Newborn physical assessment 18.7250±.33096 142.1320±3.52868 Total practice sore 22.3958±.63495 10.51 <0.001** 13.7250±.87781 6.53 <0.001** 17.6250±.73430 10.57 <0.001** 135.9517±2.40333 11.21 <0.001** P <0.001** Table (10): Distribution of studied sample regarding satisfaction score about simulation method (N=60). Satisfaction Agree Uncertain Disagree No % No % No % 44 73.3 12 20.0 4 6.7 47 78.3 9 15.0 4 6.7 motivating student to learn. 36 60.0 22 36.7 2 3.3 4. The method of simulation was suitable to the way of learning 39 65.0 16 26.7 5 8.3 41 68.3 15 25.0 4 6.7 41 68.3 13 21.7 6 10.0 1. The teaching methods used in this simulation were helpful and effective 2. The simulation provide student with a variety of learning materials and activities to promote the learning curriculum 3. The teaching materials used in this simulation were 5. Simulation covered critical content necessary for learning. 6. developing the skills and obtaining the required knowledge to perform necessary tasks in a clinical setting 7. Help in understanding the concepts covered in the simulation. 39 65.0 19 31.7 DISCUSSION Nowadays simulation is taking an solving important place in training and differential, education of healthcare professionals mastery learning (Guy et al , 2015)& .Simulations have been shown to be (Koh et al., 2010). an effective tool in traditional learning environments. Innovative advances in technology have introduced a variety of tools to enhance learning in higher education. Among these, simulations have been used to support a variation of cognitive learning styles, to facilitate higher-order thinking and problem skills, and to augment collaborative, and Several factors drive the increase of using simulation in nursing and health professional Inadequate clinical education. placement opportunities. Patient safety issues, as simulation allow health care practitioners to acquire the skills and experience required to protect patient Menoufia Nursing Journal, Vol.4, No. 1, May 2019 97 2 3.3 Effect of Simulation on Students' Achievement in Normal Labor Modules safety (Richardson & Claman, inaccurate assessment. or slow 2014). clinical decision making, the student Simulation is a teaching and learning has the opportunity to learn from the strategy that is increasingly used in experience. The primary aim of nursing education to prepare students simulation is to help the student for the clinical workplace. Simulation nurse. Achieve competence, linking is a practice that resembles reality. It their theoretical knowledge with has existed in nursing education in clinical practice (Ricketts, 2011). many forms and the first healthcare Simulation is an innovative and simulation manikins were introduced technologically advanced teaching in the early 1960s (Jeffries, 2007). and learning approach that combines As science, technology and education a have has experiential learning. The student and learns progressed; become a simulation sophisticated problem-based approach through with ‘doing’ and innovative learning and teaching ‘experiencing’, approach vast knowledge base, psychomotor skills spectrum of educational modalities. and clinical decision making based These ranges from computer games, on the information before them. role plays and skills-based trainers to (Kim, et al, 2016). patient manikins or human patient The present study is significantly simulation (Edgecombe, et al, 2013). supported The purpose of simulation is to hypothesis, achieve specific goals related to attention to stress the importance and learning or evaluation. Simulation utilization does not replace the need for learning education for improvement students' in the clinical practice setting, but achievement allows the student to develop their regarding assessment, critical thinking and enhancement of the students' clinical decision-making skills in a safe and skills. The aim of this work is to supportive encompassing environment a (Valler- study utilizing through which of simulation labor Jones et al., 2011). This also allows students' for the assessment and evaluation of labor modules. of the student demonstrates a mistake, Menoufia Nursing Journal, Vol.4, No. 1, May 2019 in our the performance process and simulation achievement the student performance, whereby if 98 research directing and effect their in on normal Effect of Simulation on Students' Achievement in Normal Labor Modules The discussion of the current study scenarios on the pediatric nursing was categorized in to three sections: students" and reported that there was characteristics, a significant difference between the knowledge and satisfaction of the study sample pretest regarding simulation methods. scores. Regarding characteristic of the This and posttest knowledge may be due to lack of students, the findings of the present knowledge related to labor because study revealed that nursing students students’ did not study this content in for both groups were in age ranged the previous curriculum. from 20:23 years with mean age Simulation is potential tools that help (21.43±1.98) (21.04±1.46) this the nursing students to practice in a accordance with real environment. It's a teaching Oh,(2015) who conducted a study to strategy that provides students with determine the effects of simulation artificial representation of a complex based learning real life for enabling them to learn in outcome of nursing students and a safe environment. it offers the founded that the mean age was opportunity for students to improve 21.44years old; more than half the intended learning outcomes such 65.27% of the students were aged as 21years old. knowledge There was no statistically significant reasoning difference between study and control satisfaction(Bezyack,2007). group regarding their knowledge Regarding about labor lecture contents pre practical skills of stages of labor, the intervention as definition of normal present study revealed that there was labor, difference between true and no statistically significant difference false premonitory between study and control groups of labor, regarding the aim of abdominal, mechanism of labor and signs of vagina and perineal care, definition, labor and characteristic of uterine value and components of partogram contractions. in addition to signs of fetal stress. finding is an training labor symptoms, in pain, stages This the finding was clinical skill performance, acquisition, ability and knowledge clinical student related to supported with Saied, (2017) who This conducted a study to "evaluate the Podlinski, (2016) who conducted a effect of using a simulation based study finding to is supported "evaluate Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect by of 99 Effect of Simulation on Students' Achievement in Normal Labor Modules Simulation Training on Nursing learning strategy", who indicated Students' Content Exam Scores", and that there was found that may limit the nursing satisfaction with learning by the student’s ability to learn and develop clinical simulation and that learner’s the necessary skills. confidence in their skills. This The current study revealed a highly may be due to lack of high knowledge knowledge about practical skills of statistical labor modules. between study and control group The present study indicated that regarding knowledge about practical studied skills groups statistical achieved significant highly difference significant during process difference of labor including aim of abdominal, vaginal regarding their knowledge about examination, labor lecture contents as definition of definitions, values and components normal labor, difference between true of partogram and signs of fetal and false labor pains, stages of labor, distress. This may be due to students mechanism of the simulation group had given a of labor and and perineal care, characteristic of uterine contractions. chance for demonstration and make a This result was matched with Omer, mistake and re-demonstration and (2016), who conducted a study to correction of their mistakes that had "explore the perception of 117 led nursing students on their satisfaction improving practical skills. and self-confidence after clinical In this respect, Pantelidis1, et al simulation experience", who reported (2016), who conducted study for Improvement of knowledge because evaluate methods used in simulation were environment of the course, as well as effective and gave them clear ideas the skills and knowledge acquired by of what is expected from them. These the participants , who founded that knowledge Students acquisition abilities to gaining the confidence general improved of educational their clinical knowledge and their ability to take improve their self-confidence. was action by diagnosing and intervening. al, As demonstrated by the pre- and (2015),who conducted a study to post- MCQs tests, students performed "evaluate better after the completion of the In addition congruent this with findings Agha medical , et students’ satisfaction with simulation based 100 seminar. Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules The present study illustrated that the This distribution of mean score of studied Zarifcanaiey, et al, (2016), who sample conducted study practice procedures regarding immediately labor at re- results effect of supported by to compare the integrated demonstration phase, had more a (simulation highly significant strategies) and the simulation based difference regarding their practical training on performance level at skills labor critical thinking ability of nursing including perineal care, abdominal students, who founded that the examination, vaginal examination, experimental group obtained higher handling performance statistical during process ,assessment of of fundus, and training critical score thinking significantly placenta examination and newborn difference than control group due to physical assessment this may be due positive effect of using integrated to improve student knowledge and methods on critical practice, problem retain solving information lecturer and gained from practical re- skills, clinical efficacy, academic achievement, and clinical competence. demonstration of the labor skill. the Regarding students satisfaction about distribution of mean score of studied simulation method, the result of this sample labor study showed that slightly more than procedures post intervention, had a three quarter of students of the highly significant studied sample agree with" the difference regarding their practical simulation provide student with a skills labor variety of learning materials and including perineal care, abdominal activities to promote the learning examination, vaginal examination, curriculum". While minority of them handling disagree with "help in understanding The current revealed practice regarding statistical during that process ,assessment of of fundus, placenta examination and newborn the physical assessment. This may be simulation. This may be attributed to due to the students’ performance the level sessions was increased by the concepts students take converted in the in the simulation opportunity procedures for application of integrated training performing on (stimulation videos and Noelle doll). mannequins in a simulation lab and seeing videos about labor procedures Menoufia Nursing Journal, Vol.4, No. 1, May 2019 101 Effect of Simulation on Students' Achievement in Normal Labor Modules (abdominal vaginal enables nursing students to gain new exanimation, perineal care, placental knowledge and build upon previous examination, and newborn physical skill. assessment). provides self-paced learning and Hall , (2013) supporting the present affords study finding, by evaluating the opportunity to make mistakes and effect of simulation based education learn from them, which cannot be on baccalaureate nursing students’ accomplished in the clinical setting. satisfaction and reporting that the Moreover, simulation training can students were very satisfied with the provide simulation learning activity. experiences to all nursing students by The examination, result of this study was Simulation nursing training also students standardized the learning enabling active experience. This congruent with Mould, et al, (2011), guides who assess the effect of simulation simulation for students in education. on student satisfaction and our attention to utilize confidence, who reported that a CONCLUSION Students who received simulation higher with based teaching acquired higher level learning by clinical simulation and of knowledge and practice than the learner confidence in their skills. students In addition to that omer, (2016), who academic teaching. reported that using simulation as a education RECOMMENDATION Simulation based teaching should be promote student satisfaction with integrated in the practice training for their learning and improve self- students before their contact with confidence. Simulations prepare the actual woman in the labor unit. learner strategy for satisfaction clinical student to for real-life experience and speed the transition to professional career. who received routine Research should be done to compare between simulation based teaching and other methods of teaching. The current study emphasized that, utilized of simulation on students’ achievement on labor modules as simulation training provides the nursing student with opportunities for active 102 involvement in learning, Reference Peisachovich, E., Gal, R., & Johnson, S. (2016): Experiences of undergraduate nursing students of standardized patient methodology in their transition Menoufia Nursing Journal, Vol.4, No. 1, May 2019 Effect of Simulation on Students' Achievement in Normal Labor Modules to nursing practice in Ontario Canada. Journal of Nursing Education and Practice, 7(3), 1–9. doi:10.5430/jnep.v7n3p1 Montagna,S., Omicini,A.(2016): Simulation & Multi-Agent Systems An Introduction Autonomous Systems Sistemi Autonomi, Universit_a di Bologna,10. Raymond, C, (2010): Do RolePlaying Simulations Generate Measureable and Meaningful Outcomes? A Simulation’s Effect on Exam Scores and Teaching Evaluations, International Studies Perspectives, 11( 1), pp.37-51. Shellenbarger, T., & Edwards, (2012): Clinical Simulation in Nursing 8(6), 249-255. Omer, T, (2016 Marzouk, T (2015): Effectiveness of simulated delivery room classes on practical achievement and satisfaction of maternity nursing students, Woman’s Health and Midwifery Nursing Department, Faculty of Nursing-Mansoura): Nursing Students’ Perceptions of Satisfaction and SelfConfidence with Clinical Simulation Experience, Journal of Education and Practice, 7 (5),131-136. Pantelidis1, P, Staikoglou1, N, Paparoidamis1, G, Drosos1, C, et al, (2016): Medical students’ satisfaction with the Applied Basic Clinical Seminar with Scenarios for Students, a novel simulation-based learning method in Greece, J Educ Eval Health Prof, 13: 13, 5. Zarifcanaiey, N, Amini, M, & Saadat, F, (2016): A comparison of educational strategies for the acquisition of nursing students’ performance and critical thinking, BMC medical education, 16, 294, 17. Agha S, Alhamrani A, Khan M. (2015): Satisfaction of Medical Students with Simulation based learning, Saudi Medical Journal, 36: 731-736. Saied, H. (2017): The Impact of Simulation on Pediatric Nursing Students’ Knowledge, Self-efficacy, Satisfaction, and Confidence, 8, (11). Hall R, Rachel M., (2013): Effects of High Fidelity Simulation on Knowledge Acquisition, SelfConfidence, and Satisfaction with Baccalaureate Nursing Students Using the SolomonFour Research Design. Electronic Theses and Dissertations. Mould, White,H., &Gallagher, R.,(2011):evaluation of critical care simulation series for undergraduate nursing students, contemporary nurse,38:180190. Oh, H., (2015): effect of simulation based training on the learning outcome of nursing students’. Advanced science and technology letters.88:251-255. Menoufia Nursing Journal, Vol.4, No. 1, May 2019 103