American Journal of Nursing Research
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American Journal of Nursing Research. 2019, 7(5), 846-855
DOI: 10.12691/ajnr-7-5-18
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Effect of Using Simulation on the Performance of Nursing Students toward Postpartum Period

Eman S. M. Ateya1, Houria A. Mohammed2, Nagwa M. Salem3, and Samar E. Abd EL Rauof3

1M.Sc. Community Health Nursing, Faculty of Nursing, Port Said University, Egypt.

2Manger of Health Technical Institute, Affiliated to Ministry of Health in Mansoura, Egypt

3Community Health Nursing, Faculty of Nursing, Mansoura University, Egypt

Pub. Date: August 12, 2019

Cite this paper:
Eman S. M. Ateya, Houria A. Mohammed, Nagwa M. Salem and Samar E. Abd EL Rauof. Effect of Using Simulation on the Performance of Nursing Students toward Postpartum Period. American Journal of Nursing Research. 2019; 7(5):846-855. doi: 10.12691/ajnr-7-5-18


Background: Using simulation as an educational tool in nursing education is not a new phenomenon. It becoming increasingly prevalent in the health care practice as there is inadequate opportunities for the nursing students to practice and refine psychomotor skills in care settings. So many institutions have a mission of producing qualified nurses with the requisite knowledge, attitudes and skills which done through adopted simulation models to improve the students' performance, promote their self-confidence and minimize the challenged that facing them during providing the clinical practices. This study aimed to assess the effect of using simulation on the performance of nursing students toward postpartum period. Methods: A nonequivalent control group pretest-posttest design was used which conducted at nursing skill lab of the Technical Health Institute affiliated to Minister of Health and Population in Mansoura, Egypt. Sample concluded of all enrolled students (130 females' students) in the academic year 2017/2018. One hundred students were in the experimental group and thirty students in the control group. Tools: Five tools were used for data collection: 1- Self-administered questionnaire to assess students' socio-demographic data, and academic characteristics, 2- Simulation-learning modules. 3- Self-administered questionnaire sheet to assess students' knowledge regarding the postpartum period, 4- Observation checklist to assess students' performance, 5-Students' perception scale. Results: The present study revealed that although there was no statistically significant difference between control and experimental groups in the pretest (p> 0.005), but there was a statistically significant difference between them in the immediate and follow up posttest (p<0.005). Conclusion: This study concluded that the majority of students in the experimental group had higher scores of knowledge and performance than the control group in the immediate and follows up posttest. Recommendation: This study was recommended to apply simulation learning method in educating and training the nursing students in all different fields of the nursing education.

simulation postpartum period knowledge performance nursing students

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[1]  Schofield, R., Ganann, R., Brooks, S., McGugan, J., Dalla Bona, K., Betker, C. & Watson, C. (2010). Community health nursing, vision for 2020: Shaping the future. Western, Journal of Nursing Research; Vol.33/ No.8, Pp: 1047-1068.
[2]  KEMPPAINEN V., TOSSAVAINEN K. & TURUNEN H. (2012). Nurses’ roles in health promotion practice, an integrative review, Health Promotion International Advance Access published August 10, 2012, Published by Oxford University Press, Vol. 12/2016, Pp: 01-12.
[3]  Juniarti, N., Zannettino, L., Fuller, J. D. & Grant, J. M. (2017). Defining Service Learning in Nursing Education: An Integrative Review, Article, Research Gate; Vol. 4/No.2 Agustus 2016, Pp: 200- 210, available at:
[4]  Benner, P., Sutphen, M., Leonard, V. & Day, L. (2010). Educating Nurses: A Call for Radical Transformation, Book Review, CJNR 2010, ISBN 978-0-470-45796-2, Vol. 42 /No. 2, Pp:141-143.
[5]  Valizadeh L., Amini A., Fathi-Azar E., Ghiasvandian Sh., Akbarzadeh B. (2013). The Effect of Simulation Teaching on Baccalaureate Nursing Students’ Self-confidence Related to Peripheral Venous Catheterization in Children: A Randomized Trial, Journal of Caring Sciences, Copyright (2013) by Tabriz University of Medical Sciences, Vol.2/ No.2, Pp:157-164.
[6]  Kapucu s. (2017). The Effects of Using Simulation in Nursing Education: A Thorax Trauma, Case Scenario, Original Article, International Journal of Caring Sciences, Vol.10| Issue 2, Pp: 1069-1073.
[7]  Arthur C., Levett-Jones T., Kable A. (2012). Quality Indicators for the Design and Implementation of Simulation Experiences, a Delphi study, Nurse Education Today, Australian learning & teaching council, The university of Newcastle Australia, Published by Elsevier Ltd, Vol.33/No.11, Pp:1357-1361.
[8]  Regan M. J. & Onello R. (2013). Knowledge, action and reflection: A theoretically based model for use with high fidelity simulation in nursing education, Reviews, Journal of Nursing Education and Practice, Published by Sciedu Press, Vol.3/ No.7, Pp: 106-113.
[9]  Pinar G., Knight C. C., Gaioso V. P., Watts P. I., Dailey K. D., Britt S. E., Catron K. S . & Zengul F. D. (2015). The Effects of High Fidelity Simulation on Nursing Students’ Perceptions and Self-Efficacy of Obstetric Skills, Research Article: Open Access, International Archives of Nursing and Health Care, ClinMed International Library, published by the Creative Commons Attribution License, ISSN: 2469-5823, Vol.1/ No.1, Pp: 2- 7.
[10]  Peisachovich, E., Gal, R., & Johnson, S. (2016). Experiences of undergraduate nursing students of standardized patient methodology in their transition to nursing practice in Ontario Canada, Journal of Nursing Education and Practice, Vol7/ No.3, Pp: 01-09.
[11]  Brewer E. P. (2011). Successful Techniques for Using Human Patient Simulation in Nursing Education, Profession and Society, Journal of Nursing Scholarship, published by Sigma Theta Tau International, Vol.43/ No.3, Pp: 311-317.
[12]  Kim J., Park J. & Shin S. (2016). Effectiveness of simulation-based nursing education depending on fidelity: a meta analysis, Research Article, Open Access, BMC Medical Education, Vol. 16/ No.152, Pp: 1-8.
[13]  Vincent-Lambert C. & Bogossian F. (2017). A guide for the assessment of clinical competence using simulation, Published in Auckland Park, South Africa, Published by Universitas 21 Health Sciences Group - U21 HSG, 2nd Edit., Pp: 1-35, Accessed on 15 June, 2019.
[14]  Guise, V., Chambers, M. &Valimaki M. (2012). What can virtual patient simulation offer mental health nursing education?, Journal of Psychiatric and Mental Health Nursing, Published by Blackwell, Vol.19/ No.5, Pp: 410-418.
[15]  Cant R. P. & Cooper S. J. (2015). The time is right for Web-based clinical simulation in nursing education, Review, Journal of Nursing Education and Practice, Published by Sciedu Press, ISSN 1925-4040, Vol. 5/ No. 11, Pp: 113-119.
[16]  Admasu K. (2015). Postnatal Care Blended Learning Module for the Health Extension Programme, Federal Democratic Republic of Ethiopia, Ministry of Health, Health Education and Training (HEAT) in Africa, UNICEF Unite for children, available at
[17]  World Health Organization (2015). Postnatal Care for Mothers and Newborns, Highlights from the World Health Organization 2013 Guidelines, WHO, USAID for the American people, Maternal and Child Health Integrated program, Maternal and Child Survival program, PP: 1-8.
[18]  Young B. C., Madden E. & Bryant A. S. (2015). What Happens after the Puerperium? Analysis of “Late” Postpartum Readmissions in California, Open Journal of Obstetrics and Gynecology, Open Journal of Obstetrics and Gynecology, Published by authors and Scientific Research Publishing Inc., 2015. 53016, Vol. 5, Pp: 123-127.
[19]  Fahey J. O. &Shenassa E. (2013). Understanding and Meeting the Needs of Women in the Postpartum Period: The Perinatal Maternal Health Promotion Model, Journal of Midwifery &Women’s Health, Original Review, printed by the American College of Nurse-Midwives, Vol.58, Pp: 613-621, available at
[20]  Yonemoto N., Dowswell T., Nagai S. & Mori R. (2014). Schedules for home visits in the early postpartum period, Evidence- Based Child Health: A Cochrane Review Journal, Official Journal of the European Pediatric Association, printed by John Wiley & Sons, Ltd., The Cochrane Library, Vol.9/Issue.7, PP:5-99.
[21]  Derricott B. & Crean H. J. (2016). Postpartum Care, Continuing Education (CEU) course for healthcare professionals, Online Nursing Continuing Education, printed by WILD IRIS MEDICAL EDUCATION INC, Pp: 1-32.
[22]  Timilsina S. &Dhakal R. (2015). Knowledge on Postnatal Care among Postnatal Mothers, Saudi Journal of Medical and Pharmaceutical Sciences, printed by Scholars Middle East Publishers, Dubai, United Arab Emirates, ISSN 2413-4929, Vol.1/ Issue. 4, PP:87-92.
[23]  Warren Ch. E. &Temmerman M. (2015). Exploring the quality and effect of comprehensive postnatal care models in East and Southern Africa, International Centre for Reproductive Health, Ghent (ICRH), Improving Sexual and Reproductive Health through research, training and Adapted Intervention, UNVERSITEIT GENT, ISBN: 9789078128335, Vol. 30/16, PP: 1-196.
[24]  Sørensen J. L., Vleuten C. V., Lindschou J., Gluud Ch., Østergaard D., LeBlanc V., Johansen M., Ekelund K., Albrechtsen Ch. K., Pedersen B. W., Kjaergaard H., Weikop P. &Ottesen B. (2013). In situ simulation versus off site simulation in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for randomized controlled trial, Study protocol, Open Access, printed by BioMed Central Ltd, Vol.14/No.220, PP:1-11.
[25]  Schams K. A. (2013). The Impact of High Fidelity Simulation on Situational Awareness of Cardiac Related Obstetric Emergencies in Novice Nurses, St. Catherine University, doctorate thesis of Nursing Practice (5-2013), Pp: 1-85.
[26]  Marzouk T. M. (2015). Effectiveness of simulated delivery room classes on practical achievement and satisfaction of maternity nursing students, Original Research, Journal of Nursing Education and Practice, Published by Sciedu Press, Vol. 5/ No. 8, Pp: 50-59.
[27]  Chen-Yeh Y., (2016). Undergraduate nursing students' perceptions of high-fidelity simulation-based learning, International archives nursing health care, Review Article: Open Access, ClinMed, International Library, ISSN: 2469-5823, Vol.2/ Issue 3, Pp: 1- 5.
[28]  Kapucu s. (2017). The Effects of Using Simulation in Nursing Education: A Thorax Trauma, Case Scenario, Original Article, International Journal of Caring Sciences, Vol.10| Issue 2, Pp: 1069-1073.
[29]  El-Gilany A., El-Wehady A. & El-Wasify M. (2012). Updating and validation of the socioeconomic status scale for health research in Egypt, Eastern Mediterranean Health Journal, La Revue de Santé de la Méditerranée orientale, Vol. 18/ No. 9, Pp: 962-968.
[30]  Ahmed E. M. & Mohamed S. M. (2016). Sim-Lab Versus Traditional Lab Training On Maternity Nursing Students' Satisfaction & Self-Confidence, IOSR Journal of Nursing and Health Science, Vol.5/ Issue 2, Pp: 108-115.
[31]  Oermann M. H. (2011). Toward Evidence-Based Nursing Education: Deliberate Practice and Motor Skill Learning, Guest Editorial, Journal of Nursing Education, Vol.50/ No.2, Pp: 63-64.
[32]  Oermann M.H., Kardong-Edgren S. E., Odom- Maryon T., Hallmark B. F., Hurd D., Rogers N., Haus C., MCColgan J. I., Snelson C., Dowdy S. W., Resurreccion L. A., Kuerschner D. R., Lamar J., Tennant M. N.& Smart D. A. (2011). Deliberate practice of motor skills in nursing education: CPR as exemplar, Teaching with Technology/ Motor Skills, Nursing education perspectives, PubMed, Vol. 32/ No.5, Pp: 311-315.
[33]  Sheha E. A., Soliman S. M. & Abd El-Mouty (2015). Effect of Using Simulation Learning in Home Visiting Module on Perception of Community Health Nursing Students, Medical Journal of Cairo University, Vol. 83/ No.1, Pp: 689-698.
[34]  Chiniara G., Cole G., Brisbin K., Huffman D., Cragg B., Lamacchia M. & Norman D. (2013). Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection, Medical Teacher, Published by Informa UK Ltd., Vol.35/ No.8, Pp: e1380-e1395.
[35]  Saied H. (2017). The Impact of Simulation on Pediatric Nursing Students’ Knowledge, Self-efficacy, Satisfaction, and Confidence, Journal of Education and Practice, ISSN 2222-1735, Vol.8/ No.11, 2017, Pp: 95-102.
[36]  Durmaz A., Dicle A., Cakan E. &Cakir S. (2012). Effect of screen-based computer simulation on knowledge and skill in nursing students' learning of preoperative and postoperative care management: a randomized controlled study, Comput Inform Nurs.,, Vol.30/ No4, Pp: 196- 203.
[37]  Zaky N. H. (2017). Effect of a Medium Fidelity Simulation Based Training on Nurses' Knowledge, Performance and Clinical Judgment of Postpartum Hemorrhage Management, IOSR Journal of Nursing and Health Science, Vol. 6/ Issue 2 Ver., Pp: 89-100.
[38]  Kamel F. F., Shoulah A. S., Azab A. E., Nour A. M. & Mahmoud S. I. (2010). Study the effectiveness of teaching the clinical administrative course by using computer based training in developing nurse intern administrative knowledge and skills at Benha university hospital, doctorate thesis.
[39]  Ameh C., Adegoke A., Hofman J., Ismail F. M., Ahmed F. M. & Broek N.V. (2012). The impact of emergency obstetric care training in Somaliland, Clinical Article, Somalia International Journal of Gynecology and Obstetrics, Maternal and Newborn Health Unit, Published by Elsevier Ireland Ltd, Vol. 117, Pp: 283-287.
[40]  Kumar N., Singh N. K. & Rudra S. (2016). Role of Simulation based teaching in Management of Postpartum Hemorrhage amongst Postgraduate Students of Department of Obstetrics and Gynecology: A Prospective Study, Future of Medical Education Journal, Vol. 6/ No.1, Pp: 31-35.
[41]  Abd Elhakm E. M. & Elbana H. M. (2018). Effect of Simulation Based Training on Maternity Nurses’ Performance and Self-confidence Regarding Primary Postpartum Hemorrhage Management, American Journal of Nursing Research, Published by Science and Education, 2018, Vol. 6/ No. 6, Pp: 388-397.
[42]  Karadag A., Caliskan N., Korkut H., Baykara Z. G. & Ozturk D. (2012). The effect of simulation training on the learning of some psychomotor skills by first year nursing students: the case of Turkey, Procedia - Social and Behavioral Sciences, SciVerse Science Direct, Published by Elsevier Ltd, Vol. 47, Pp: 781-785.
[43]  Ma, X. (2013). BSN Students’ Perception of Satisfaction and Self confidence After a Simulated Mock Code Experience: A Descriptive Study, Master of Science in Nursing Theses, School of Nursing, Cedarville University, Digital Commons @Cedarville, Vol. 8/ No. 2013, Pp: 01-38.
[44]  Omer, T. (2016). Nursing Students’ Perceptions of Satisfaction and Self-Confidence with Clinical Simulation Experience, Journal of Education and Practice, ISSN 2222-1735, Vol.7/ No.5, Pp: 131- 138, available at
[45]  McGowan L. W., McLaughlin D. F., Roddy U., Kirby C., Ferris J. & McCracken F. (2011). Evaluation of a management simulation exercise, Royal College of Nursing Education Conference, Belfast, University of Ulster, Pp: 1-19.