Effects of simulation-based education on nurses’ and midwives’ knowledge and self-efficacy in preeclampsia care: a randomized controlled trial

This study aimed to assess the effects of simulation-based education on nurses’ and midwives’ knowledge and self-efficacy in caring for pregnant women with preeclampsia. Simulation in gynecology involves recreating routine or critical gynecologic events across the female lifespan for procedural and behavioral skills training, practice, assessment, and research. This randomized controlled trial was conducted between February 2019 and August 2020 at a university hospital in Istanbul. A total of 76 nurses and midwives were randomized, with 38 participants allocated to each group, whereas 61 participants with complete baseline and four-week outcome data were included in the current complete-case analysis (intervention, n = 30; control, n = 31). The sample consisted of 61 nurses and midwives who held at least a bachelor’s degree and had a minimum of six months of experience in obstetrics and delivery services. All participants in the intervention and control groups received online theoretical training on preeclampsia care. One week later, the intervention group participated in a simulation session using a standardized patient. Data were collected using the “Participant Information Form”, “Self-Efficacy Scale in the Follow-up and Care of Pregnant Women with Preeclampsia (SESPWP)”, “Preeclampsia Information Assessment Form”, “Objective Structured Clinical Assessment Form”, “Educational Practices Questionnaire (EPQ)”, and “Student Satisfaction and Self-Confidence in Learning Scale (SSSCLS)”. Posttest scores on the Preeclampsia Information Assessment Form were significantly higher in the intervention group than in the control group ( p < 0.05). Although no significant between-group difference was observed in SESPWP scores, within-group analysis showed a significant pretest-to-posttest increase in the intervention group ( p = 0.015). However the baseline-adjusted between-group effect was not statistically significant, the between-group difference in pre–post change was also not statistically significant. Scores on the EPQ and SSSCLS indicated high levels of satisfaction and positive evaluations of the simulation experience. Adding simulation-based training to shared online theoretical education was associated with higher baseline-adjusted knowledge at four weeks, although the between-group difference in pre-post change was not statistically significant in sensitivity analysis. No simulation-specific between-group effect on self-efficacy was demonstrated. Clinical Trial registration number: NCT04915794, first submitted date: 26.01.2021, Preeclamptic Pregnancy Care Education