Intranatal teaching for male students has been a great challenge worldwide. Generally, most male students face the brunt of gender bias when it comes to obstetrical education. Nurse educators strive continuously to promote competencies in students through various methods of teaching and learning. Simulation is one such strategy, where the student is exposed to real life-like clinical situation where they are trained to practice in safe clinical environment.
The nature of the learning background of undergraduate students in the field of obstetrics and gynecology nursing, especially in clinical skill has been a great challenge. This is particularly valid for male students because of many constraints they experience during clinical training including experience refusal by patients when compared to female students. In a survey of 181 patients attending a gynecology clinic, O’Flynn and Rymer (2002) found that significantly more patients allowed female students to observe their genital area and perform a pelvic examination compared to the male students (O’Flynn & Rymer, 2002). As a result, male students have been shown to have significantly less clinical experience compared to female students in key areas of obstetrics and gynecology (Zahid, et al, 2015).
In order to mitigate this challenge, the College of Nursing at Sultan Qaboos University decided to integrate the use of high fidelity simulation as a clinical teaching methodology, especially in Intranatal teaching of undergraduate male nursing students. However, while simulation based teaching has gained momentum in nursing education, some educators have continued to question its effectiveness in transferring knowledge to the students.
Methods:
High fidelity simulation was included to complement clinical teaching in the Intranatal area for male students. To analyze acceptance of students regarding simulation as paired method of clinical teaching, the team commenced a study to identify perceptions of male nursing students regarding their experience of Intranatal learning through simulation.
This study aimed at establishing a strong simulation framework to make the clinical learning of male students in maternity clinical education effective. It was justified as method of teaching for the reason that due to cultural barriers male students were not permitted to enter the labor room and provide nursing care to women in labor. High fidelity simulation was used as an alternative to meet the clinical learning objective of male students.
Qualitative data was collected from students who completed their clinical rotation in the maternity area during the academic year 2017/2018 using Focus Group Discussion interview method. Four focus groups of male nursing students participated in the guided interviews which were conducted to understand how they perceived high fidelity simulation in helping them achieve clinical learning objective of caring for a woman in the labor room.
Results:
Students verbalized that they found simulation to be very effective to learn the physiology of labour process. Since they were never allowed to witness the clinical scenario of labour process in real patients, witnessing the same in the high fidelity simulation manikin gave them deeper understanding of the physiology. One student mentioned the experience as “I understood the real life process so well and can now understand why no women will ever allow our presence in the labor room”.
Students also verbalized effectiveness of simulation in terms of their emotions that they felt the simulation process as real life experience with similar anxiety level as “….the scenario felt so real and the patient was so much in pain I wanted the scenario to end as soon as possible”.
At the end of the simulation students felt they were overwhelmed with real emotions during the scenario run “…I wanted to save the baby and was very happy when the baby was delivered”
Students verbalized the confidence they gained during the scenario run in absence of female counterparts as it gave them freedom to handle the female simulator. “I was happy that no female was observing me learning this except the instructor.” This comment may be attributed to the cultural barrier prevailing in this part of the world which emphasizes separation between male and females, which oftentimes hinders co-educational activities.
Conclusion:
The researchers concluded at the end of the study that male nursing students perceived simulation as the most effective way of intranatal clinical education in a society where cultural barriers are prevalent. As further evidence of their appreciation of this strategy, the students recommended that more simulation sessions should be planned, preferably alternating these sessions with regular clinical postings to complement their clinical learning.