Perception of Clinical Simulation Methodology Among Obstetrics Students at the Center for Health Training and Innovation, Universidad Viña del Mar
Abstract
Introduction: Clinical simulation has become a key educational strategy in health sciences, promoting critical thinking, technical proficiency, and decision-making. In Midwifery education, it supports the development of clinical competencies in a safe, structured environment. Understanding students’ perceptions of simulation-based learning is essential for continuous curricular improvement. Methods: A descriptive, observational study was conducted among 171 Obstetrics students at Universidad Viña del Mar during the second semester of 2024. Participants had previous exposure to high-fidelity simulation scenarios at the university’s Center for Health Training and Innovation (CEIS). Data were collected using a validated perception survey with Likert-scale items. Descriptive statistics, correlation analyses, and regression models were applied using GraphPad Prism 9.0. Results: The survey showed excellent internal consistency (Cronbach’s alpha coefficient= 0.94). Overall, student perception was highly positive: over 70% Agreed or Strongly Agreed on the educational value of simulation. Items related to critical thinking, decision-making, and clinical competence received the highest scores (>80% positive responses). A weak but statistically significant inverse correlation was found between academic year and perception scores (r = –0.20, p = 0.0054), suggesting a slight decline in perception among senior students. Conclusion: Obstetrics students perceive high-fidelity clinical simulation as a valuable and effective educational tool. The method supports both course-level learning and professional competencies. While satisfaction remains high across academic levels, refinement in scenario design and instructor training may enhance its impact, especially for advanced students. These findings reinforce the role of simulation in competency-based midwifery education.
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References
1. Astudillo Á, López MÁ, Cádiz V et al. Validación de la Encuesta de Calidad y Satisfacción de Simulación Clínica en Estudiantes de Enfermería. Ciencia y Enfermería 2017, 23, 133–45. https://doi.org/10.4067/S0717-95532017000200133.
2. Motola I, Devine LA, Chung HS et al. Simulation in healthcare education: a best evidence practical guide. Medical Teacher 2013, 35, e1511–30. https://doi.org/10.3109/0142159X.2013.818632.
3. INACSL Standards of Best Practice Committee, Sapp A, Bibin L et al. INACSL Standards of Best Practice: Simulation Design. Clinical Simulation in Nursing 2016, 12, S5–12. https://doi.org/10.1016/j.ecns.2016.09.005.
4. Thompson JB, Fullerton JT, Sawyer AJ et al. The International Confederation of Midwives: Global Standards for Midwifery Education (2010) with Companion Guidelines. Midwifery 2011, 27, 409–16. https://doi.org/10.1016/j.midw.2011.04.001.
5. Jolly L, Ooms A, Ransome H et al. Student midwives’ experiences of high-fidelity simulation in midwifery education: a qualitative systematic review. Nurse Education Today 2025, 152, 106779. https://doi.org/10.1016/j.nedt.2025.106779.
6. Brady S, Bogossian F, Gibbons K et al. The effectiveness of varied levels of simulation fidelity on integrated performance of technical skills in midwifery students. Nurse Education Today 2015, 35, 524–9. https://doi.org/10.1016/j.nedt.2014.11.005.
7. Cook DA, Hatala R, Brydges R et al. Technology-enhanced simulation for health professions education. JAMA 2011, 306, 978–88. https://doi.org/10.1001/jama.2011.1234.
8. Decker S, Sapp A, Bibin L et al. The impact of simulation debriefing process on learning outcomes: an umbrella review. Clinical Simulation in Nursing 2025, 101, 101715. https://doi.org/10.1016/j.ecns.2025.101715.
9. Almomani E, Sullivan J, Saadeh O et al. Reflective learning conversations model for simulation debriefing: a co-design process and development innovation. BMC Medical Education 2023, 23, 837. https://doi.org/10.1186/s12909-023-04778-0.
10. Stoodley C, McKellar L, Steen M et al. Simulation in midwifery education: a descriptive explorative study. Nurse Education in Practice 2020, 42, 102635. https://doi.org/10.1016/j.nepr.2019.102635.
11. Armijo-Rivera S, Machuca-Contreras F, Raul N et al. Characterization of simulation centers and programs in Latin America. Advances in Simulation 2021, 6, 41. https://doi.org/10.1186/s41077-021-00188-8.
12. Orjuela D, Osses M. Percepción de la simulación clínica como estrategia de enseñanza para el desarrollo de competencias transversales en terapia ocupacional. Cadernos Brasileiros de Terapia Ocupacional 2021, 29, 1–12. https://doi.org/10.1590/2526-8910.ctoao2199.
13. Altamirano-Droguett JE. La simulación clínica: un aporte para la enseñanza y aprendizaje en obstetricia. Revista Electrónica Educare 2019, 23, 1–21. https://doi.org/10.15359/ree.23-2.9.
14. Baptista RCN, Martins JCA, Pereira MFCR et al. Students’ satisfaction with simulated clinical experiences: validation of an assessment scale. Revista Latino-Americana de Enfermagem 2014, 22, 709–15. https://doi.org/10.1590/0104-1169.3295.2471.
15. Levett-Jones T, McCoy M, Lapkin S et al. The development and psychometric testing of the Satisfaction with Simulation Experience Scale. Nurse Education Today 2011, 31, 705–10. https://doi.org/10.1016/j.nedt.2011.01.004.
16. Muñoz LC. Formación profesional de la matrona/matrón en Chile: años de historia. Revista Chilena de Obstetricia y Ginecología 2020, 85, 115–22. https://doi.org/10.4067/S0717-75262020000200115.
17. Sharif S, Yap WS, Fun WH et al. Midwifery qualification in selected countries: a rapid review. Nursing Reports 2021, 11, 859–80. https://doi.org/10.3390/nursrep11040080.
18. Vermeulen J, Luyben A, O’Connell R et al. Failure or progress?: the current state of the professionalisation of midwifery in Europe. European Journal of Midwifery 2019, 3, 1–10. https://doi.org/10.18332/ejm/115038.
19. Kranz A, Schulz AA, Weinert K et al. Master’s programs in midwifery across OECD countries: a narrative review. European Journal of Midwifery 2024, 8, 1–30. https://doi.org/10.18332/ejm/188195.
20. Casas R, Freedman L, Ramm A et al. Chilean Medical and Midwifery Faculty’s Views on Conscientious Objection for Abortion Services. International Perspectives on Sexual and Reproductive Health 2020, 46, 25–33. https://doi.org/10.1363/46e0620.
21. Binfa L, Pantoja L, Valli L et al. Assessment of professional empowerment among midwives in Latin America. Midwifery 2024, 138, 104130. https://doi.org/10.1016/j.midw.2024.104130.
22. Zalewska K, Zarzycka D. Best educational techniques in high-fidelity simulation according to nursing students. International Journal of Environmental Research and Public Health 2022, 19, 14688. https://doi.org/10.3390/ijerph192214688.
23. Hallin K, Haggstrom M, Backstrom B et al. Correlations between clinical judgement and learning style preferences of nursing students. Global Journal of Health Science 2015, 8, 1–10. https://doi.org/10.5539/gjhs.v8n6p1.
24. Elendu C, Amaechi DC, Okatta AU et al. The impact of simulation-based training in medical education: a review. Medicine 2024, 103, e38813. https://doi.org/10.1097/MD.0000000000038813.
25. Zainal NH, Islam MA, Rasudin NS et al. Critical thinking and clinical decision making among registered nurses: a systematic review and meta-analysis. Nursing Reports 2025, 15, 175–90. https://doi.org/10.3390/nursrep15050175.
26. Carvajal N, Daza Arana JE, Urrea Arango DC et al. Nivel de satisfacción de la simulación clínica en estudiantes de fisioterapia. Retos 2023, 48, 60–8. https://doi.org/10.47197/retos.v48.93099.
27. Serna Corredor DS, Martínez Sánchez LM. La simulación en la educación médica: una alternativa para facilitar el aprendizaje. Archivos de Medicina 2018, 18, 447–54. https://doi.org/10.30554/archmed.18.2.2624.2018.
28. Martínez F, Montmany S, Rebasa P et al. Práctica clínica vs. simulación clínica: impacto en el aprendizaje de estudiantes de Medicina. Educación Médica 2025, 26, 101001. https://doi.org/10.1016/j.edumed.2024.101001.
29. Akaike M, Fukutomi M, Nagamune M et al. Simulation-based medical education in clinical skills laboratory. Journal of Medical Investigation 2012, 59, 28–35. https://doi.org/10.2152/jmi.59.28.
30. Dieckmann P, Torgeirsen K, Qvindesland SA et al. The use of simulation to prepare and improve responses to infectious disease outbreaks like COVID-19: practical tips and resources from Norway, Denmark, and the UK. Advances In Simulation 2020, 5, 3. https://doi.org/10.1186/s41077-020-00121-5.
31. Barlow M, Heaton L, Ryan C et al. The application of evidence-based best practice standards to simulation design: a scoping review. Clinical Simulation in Nursing 2024, 87, 101495. https://doi.org/10.1016/j.ecns.2023.101495.
32. Dreifuerst KT, Bradley CS, Johnson BK et al. Using debriefing for meaningful learning with screen-based simulation. Nurse Educator 2021, 46, 239–44. https://doi.org/10.1097/NNE.0000000000000930.
33. Fegran L, ten Ham-Baloyi W, Fossum M et al. Simulation debriefing as part of clinical teaching and learning. Nursing Open 2023, 10, 1217–33. https://doi.org/10.1002/nop2.1426.
34. Olvera Cortés HE, Fernández Rangel V, Hernández Moreno CA et al. Elementos esenciales del debriefing educativo en simulación clínica. Revista de Simulación en Ciencias de la Salud 2025, 4, 1–15. https://doi.org/10.22201/fm.30617243e.2025.4.111.
35. Niu Y, Liu T, Li K et al. Effectiveness of simulation debriefing methods in nursing education: a systematic review. Nurse Education Today 2021, 107, 105113. https://doi.org/10.1016/j.nedt.2021.105113.
36. Rueda-Medina B, Reina-Cabello JC, Buendía-Castro M et al. Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary training. Nurse Education in Practice 2024, 75, 103901. https://doi.org/10.1016/j.nepr.2024.103901.
37. Dubois N, Tonus C, Klenkenberg S et al. Massive open online course for faculty development needs in healthcare simulation. Advances in Simulation 2024, 9, 44. https://doi.org/10.1186/s41077-024-00318-y.
38. EuSim. Becoming Simulation Faculty: Advanced Facilitator Courses and Faculty Development in Europe [Internet]. 2024; [citado 2025 Dic 03]. Disponible en: https://eusim.org/.
39. Martins T, Santos F, Lumini MJ et al. Realistic simulation in nursing education: testing two scenario-based models. Nursing Open 2023, 10, 3326–35. https://doi.org/10.1002/nop2.1585.
40. Harrington DW, V S. Designing a simulation scenario. StatPearls 2025, 1–12. https://www.ncbi.nlm.nih.gov/books/NBK547670/.
41. Decker S, Alinier G, Crawford SB et al. Healthcare Simulation Standards of Best Practice: The Debriefing Process. Clinical Simulation in Nursing 2021, 58, 27–32. https://doi.org/10.1016/j.ecns.2021.08.011.
42. Svendsen BT, Petersen LF, Skjelsager A et al. Using simulation scenarios and a debriefing structure to promote feedback skills. Advances in Simulation 2024, 9, 39. https://doi.org/10.1186/s41077-024-00303-5.
43. Dennis D, Cipriano L, Mulvey G et al. Efficacy and effectiveness of a new model of peer-assisted simulation-based learning. International Journal of Environmental Research and Public Health 2022, 19, 4505. https://doi.org/10.3390/ijerph19084505.
44. Feng H, Luo Z, Wu Z et al. Effectiveness of peer-assisted learning in health professional education: a scoping review. BMC Medical Education 2024, 24, 1467. https://doi.org/10.1186/s12909-024-06434-7.
45. Alzaabi S, Nasaif M, Khamis AH et al. Medical students’ perception and value of peer learning in clinical skill development. JMIR Medical Education 2021, 7, e25875. https://doi.org/10.2196/25875.
46. Abildgren L, Lebahn-Hadidi M, Mogensen CB et al. Improving healthcare teams’ human factor skills using simulation-based training: a systematic review. Advances in Simulation 2022, 7, 12. https://doi.org/10.1186/s41077-022-00207-2.
47. Janighorban M, Yousefi H, Yamani N et al. Structural empowerment of midwifery students following simulation-based training. BMC Medical Education 2023, 23, 368. https://doi.org/10.1186/s12909-023-04365-3.
48. Casallas-Hernández N, Castillo-Daza CA, González-Guzmán VA et al. Acceptance and effectiveness of high-fidelity simulation in nursing education. Clinical Simulation in Nursing 2025, 105, 101765. https://doi.org/10.1016/j.ecns.2025.101765.
49. Jiménez-Álvarez JA, Guerra-Martín MD, Borrallo-Riego Á et al. Nursing students’ satisfaction with clinical simulation: a cross-sectional study. Nursing Reports 2024, 14, 3178–90. https://doi.org/10.3390/nursrep14040231.
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