Midwifery students better approximate their self-efficacy in clinical lactation after reflecting in and on their performance in the LactSim OSCE

Advances in Simulation

Olivia S. Anderson¹  Aria Grabowski¹  Lisa Hammer¹  Muriel Bassil¹  Samantha A. Chuisano²  Anna Sadovnikova³  Ruth Zielinski⁴  Melisa Scott⁵ 

[1] Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, USA;LiquidGoldConcept, Inc., Ypsilanti, USA;LiquidGoldConcept, Inc., Ypsilanti, USA;Physician Scientist Training Program, Graduate Group in Nutritional Biology, University of California, Davis, Davis, USA;School of Nursing, University of Michigan, Ann Arbor, USA;University of Michigan, Ann Arbor, USA;

关键词: Breastfeeding education;    High-fidelity simulation;    Lactation simulation model;    Midwifery education;    Observed structured clinical examination;    Self-reflection;    Abbreviations;    LactSim Lactation simulation;    OSCE Objective structured clinical exam;    LSM Lactation simulation model;    IBCLC International Board-Certified Lactation Consultant;   

DOI  :  10.1186/s41077-020-00143-z

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY