Computer-Assisted Versus Traditional Classroom Instruction to Promote Change in the Nursing Management of the Second Stage of Labor

The intrapartum nurse’s knowledge of pushing and positioning techniques during the second stage of labor can impact a mother’s success for a vaginal delivery and the families birthing experience. Finding innovative ways to educate nurses about  new and revised evidence-based clinical guidelines in obstetrics is an ongoing problem for nurse educators. Constraints on healthcare budgets are recognized worldwide, impacting the amount of educational support available for staff development programs. Increased workloads, lost productivity and nursing shortages only compound the problem. Reduction in personnel costs, flexibility and convenience are convincing rationales for using computer-assisted instruction (CAI) in clinical staff development. An evidence-based study was conducted to compare knowledge acquisition and retention, modification in clinical practice and learner satisfaction using computer-assisted and traditional classroom instruction of positioning and pushing guidelines during the second stage of labor. The theory of andragogy by Malcolm Knowles formed the research underpinnings.

A randomized posttest only, two-group design was used. Intrapartum registered nurses in a women’s specialty hospital in South Central United States were recruited and randomized into an experimental and control group. The nurses all received the identical content with the experimental group using a computer module and the control group attending a lecture. The instruments included a demographic data form; a posttest administered immediately post-intervention and a 30-days post-instruction, a satisfaction scale and; a 30-day post-intervention questionnaire of pushing and positioning clinical practice.

A statistically significant difference (p<.05) was found for knowledge gained immediately and 30-days post-intervention. A statistically significant difference was found with overall satisfaction rates with CAI. No significant difference was found with reports of changes in clinical practice between the two groups. Overall, results indicated that CAI is an appropriate alternative to teaching intrapartum management of the second stage of labor, clinical practice guidelines in intrapartum staff nurse development.