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Nursing education, Obstetric nursing, Self-efficacy, Simulation training



  1. Ehmke, Sabrina DNP, RNC-OB, NPD-BC, PHN
  2. Swan, Marilyn PhD, RN
  3. Van Gelderen, Stacey DNP, MS, RNC-MNN, PHN
  4. Bourdeanu, Laura PhD


Purpose: The purpose of this study was to explore the impact of an obstetric emergency high-fidelity simulation on maternity nurses' perceived self-efficacy levels at three different time points.


Study Design: We used a quasi-experimental, repeated measures design.


Methods: A convenience sample of maternity nurses recruited from three institutions within a single rural health care system participated in simulation exercises at an academic high-fidelity simulation center. They completed the Obstetric Nursing Self Efficacy survey before, immediately after, and 2 months following the simulation.


Results: Twenty-nine nurses were included in the analysis. All were women and Caucasian. Most (72.4%) had a baccalaureate nursing degree, with an average nursing experience of 11 years (range 1 to 44 years), and <5 years of OB experience (55.1%). Self-efficacy scores were 55.62 (SD = 9.8), 58.93 (SD = 8.9), and 61.86 (SD = 9.5) for pre-, post-, and 2 months postsimulation, respectively. There were significant changes from self-efficacy scores before the simulation when compared with scores 2 months after the simulation (p < 0.001), with a medium effect size of .45.


Clinical Implications: High-fidelity simulation can improve maternity nurses' perceived self-efficacy in managing emergency obstetric clinical situations. Health care institutions should consider investing in high-fidelity simulation education or partnering with academic institutions that have simulation centers to promote maternity nurses' self-efficacy that can potentially translate into improved clinical skills and improved patient outcomes.