مقایسه تأثیر آموزش مبتنی بر شبیه‌سازی، تلفیقی و سخنرانی بر مهارت شناختی ماماها در اداره پره‌اکلامپسی و اکلامپسی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 دانشیار گروه آمار زیستی و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: پره‌اکلامپسی به عنوان یک مشکل جهانی سلامت زنان مطرح شده است. آموزش ماماها جهت کسب صلاحیت لازم برای مدیریت بحران­های مامایی از جمله پره‌اکلامپسی و اکلامپسی ضروری می­باشد، لذا مطالعه حاضر با هدف مقایسه تأثیر آموزش مبتنی بر شبیه‌سازی، تلفیقی و سخنرانی بر مهارت شناختی ماماها در اداره پره‌اکلامپسی و اکلامپسی انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1395 بر روی 90 ماما در بیمارستان­های منتخب شهر مشهد انجام شد. ماماها با استفاده از جدول اعداد تصادفی به سه گروه آموزش شبیه‌سازی، تلفیقی و سخنرانی تقسیم شدند. گروه شبیه‌سازی به مدت 6 ساعت در مرکز مهارت‌های بالینی، گروه تلفیقی به مدت 4 ساعت سخنرانی و سپس به مدت یک هفته از طریق وب سایت آموزشی و گروه سخنرانی به مدت 6 ساعت به صورت سخنرانی آموزش دیدند. قبل و 2 هفته بعد از مداخله، آزمون مهارت شناختی گرفته شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 23) و آزمون­های تی زوجی، آنالیز واریانس یک‌طرفه، ویلکاکسون و کروسکال والیس انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین نمره مهارت شناختی ماماها در هر سه گروه قبل از آموزش تفاوت آماری معنی‌داری نداشت (05/0<p). میانگین نمره مهارت شناختی ماماها 2 هفته بعد از آموزش در هر سه گروه افزایش معنی‌داری داشت (001/0>p) و بر اساس نتایج مقایسه بین‌گروهی، میانگین نمره مهارت شناختی در گروه تلفیقی و سخنرانی به‌طور معنی‌داری بیشتر از گروه شبیه‌سازی بود (001/0>p)، اما اختلاف معنی‌داری در میانگین نمره مهارت شناختی بین دو گروه تلفیقی و سخنرانی وجود نداشت (869/0=p).
نتیجه‌گیری: آموزش مبتنی بر شبیه‌سازی، تلفیقی و سخنرانی، باعث افزایش مهارت شناختی ماماها در اداره پره‌اکلامپسی و اکلامپسی گردید که در گروه آموزش تلفیقی و سخنرانی بیشتر از گروه شبیه‌سازی بود و با توجه به اینکه روش تلفیقی، روشی فعال و فراگیر محور است، بنابراین می­توان از روش تلفیقی برای آموزش اورژانس­های مامایی استفاده کرد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the Effects of Simulation-Based Training, Compilation Training, and Lectures on the Cognitive Skills of Midwives in the Management of Preeclampsia and Eclampsia

نویسندگان [English]

  • Maryam Tabatabaeian 1
  • Masoumeh Kordi 2
  • Salmeh Dadgar 3
  • Habibollah Esmaily 4
  • Talat Khadivzadeh 5
1 M.Sc. in Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Associate Professor, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Preeclampsia is a global health concern in women. Midwifery education is essential to acquiring the necessary skills to manage midwifery crises, such as preeclampsia and eclampsia. The present study aimed to compare the effects of simulation-based training, compilation training, and lectures on the cognitive skills of midwives in the management of preeclampsia and eclampsia.
Methods: This clinical trial was conducted on 90 midwives employed in the hospitals in Mashhad, Iran in 2016. Participants were divided into three groups of simulation-based training, compilation training, and lecture using a random number table. The simulation group received training for six hours at the Center for Clinical Skills. Subjects in the compilation group were trained for four hours through lectures and an educational website for a week. Participants in the lecture group received training for six hours through lectures. Before and two weeks after the intervention, a cognitive skills test was performed on the midwives. Data analysis was performed in SPSS version 23 using descriptive statistics (frequency distribution, frequency percentage, standard deviation, mean), paired t-test, one-way ANOVA, Wilcoxon test, and Kruskal-Wallis test at the significance level of P<0.05.
Results: Before the training, mean score of cognitive skills was not significant in the study groups (P<0.05), while it increased significantly in all the groups after two weeks of training (P<0.001). In addition, mean score of cognitive skills was significantly higher in the compilation training and lecture groups compared to the simulation-based training group (P<0.001). However, no significant difference was observed in the mean score of cognitive skills between the compilation training and lecture groups (P=0.869).
Conclusion: According to the results, simulation, compilation, and lectures could effectively enhance the cognitive skills of midwives in the management of preeclampsia and eclampsia, while the improvement was more significant in the compilation training and lecture groups compared to the simulation group. Considering that compilation training is an active, learner-oriented method, it is recommended for the training of midwives in emergencies.

کلیدواژه‌ها [English]

  • Simulation-based Training
  • Lectures
  • Midwifery
  • Preeclampsia
  • Eclampsia
  1. Cekmen MB, Erbagci AB, Balat A, Duman C, Maral H, Ergen K, et al. Plasma Lipid and Lipoprotein concentrations in Pregnancy-induced hypertention. Clin Biochem 2003; 36(7):575-8.
  2. Kahnameoe F, Asadzadeh MF. Assessing the quality of perinatal care in women with preeclmpsia-eclmpsia at Aslavi Hospital in Ardabil, Iran, 2000-2001. Med J Tabriz Univ Med Sci 2004; 38(63):76-80. (Persian)
  3. Afshari P, Sheinizadeh S, Ranjbari A, khalilinejad F. Maternal periodontitis, preeclampsia and adverse pregnancy outcomes. J Midwifery Reprod Health 2013; 1(1):19-25.
  4. Safary M, Yazdan PP. Prevalence of pre-eclampsia and its correlated maternal and fetal complications, Emam Sajjad Hospital, Yasuj, 2001. Shahrekord Univ Med Sci J 2003; 5(2):47-53.
  5. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics. 24th ed. New York: Mcgraw-Hill; 2014.
  6. Taghizadeh ZI, Rezaeipour A, Kazemnejad AN, Golboni F. Effect of positive predictive value of serum hematocrit levels on early detection of preeclampsia. J Hayat 2009; 15(2):39-45. (Persian).
  7. Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi JM. Pre-eclampsia: pathophysiology, diagnosis and management. Vascular Health Risk Manag 2011; 7:467-74.
  8. Ruhl C. Association of women's health, obstetric and neonatal nurses. 3rd ed. Philadelphia, PA: Wolters Kluwer/Lippincott, Williams, & Wilkins; 2008.
  9. Mirzabeygi A. Lesson planning and course plan in formal education and personal training. Tehran: Yasteron; 2008. (Persian).
  10. Kadivar P. Educational psychology. Tehran: Centre for Research and Development of Human Sciences; 2013. (Persian).
  11. Saif AA. Educational measurement, assessment and evaluation. 4th ed. Tehran: Doran Publications; 2006. (Persian).
  12. Petchtone P, Chaijaroen S. The development of web-based learning environments model to enhance cognitive skills and critical thinking for undergraduate students. Proc Soc Behav Sci 2012; 46:5900-4.
  13. Whyte J, Ward P, Eccles DW, Harris KR, Nandagopal K, Torof JM. Nurses’ immediate response to the fall of a hospitalized patient: a comparison of actions and cognitions of experienced and novice nurses. Int J Nurs Stud 2012; 49(9):1054-63.
  14. 39. Shabani H. Instructional skills (Methods and Techniques of Teaching). 23th ed. Tehran: Samt; 2010.
  15. Lake S, McInnes RJ. Exploring cognitive skill development in midwifery education. Nurse Educ Practice 2012; 12(5):264-8.
  16. Koleini N, Farshidfar F, Shams B, Salehi M. Problem based learning or lecture, a new method of teaching biology to first year medical students: an experience. Iran J Med Educ 2003; 3(2):57-63.
  17. Karimi Moonaghi H, Mohammady A, SalehMoghaddam A, Gholami H, Karshki H, Zamanian N. Comparing the effects of cooperative learning to lecture trainings on the motivational beliefs and self-regulating learning strategies. Iran J Med Educ 2014; 14(5):393-402.
  18. Brady S, Bogossian F, Gibbons K, Wells A, Lyon P, Bonney D, et al. 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. BMC Med Educ 2013; 13(1):72-9.
  19. Haghani F, Ehsani M, Jafari MS. Simulation, strides in development of medical education. J Med Educ Dev 2014; 11(2):272-9. (Persian).
  20. Johnson PG, Fullerton JT. Midwifery education models a contemporary review. J Midwifery Womens Health 1998; 43(5):351-7.
  21. Garrison DR, Voughan ND. Blended learning in higher education: framework, principles and guidelines. Trans: Zavarki A, Ramezani S, Saeidpoor M. Tehran: Avaynoor; 2015. (Persian).
  22. Fisher N, Bernstein PS, Satin A, Pardanani S, Heo H, Merkatz IR, et al. Resident training for eclampsia and magnesium toxicity management: simulation or traditional lecture? Am J Obstet Gynecol 2010; 203(4):379.e1-5.
  23. Gordon JA, Shaffer DW, Raemer DB, Pawlowski J, Hurford WE, Cooper JB. A randomized controlled trial of simulation-based teaching versus traditional instruction in medicine: a pilot study among clinical medical students. Adv Health Sci Educ 2006; 11(1):33-9.
  24. Baniyaghoobi F, Aliyari S, Sharifi FS, Pishgooei A. Effect of radiation injured management education by web-based method on cognition learning levels of nursing students. J Nurses Phys Within War 2014; 2(3):72-80. (Persian).
  25. Gilbert ES. Manual of high risk pregnancy and delivery. 4th ed. New York: Elsevier Health Sciences; 2007.
  26. Ghare Khani P, Sadation SA. Cardinal manifestations & management of diseases. Tehran: Noordanesh Publication; 2007. (Persian).
  27. Fraser D, Cooper MA. Myles textbook for midwives. 15th ed. Mashhad: Parastaran Javan; 2009. (Persian).
  28. Country Guide for the provision of midwifery and childbirth at maternity-friendly hospitals/Compilation of the group of authors. Ministry of Health and Medical Education, Office Family and population health, Mothers Health Office. Tehran: Char-e-Art; 2011.
  29. World Health Organization. Department of making pregnancy safer. Education material for teachers of midwifery: midwifery education modules, managing eclampsia. 2nd ed. Geneva: World Health Organization; 2008.
  30. Danforth DN. Danforth's obstetrics and gynecology. Philadelphia: Lippincott Williams & Wilkins; 2008.
  31. Clinical factors that have been associated with an increased risk of developing preeclampsia. UpToDate. Available at: URL: http://www.uptodate.com/contents/image?imageKey=OBGYN%2F61266&topicKey=OBGYN%2F6750&rank=1~150&source=see_link&search=preeclampsia+risk+factor&utdPopup=true; 2018.
  32. Valafir S. Safe maternity program: integrated care moms health mamma-doctor. Tehran: Ministry of Health and Medical Education, Family and Population Health Office, Mothers' Health Office; 2009. (Persian).
  33. Farshi M, Babatabar H, Nouri JN, Mahmodi H. Study of the effect of air evacuation and transport training using lecture method on nurses' level of learning. Iran J Crit Care Nurs 2012; 5(1):17-22.
  34. White A, Brannan J, Long J, Kruszka K. Comparison of instructional methods: cognitive skills and confidence levels. Clin Simulation Nurs 2013; 9(10):e417-23.
  35. Flood LS, Higbie J. A comparative assessment of nursing students' cognitive knowledge of blood transfusion using lecture and simulation. Nurse Educ Pract 2016; 16(1):8-13.
  36. Sajadi SA, Farsi Z. Simulation based education. J Educ Stud Center Army Univ Med Sci 2015; 3(2):21-30 (Persian).
  37. Zolfaghari M, Mehrdad N, Parsa Yekta Z, Salmani Barugh N, Bahrani N. The effect of lecture and e-learning methods on learning mother and child health course in nursing students. Iran J Med Educ 2007; 7(1):31-8.
  38. Daneshmandi M, Asgari A, Tadrisi S, Ebadi A, Mokhtari Nouri J. Effect of self-and buddy-aid education by lecture and multimedia software package methods on the knowledge level of personnel. J Mil Med 2011; 13(1):7-10.
  39. Fakari FR, Kordi M, Mazloom SR, Khadivzadeh T, Tara M, Akhlaghi F. Comparing the effect of traditional, web based and simulation training on the sustainability of knowledge and management skill postpartum hemorrhage in midwifery students. Iran J Obstet Gynecol Infertil 2014; 89(16):8-14. (Persian).
  40. Mafyan F, Nouhi E, Abbaszadeh A. Effect of blended electronic education on learning and self-efficiency in nursing students in the cardiovascular intensive care courses. J Nurs Educ 2014; 3(3):42-9. (Persian).
  41. Rashidi Fakari F. The effect of web-based and simulation-based education on midwifery students’ self-confidence in postpartum hemorrhage management. [Master Dissertation]. Mashhad: Mashhad University of Medical Sciences; 2015.
  42. Jonas D, Burns B. The transition to blended e-learning. Changing the focus of education delivery in children's pain managing. Nurse Educ Practice 2010; 10(1):1-7.
  43. Sadeghi R, Sedaghat MM, Ahmadi FS. Comparison of the effect of lecture and blended teaching methods on students’ learning and satisfaction. J Adv Med Educ Prof 2014; 2(4):146-50.
  44. Bahadorani M, Yousefy A, Changiz T. The effectiveness of three methods of teaching Medline to medical students: online, face to face and combined educational methods. Iran J Med Educ 2006; 6(2):35-43.
  45. Heidarzadeh A, Forozy MA, Kazemi M, Jahani Y. Comparing the effect of two methods of cardiopulmonary resuscitation education including computer-based stimulation and mannequin stimulation on nursing students' knowledge and satisfaction. J Med Educ Dev 2015; 8(17):12-20.
  46. Hajrezayi B, Roshani HA, Shahalizade M, Zeynali M, Badali M. Effectiveness of blended learning on critical thinking skills of nursing students. J Nurs Educ 2015; 14(1):49-59.
24.     Kiviniemi M. Effects of a blended learning approach on student outcomes in a graduate-level public health course. BMC Med Educ 2014; 14:47. 
Saeidpoor M, Tabasi SZ. Blended learning: a new approach to the application of e-learning. Horizons Med Educ Dev 2010; 4(1):56-63. (Persian).