Abstract: Nursing duties are often sensitive in nature and may contribute to feelings of inadequacy for students, especially when providing postpartum care. Our study assessed confidence levels among 61 junior baccalaureate nursing students before and after a simulation workshop with a follow-up survey administered after completion of two full clinical days on a postpartum unit. The four-hour simulation included stations for breast, fundus, and lochia exam skills. Overall confidence and confidence in performing patient assessments were significantly increased at postsimulation and follow-up (p < .001), demonstrating the efficacy of the simulation.

Clinical simulation is an effective teaching strategy that enhances student learning by decreasing anxiety (Hollenbach, 2016) and increasing satisfaction and confidence (Bambini, Washburn, & Perkins, 2009; Lewis & Ciak, 2011). Postpartum nursing can be sensitive in nature, and examination of the female breast, fundus (uterus), and lochia (vaginal discharge) may lead to feelings of inadequacy for nursing students. Simulation has been used successfully to prepare nursing students for other sensitive areas, for example, mental health nursing (Goh, Selvarajan, Chng, Tan, & Yobas, 2016). However, little research to date has examined the effects of simulation on the confidence levels of nursing students preparing for the sensitive and intimate care needs inherent to the maternity practicum.

Bambini et al. (2009) noted that confidence levels of 112 baccalaureate nursing students increased significantly after a 3-hour postpartum simulation workshop. Partin, Payne, and Slemmons (2011) qualitatively analyzed comments of 49 nursing students after a postpartum simulation experience with major themes including “feeling prepared for practice” and “enhancement of learning.” These studies support the use of simulation in the maternity setting; however, lack of diversity in participant characteristics (race-ethnicity, gender) limits generalizability of the findings. Therefore, the purpose of this study was to evaluate the effect of simulation on confidence levels (with pre- and postpartum care tasks) of a group of diverse nursing students at a large public university in California.