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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
32
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.
Participants will complete the severe 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
Clinical Judgment in Managing Preeclampsia
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.
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 severe 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).
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