Objective: To evaluate the effectiveness of a combined virtual and clinical simulation strategy compared to virtual simulation alone and clinical simulation alone in the development of theoretical knowledge and clinical judgment among midwifery students, specifically in the management of preeclampsia. Study Population: 75 undergraduate midwifery students in the second cycle of their studies at the Universidad de Los Andes, Chile. Interventions: Group 1: Virtual and Clinical Simulation combined (VSim® case on preeclampsia followed by hands-on clinical simulation with a manikin). Group 2: Virtual Simulation only (VSim® case on preeclampsia). Primary Outcomes: Development of theoretical knowledge (measured by a test) on preeclampsia. Improvement in clinical judgment skills (assessed using the Lasater Clinical Judgment Rubric). Secondary Outcomes: Student satisfaction with the training. Perceived self-efficacy in managing preeclampsia. Usability of simulation platform Duration: The intervention lasts for 4 days. Pre- and post-tests will assess knowledge, clinical judgment, satisfaction, and self-efficacy. Methodology: A randomized controlled trial (RCT) with 35 participants divided equally into two groups. Each group will undergo either virtual simulation, or both. Data analysis will involve repeated measures ANOVA to assess the differences in learning outcomes between the groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
40
Participants will complete a 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.
Participants will complete the preeclampsia case scenario using the vSim® platform, allowing them to engage in virtual clinical decision-making.
Universidad de los Andes, Chile
Santiago, Santiago Metropolitan, Chile
RECRUITINGClinical Judgment in Managing Preeclampsia
Clinical judgment will be evaluated using 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.
Time frame: Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention).
Theoretical Knowledge on Preeclampsia
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 preeclampsia.
Time frame: Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention).
Satisfaction with the Learning Experience
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.
Time frame: Immediately after the assigned intervention
Perceived Self-Efficacy in Managing Preeclampsia
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.
Time frame: Pre-intervention (before randomization) and post-intervention (Immediately after the assigned intervention).
Usability of simulation platform
The usability of the virtual and clinical simulation platforms will be assessed using the System Usability Scale (SUS), a widely used questionnaire that evaluates the ease of use, efficiency, and satisfaction with the simulation platforms. This outcome will provide insight into how user-friendly the simulation technologies are for midwifery students. The total SUS score ranges from 0 (minimum) to 100 (maximum), where higher scores indicate better usability. A SUS score above 68 is considered above average usability, while scores below that are considered below average.
Time frame: Immediately after the completion of the assigned intervention.
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