title: The effects of simulated patients and simulated gynecologic models on student anxiety in providing IUD services.
abstract: BACKGROUND
  Midwifery students experience high levels of stress during their initial clinical practices. Addressing the learner's source of anxiety and discomfort can ease the learning experience and lead to better outcomes. The aim of this study was to find out the effect of a simulation-based course, using simulated patients and simulated gynecologic models on student anxiety and comfort while practicing to provide intrauterine device (IUD) services.
  
  
  METHODS
  Fifty-six eligible midwifery students were randomly allocated into simulation-based and traditional training groups. They participated in a 12-hour workshop in providing IUD services. The simulation group was trained through an educational program including simulated gynecologic models and simulated patients. The students in both groups then practiced IUD consultation and insertion with real patients in the clinic. The students' anxiety in IUD insertion was assessed using the "Spielberger anxiety test" and the "comfort in providing IUD services" questionnaire.
  
  
  RESULTS
  There were significant differences between students in 2 aspects of anxiety including state (P < 0.001) and trait (P = 0.024) and the level of comfort (P = 0.000) in providing IUD services in simulation and traditional groups. "Fear of uterine perforation during insertion" was the most important cause of students' anxiety in providing IUD services, which was reported by 74.34% of students.
  
  
  CONCLUSIONS
  Simulated patients and simulated gynecologic models are effective in optimizing students' anxiety levels when practicing to deliver IUD services. Therefore, it is recommended that simulated patients and simulated gynecologic models be used before engaging students in real clinical practice.
authors.affiliation: Women Health Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Talat
authors.initials: T
authors.lastname: Khadivzadeh
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Erfanian
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000517:prevention & control*; D002983:Clinical Competence; D003198:Computer Simulation; D003200:Computer User Training; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D007492:Iran; D008880:Midwifery / Q000193:education*; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D016544:Patient Simulation; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult