Clinical Competence, Education, Health, Midwifery Students Education, Simulation Training, Virtual Simulation
Conditions
Keywords
virtual simulation, clinical simulation, clinical judgment, randomized clinical trial, preeclampsia
Brief summary
Objective: To evaluate the effectiveness of combined virtual and high-fidelity clinical simulation compared with virtual simulation only on theoretical knowledge and clinical judgment in undergraduate midwifery students managing severe preeclampsia. Study Population: Thirty-two undergraduate midwifery students enrolled in a maternal health clinical course at Universidad de los Andes, Chile. Interventions: Group 1 (intervention): Virtual and Clinical Simulation combined (VSim® case followed by hands-on clinical simulation with a manikin). Group 2 (control): Virtual Simulation only (VSim® case). Primary Outcomes: Development of theoretical knowledge (measured by a test) on severe preeclampsia. Improvement in clinical judgment skills (assessed using the Spanish Lasater Clinical Judgment Rubric). Secondary Outcomes: Student satisfaction with the training. Perceived self-efficacy in managing severe preeclampsia. Duration: The intervention period lasted five days, including baseline assessment, access to learning activities, and post-intervention evaluation. Methodology: Randomized controlled trial with parallel groups (1:1 allocation). Changes over time and differences between groups were analysed using linear mixed-effects models.
Interventions
OTHERCombined Virtual and Clinical Simulation
Participants will complete a severe preeclampsia case scenario through virtual simulation first and then engage in a clinical simulation involving the same case. This sequential intervention is designed to reinforce knowledge and skills.
OTHERvirtual simulation
Participants will complete the severe preeclampsia case scenario using the vSim® platform, allowing them to engage in virtual clinical decision-making.
Sponsors
Universidad de los Andes, Chile
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors were blinded to group allocation to minimise assessment bias. Evaluators were not informed whether participants belonged to the virtual simulation only group or the combined virtual and clinical simulation group. For clinical judgment assessment, performance was evaluated using the Spanish Lasater Clinical Judgment Rubric. All participants were identified using unique codes, and assessors received only coded performance records without any information regarding group assignment. This procedure ensured that outcome evaluation was conducted independently and without knowledge of the educational intervention received.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Enrollment Status: Students in the second cycle of the midwifery program at the University of Los Andes. * Educational Background: Participants must have completed the foundational courses in obstetrics and gynecology, as well as their initial clinical rotations. * Consent: Participants must provide written informed consent to participate in the study.
Exclusion criteria
* Previous Clinical Experience: Students who have had prior clinical experience in high-risk obstetric units, or in preeclampsia management, will be excluded. * Other Professional Backgrounds: Individuals with a degree or professional certification in obstetric or gynecological nursing (e.g., technicians with a title in obstetric nursing) will not be eligible. * Exchange Students: Midwifery students participating in exchange programs will not be permitted to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Judgment in Managing Preeclampsia | Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention). | Clinical judgment will be evaluated using the Spanish version of the Lasater Clinical Judgment Rubric (LCJR), a tool designed to assess the ability to observe, interpret, respond, and reflect in clinical situations. The rubric will be applied during a standardized clinical simulation scenario for preeclampsia management. The LCJR consists of 11 items, each rated on a scale from 1 to 4, for a total score ranging from 11 (minimum) to 44 (maximum). Higher scores indicate better clinical judgment and a more effective ability to manage clinical situations. |
| Theoretical Knowledge on Preeclampsia | Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention). | Theoretical knowledge will be assessed using a 10-item multiple-choice questionnaire specifically developed for this study, based on concepts from the American College of Obstetricians and Gynecologists (ACOG) and best practices for item construction. The test will be applied before and after the intervention to compare knowledge gains. The questionnaire will have a total score range of 0 (minimum) to 10 (maximum), with higher scores indicating better theoretical knowledge of severe preeclampsia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction with the Learning Experience | Immediately after the assigned intervention | The satisfaction of participants with the educational interventions will be measured using the Clinical Simulation Satisfaction Survey. This 15-item survey will use a 5-point Likert scale to gauge participants; satisfaction with the simulation activities. The scale ranges from 15 (minimum) to 75 (maximum). Higher scores indicate greater satisfaction with the educational interventions. |
| Perceived Self-Efficacy in Managing Preeclampsia | Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention). | Participants; perceived self-efficacy will be measured using the General Self-Efficacy Scale, validated for use in Chile. This scale contains 10 items rated on a 4-point Likert scale, assessing the participants' confidence in managing clinical situations like preeclampsia. The scale ranges from 10 (minimum) to 40 (maximum). Higher scores indicate greater perceived self-efficacy in managing clinical situations. |
Countries
Chile
Outcome results
None listed