title: Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial.
abstract: BACKGROUND
  Clinical simulations can provide students with realistic clinical learning environments to increase their knowledge, self-confidence, and decrease their anxiety prior to entering clinical practice settings.
  
  
  OBJECTIVE
  To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation.
  
  
  METHODS
  Randomized pretest-posttest design.
  
  
  METHODS
  A public research university in Canada.
  
  
  METHODS
  Fifty-six third year Bachelor of Science in Nursing students.
  
  
  METHODS
  Participants were randomized to either face-to-face or virtual clinical simulation and then to dyads for completion of two clinical simulations. Measures included: (1) Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM) (White, 2011), (2) knowledge pretest and post-test related to preeclampsia and group B strep, and (3) Simulation Completion Questionnaire. Before and after each simulation students completed a knowledge test and the NASC-CDM and the Simulation Completion Questionnaire at study completion.
  
  
  RESULTS
  There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations. Anxiety scores were higher for students in the virtual clinical simulation than for those in the face-to-face simulation. Students' self-reported preference was face-to-face citing the similarities to practicing in a 'real' situation and the immediate debrief. Students not liking the virtual clinical simulation most often cited technological issues as their rationale.
  
  
  CONCLUSIONS
  Given the equivalency of knowledge and self-confidence when undergraduate nursing students participate in either maternal newborn clinical scenarios of face-to-face or virtual clinical simulation identified in this trial, it is important to take into the consideration costs and benefits/risks of simulation implementation.
authors.affiliation: 58 Vancouver St., Yarmouth, NS, Canada. Electronic address: Shelley.Cobbett@Dal.Ca.
authors.forename: Shelley
authors.initials: S
authors.lastname: Cobbett
authors.affiliation: 5869 University Ave., PO Box 15000, School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada. Electronic address: erna.snelgrove-clarke@dal.ca.
authors.forename: Erna
authors.initials: E
authors.lastname: Snelgrove-Clarke
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D002170:Canada; D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate / Q000379:methods; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D016389:Maternal-Child Nursing / Q000193:education*; D011247:Pregnancy; D012649:Self Concept; D000066908:Simulation Training / Q000379:methods; D013338:Students, Nursing / Q000523:psychology*; D055815:Young Adult
keywords: Critical thinking; Maternal child; Nursing; Randomized controlled trial; Simulation; Students