Learning by simulation – is it a useful tool for midwifery education?

Abstract

Background: In both undergraduate teaching and post-registration education, simulation is increasingly being used as a teaching tool within midwifery to teach both emergency situations and practice skills. Yet simulation may not suit the needs of all. It can increase stress, especially if it is related to assessing competency. A literature review was undertaken with the aim of exploring and facilitating a greater understanding of simulation as a learning strategy within midwifery from a pedagogical perspective. Methods: CINAHL Plus and Science Direct databases were searched using the search terms: simulation, drill and midwifery or obstetrics. Inclusion and exclusion criteria were applied, resulting in 15 studies being reviewed. These studies used both qualitative and quantitative methodologies so a thematic analysis was undertaken to identify the consistent themes. Findings: Eight themes were identified demonstrating that simulation is frequently used within midwifery education. Simulation supports feelings of confidence and self-efficacy but in order to be effective needs to include briefing, good communication, observation (witnessing peers/being observers), repetition, reflection/debriefing and evaluation. Lecturer preparation is important as is the realism of the simulation. Conclusion: Although simulation can improve confidence, it is less convincing as a determinant of skill acquisition/clinical ability. Ongoing caution is warranted before considering simulation as a substitute to clinical practice experience without further evidence of its impact on clinical outcomes. As exposure to clinical emergencies can be rare it is important to ensure that substitute education is appropriate. Simulated activities, that allow participants to establish expectations, seek clarification, collaborate, assess against an accepted standard and integrate reflections, can improve learning. Further research is necessary which recognises the expectant and observational nature of midwifery and how this could be incorporated into simulation activities. ABSTRACT: