title: A protocol for evaluating progressive levels of simulation fidelity in the development of technical skills, integrated performance and woman centred clinical assessment skills in undergraduate midwifery students.
abstract: BACKGROUND
  Simulation as a pedagogical approach has been used in health professional education to address the need to safely develop effective clinical skills prior to undertaking clinical practice. However, evidence for the use of simulation in midwifery is largely anecdotal, and research evaluating the effectiveness of different levels of simulation fidelity are lacking.Woman centred care is a core premise of the midwifery profession and describes the behaviours of an individual midwife who demonstrates safe and effective care of the individual woman. Woman centred care occurs when the midwife modifies the care to ensure the needs of each individual woman are respected and addressed. However, a review of the literature demonstrates an absence of a valid and reliable tool to measure the development of woman centred care behaviours. This study aims to determine which level of fidelity in simulated learning experiences provides the most effective learning outcomes in the development of woman centred clinical assessment behaviors and skills in student midwives.
  
  
  METHODS
  Three-arm, randomised, intervention trial.In this research we plan to:a) trial three levels of simulation fidelity - low, medium and progressive, on student midwives performing the procedure of vaginal examination;b) measure clinical assessment skills using the Global Rating Scale (GRS) and Integrated Procedural Performance Instrument (IPPI); andc) pilot the newly developed Woman Centred Care Scale (WCCS) to measure clinical behaviors related to Woman-Centredness.
  
  
  CONCLUSIONS
  This project aims to enhance knowledge in relation to the appropriate levels of fidelity in simulation that yield the best educational outcomes for the development of woman centred clinical assessment in student midwives. The outcomes of this project may contribute to improved woman centred clinical assessment for student midwives, and more broadly influence decision making regarding education resource allocation for maternity simulation.
authors.affiliation: School of Nursing & Midwifery, The University of Queensland, Ipswich Campus, Salisbury Road, Ipswich, QLD 4035, Australia. s.brady@uq.edu.au
authors.forename: Susannah
authors.initials: S
authors.lastname: Brady
authors.forename: Fiona
authors.initials: F
authors.lastname: Bogossian
authors.forename: Kristen
authors.initials: K
authors.lastname: Gibbons
authors.forename: Andrew
authors.initials: A
authors.lastname: Wells
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyon
authors.forename: Donna
authors.initials: D
authors.lastname: Bonney
authors.forename: Melanie
authors.initials: M
authors.lastname: Barlow
authors.forename: Anne
authors.initials: A
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D008880:Midwifery / Q000193:education* / Q000592:standards; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards; D010808:Physical Examination / Q000379:methods / Q000592:standards; D055815:Young Adult