Journal List > Korean J Women Health Nurs > v.20(4) > 1089484

Song: Effect of Simulation-based Practice by applying Problem based Learning on Problem Solving Process, Self-confidence in Clinical Performance and Nursing Competence



The purpose of this study was to analyze the effectiveness of simulation-based maternity nursing practice by applying problem based learning (PBL) on the problem solving process, self-confidence in clinical performance and nursing competence of nursing students.


This study was one group pre-posttest design, with 123 third year nursing students. Data were collected from March 19 to May 29, 2013 as the students completed their simulation practice class. Students completed a survey about their problem solving process, self-confidence, and nursing competence at the beginning and the end of the class.


Students' problem solving process, self-confidence, and nursing competence showed significant improvements after the simulation-based maternity nursing practice.


Therefore, it is recommended that current maternity nursing curriculum should be reviewed and improved, and the students should be provided variety of simulation-based education and maternity nursing skills.

Figures and Tables

Table 1
Comparison of Problem Solving Process before and after the Simulation-based Practice by applying Problem based Learning (N=123)
Table 2
Comparison of Self-confidence in Clinical Performance before and after Simulation-based Practice by applying Problem based Learning (N=123)
Table 3
Comparison of Nursing Competence before and after Simulation-based Practice by applying Problem Based Learning (N=123)
Table 4
Evaluation for Using of Birthing Simulator (N=123)

Summary Statement

▪ What is already known about this topic?
Simulation-based practice is an effective learning method in maternity nursing. It also helps nursing students to build up their self-confidence for clinical performance in childbirth and postpartum cares.
▪ What this paper adds?
PBL-integrated simulation practice provided a chance to learn by more practical experience with increased problem solving process, self-confidence, and nursing competence.
▪ Implications for practice, education and/or policy
It is necessary to develop simulation-based maternity nursing practice strategies such as construction of infrastructure including nurse practitioner and preceptors to increase the competence in nursing students.


1. Son YJ, Song YA. Effects of simulation and problem-based learning courses on student critical thinking, problem solving abilities and learning. J Korean Acad Soc Nurs Educ. 2012; 18(1):43–52.
2. Bremner MN, Aduddell K, Bennett DN, VanGeest JB. The use of human patient simulators: Best practices with novice nursing students. Nurse Educ. 2006; 31(4):170–174.
3. Roh YS, Cho ES, Lee WS. Analysis of main instructional design factors for simulation integrated PBL nursing courses. J Educ Inf Media. 2010; 16(1):125–143.
4. Song YA, Son YJ. Effects of simulation-based practice education for core skill of maternity nursing. Korean Parent Child Health J. 2013; 16(1):37–44.
5. Chung CW, Kim HS, Park YS. Effects of high-fidelity simulation-based education on maternity nursing. Perspect Nurs Sci. 2011; 8(2):86–96.
6. Park JH, Jung E, Ko JK, Yoo HB. Delivery training for undergraduate medical students using birth simulator. Korean J Obstet Gynecol. 2008; 51(9):950–956.
7. Reilly A, Spratt C. The perceptions of undergraduate student nurses of high-fidelity simulation-based learning: A case report from the University of Tasmania. Nurse Educ Today. 2007; 27(6):542–550.
8. Kim JY, Choi EY. Learning element recognition and academic achievement of nursing student receiving PBL with simulation education. J Korean Acad Adult Nurs. 2008; 20(5):731–742.
9. Lathrop A, Winningham B, VandeVusse L. Simulation-based learning for midwives: Background and pilot implementation. J Midwifery Womens Health. 2007; 52(5):492–498.
10. Jeffries PR. A framework for designing, implementing, and evaluating simulation used as teaching strategies in nursing. Nurs Educ Perspect. 2005; 26(2):96–103.
11. Back KS, Song AR, Kim YH, Kim TK. Relationship among satisfaction level with PBL-based clinical practice education, autonomy and achievement motivation. J East West Nurs Res. 2007; 13(2):92–106.
12. Lee WS, Cho KC, Yang SH, Roh YS, Lee GY. Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students. J Korean Acad Fundam Nurs. 2009; 16(1):64–72.
13. Kim SA, Lee SK, Chae HJ. Effects of clinical practice and simulation-based practice for obstetrical nursing. Korean J Women Health Nurs. 2012; 18(3):180–189.
14. Ackermann AD, Kenny G, Walker C. Simulator programs for new nurses' orientation: A retention strategy. J Nurses Staff Dev. 2007; 23(3):136–139.
15. Kim YH, Jang KS. Effect of a Simulation-based education on cardio-pulmonary emergency care knowledge, clinical performance ability and problem solving process in new nurses. J Korean Acad Nurs. 2011; 41(2):245–255.
16. Turcato N, Roberson C, Covert K. Simulation-based education: What's in it for nurse anesthesia educators. AANA J. 2008; 76(4):257–264.
17. Moule P, Wilford A, Sales R, Lockyer L. Student experiences and mentor views of the use of simulation for learning. Nurse Educ Today. 2008; 28(7):790–797.
18. Lee JS. The effects of process behaviors on problem-solving performance on various test [dissertation]. Chicago: Chicago University;1978.
19. Fehring RJ. Methods to validate nursing diagnoses. Heart Lung. 1987; 16(1):625–629.
20. Kneebone R. Evaluating clinical simulations for learning procedural skills: A theory-based approach. Acad Med. 2005; 80(6):549–553.
21. Baird SC, Bopp A, Kruckenberg Schofer KK, Langenberg AS, Matheis-Kraft C. An innovative model for clinical teaching. Nurse Educ. 1994; 19(3):23–25.
22. Yang JJ. Development and evaluation of a simulation-based education course for nursing students. J Korean Acad Adult Nurs. 2008; 20(4):548–560.
23. Baillie L, Curzio J. Students' and facilitators' perceptions of simulation in practice learning. Nurse Educ Pract. 2009; 9(5):297–306.
24. Oh HK, Han YI. Effects of simulation-based training on stress and self-efficacy in nursing students. J Korean Soc Sch Health. 2011; 24(1):33–40.
25. Decker S, Sportsman S, Puetz L, Billings L. The evolution of simulation and its contribution to competency. J Contin Educ Nurs. 2008; 39(2):74–80.
26. Lee WS, Kim MO. Effects and adequacy of high-fidelity simulation-based training for obstetrical nursing. J Korean Acad Nurs. 2011; 41(4):433–443.
27. Jude DC, Gilbert GG, Magrane D. Simulation training in the obstetrics and gynecology clerkship. Am J Obstet Gynecol. 2006; 195(5):1489–1492.
28. Lee JO. The effects of simulation-based training, underwent before or after the clinical practice for the nursing students. J Korean Acad Soc Nurs Educ. 2014; 20(2):203–211.
Similar articles