title: Looking for zebras and finding horses: A qualitative narrative study of pre-RN licensure nursing Students' experience of a "normal" postnatal simulation.
abstract: BACKGROUND
  Simulation-based learning may be particularly useful in specialty nursing clinical rotations, such as maternal-newborn care, where pre-RN licensure nursing students typically have fewer clinical hours or 'hands-on' opportunities. Although simulated obstetric emergencies are frequently reported in the literature, childbirth and the postnatal period involve normal physiologic processes, and therefore a focus on "normal" challenges in immersive perinatal simulations may provide students with vital uniform clinical learning experiences.
  
  
  OBJECTIVE
  To explore the value and meaning of an uncomplicated immersive postnatal simulation-based experience for pre-RN licensure nursing students.
  
  
  METHODS
  Qualitative design using narrative analysis.
  
  
  METHODS
  Pre-RN licensure nursing program at a university in the northeastern United States.
  
  
  METHODS
  Narrative analysis was used to assess 229 written reflections from students following an uncomplicated, immersive postnatal simulation experience.
  
  
  RESULTS
  Themes identified through the analysis demonstrated that students experienced high anxiety in anticipation of the scenario, expecting a crisis to occur; students described looking for zebras as they searched for pathology but found "normality". Students derived confidence from performing assessments and making clinical decisions, moving from anxiety to relief as they concluded that the mother and infant were experiencing normal, rather than emergent, challenges of the postnatal period.
  
  
  CONCLUSIONS
  Most students found value in the experience, recognizing the importance of learning maternal-newborn nursing from a physiologic rather than pathologic perspective.
authors.affiliation: Yale School of Nursing, PO Box 27399, West Haven, CT 06516-7399, United States. Electronic address: allison.shorten@yale.edu.
authors.forename: Allison
authors.initials: A
authors.lastname: Shorten
authors.affiliation: Yale School of Nursing, PO Box 27399, West Haven, CT 06516-7399, United States. Electronic address: halley.ruppel@yale.edu.
authors.forename: Halley
authors.initials: H
authors.lastname: Ruppel
mesh_terms: D004508:Education, Nursing, Baccalaureate; D005260:Female; D006801:Humans; D033262:Narration; D009511:New England; D015402:Nursing Education Research; D016544:Patient Simulation; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D018794:Problem-Based Learning; D013338:Students, Nursing / Q000523:psychology*
keywords: Maternal-child nursing; Nursing education; Patient simulation; Postnatal care; Qualitative studies