Abstract
BackgroundMidwives are expected to support women with lactation initiation and maintenance. Midwifery students engaged in a simulation-based exercise (LactSim OSCE) where they role-played the clinician and the breastfeeding patient by wearing a high-fidelity breast model. We provided participants opportunities for reflecting in and on practice to compare their perceived self-confidence in clinical lactation skills to actual clinical performance. We also describe feasibility of implementing the LactSim OSCE with an emphasis on preparation and time spent on tasks during the OSCE.MethodsAudio-video recordings from the LactSim OSCE were viewed and assessed using a technical skills checklist by an independent rater and by the study participants as part of the self-reflection. Mixed data on participants’ self-efficacy in clinical lactation, experience with the LactSim OSCE, and self-assessment of clinical performance were collected in survey instruments and a focus group. Time spent on each component and clinical lactation skill during the LactSim OSCE was documented.ResultsImmediately following the LactSim OSCE, participants’ confidence in clinical lactation was high (5.7/7), but after a guided video reflection exercise, their self-efficacy was 4.4/7. Participants spent approximately 2 of the allotted 10 min per case scenario discussing the OSCE logistics due to inadequate preparation. Participants spent approximately 2 min of the total encounter performing hands-on clinical lactation skills by touching, looking at, or using the high-fidelity breast model worn by their peer.ConclusionWe described the development and evaluation of the first simulated experience in clinical lactation with all three components of fidelity: conceptual, psychological, and physical. Multiple opportunities for reflecting on performance allowed the nurse-midwifery students to evaluate their competence in decision-making, technical, and counseling skills which resulted in a more realistic approximation of their perceived self-confidence in breastfeeding skills. Another innovation of this pilot work is the documentation of how long a learner spends on various tasks relevant to lactation support in a simulated encounter. Our findings highlight the importance of providing multiple opportunities for self-reflection using guided video reflection and checklists for objective self-assessment in the clinical lactation field.
Highlights
Midwives are expected to support women with lactation initiation and maintenance
High-fidelity LactSim objective structured clinical exam (OSCE) where nurse-midwifery students took turns role-playing as a breastfeeding patient by wearing the Lactation Simulation Model (LSM)
While self-efficacy in clinical skills is a standard metric in high-fidelity simulations, our findings indicate that perceived self-efficacy was not a reliable outcome metric of immediate learning gains from the LactSim OSCE [29]
Summary
Midwifery students engaged in a simulation-based exercise (LactSim OSCE) where they role-played the clinician and the breastfeeding patient by wearing a high-fidelity breast model. Midwives are frontline providers of postpartum care, supporting mothers with breastfeeding initiation and maintenance [1, 2]. Throughout nursing, midwifery, and medical school, there are limited opportunities to actively practice skills because mothers often do not want trainees crowding their rooms and touching their newborns [4]. The clinical case scenario (conceptual fidelity) combined with the realistic nature of the clinic room and mock patient (psychological fidelity) enables the student to suspend disbelief and practice clinical skills in a way that leads to improved learning outcomes [7, 8].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
