Journal List > Korean J Women Health Nurs > v.24(2) > 1100170

Korean J Women Health Nurs. 2018 Jun;24(2):150-162. Korean.
Published online June 20, 2018.
© 2018 Korean Society of Women Health Nursing
Effect of Practical Delivery-nursing Simulation Education on Team-based Learning on the Nursing Knowledge, Self-efficacy, and Clinical Competence of Nursing Students
Sun Hee Lee
Department of Nursing Science, Gimcheon University, Gimcheon, Korea.

Corresponding author: Corresponding author: Lee, Sun Hee. Department of Nursing Science, Gimcheon University, 214 Daehak-ro, Gimcheon 39528, Korea. Tel: +82-54-420-4252, Fax: +82-54-420-4492, Email:
Received April 10, 2018; Revised May 09, 2018; Accepted May 25, 2018.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



To identify the effects of delivery-nursing simulation education using team-based learning on the delivery nursing knowledge, self-efficacy, and clinical competence of nursing students.


The study used a nonequivalent, control group, quasi-experimental design. The team-based learning was applied to the experimental group, while the individual learning was applied to the control group. Data were collected from October 12 to December 7, 2016, and analyzed using the SPSS/WIN 22.0 program.


Comparison between the experimental and control group showed no significant difference in delivery-nursing knowledge (t=−0.33, p=.741) or self-efficacy (t=−0.65, p=.515). However, a significant difference (t=−2.09, p=.048) in the nursing-skills aspect of clinical competence was found between the experimental and control groups after the practical simulation education.


Delivery-nursing simulation education using team-based learning was more effective in improving the nursing-skills aspect of nursing competence than was delivery-nursing simulation education based on individual learning.

Keywords: Patient simulation; Delivery; Knowledge; Self-efficacy; Clinical competence


Figure 2
Development and operation of delivery nursing simulation program.
Click for larger imageDownload as PowerPoint slide


Table 1
Homogeneity Test of General Characteristics and Dependent Variables (N=91)
Click for larger imageClick for full tableDownload as Excel file

Table 2
Comparison of Knowledge and Self-efficacy on Delivery between Experimental and Control Group (N=91)
Click for larger imageClick for full tableDownload as Excel file

Table 3
Comparison of Clinical Competency between Two Groups at Posttest (N=91)
Click for larger imageClick for full tableDownload as Excel file


This work was supported by the 2016 Gimcheon University research grant.

Summary Statement

▪ What is already known about this topic?

Simulation practice education is effective for nursing knowledge, problem-solving ability, clinical competence, and self-efficacy.

▪ What this paper adds?

The delivery-nursing simulation education using team-based learning is an effective way to improve the delivery-nursing skills aspect of clinical competence.

▪ Implications for practice, education and/or policy

The delivery-nursing simulation using team-based learning is a teaching and learning strategy that can improve clinical competence.

1. Choi D. Clinical competence according to experiences on the essential of fundamental nursing skills in nursing students. J Korean Acad Soc Nurs Educ 2014;20(2):184–191. [doi: 10.5977/jkasne.2014.20.2.184]
2. 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. [doi: 10.4040/jkan.2011.41.2.245]
3. Park HJ, Lee SH. Development and effects of integrated simulation program (maternal-child) on nursing students. Child Health Nurs Res 2015;21(4):293–301. [doi: 10.4094/chnr.2015.21.4.293]
4. Lee WS, Kim MO. Effects and adequacy of highfidelity simulation-based training for obstetrical nursing. J Korean Acad Nurs 2011;41(4):433–443. [doi: 10.5977/jkasne.2014.20.2.203]
5. Yang SH, Hong S. Development and effects of simulation practice program about family centered delivery care. Korean J Women Health Nurs 2017;23(1):52–61. [doi: 10.4069/kjwhn.2017.23.1.52]
6. Chung KS. RN of this year, 'Man licence' 2,344 people [Internet]. Seoul: korean nurses association; 2018 [cited 2018 May 04].
7. Kim DH, Lee YJ, Hwang MS, Park JH, Kim HS, Cha HG. Effects of a simulation-based integrated clinical practice program (SICPP) on the problem solving process, clinical competence and critical thinking in a nursing student. J Korean Acad Soc Nurs Educ 2012;8(3):499–509. [doi: 10.5977/jkasne.2012.18.3.499]
8. Seomun GA. Revision standards by area (2). In: Yang S, editor. Three-cycle nursing education certification evaluation presentation. Seoul: Korean Accreditation Board of Nursing; 2016. pp. 86.
9. Cooper S, Cant R, Porter J, Bogossian F, McKenna L, Brady S, et al. Simulation based learning in midwifery education: A systematic review. Women Birth 2011;25(2):64–78. [doi: 10.1016/j.wombi.2011.03.004]
10. Lee JO. The effects of simulation-based training, underwent before or after the clinical practice for the nursing students. J Korean Soc Matern Child Health 2014;20(2):203–211. [doi: 10.21896/jksmch.2014.18.1.125]
11. Kim SH. Effects of simulation-based practice using standardized patients for the care of women with postpartum hemorrhage on nursing student's clinical performance competence and critical thinking deposition. Korean Parent Child Health J 2012;15(2):71–79.
12. Shim CS, Park MK, Kim JH. Effects of simulation-based delivery education regarding to obstetric clinical practice before and after of nursing students. J Korean Soc Matern Child Health 2014;18(1):125–133. [doi: 10.21896/jksmch.2014.18.1.125]
13. Song YA, Son YJ. Effects of simulation-based practice by applying problem based learning on problem solving process, self-confidence in clinical performance and nursing competence. Korean J Women Health Nurs 2014;20(4):246–254. [doi: 10.4069/kjwhn.2014.20.4.246]
14. Lee SK. The effect of simulation practice education on the clinical judgment, self-confidence and clinical performance ability in nursing student. Int J Conten 2017;17(17):577–587. [doi: 10.5392/JKCA.2017.17.11.577]
15. Kim KA. In: Effects of a simulation-based labor education program on skill competence, knowledge, and satisfaction for education in nursing students [dissertation]. Seoul: The Catholic University of Korea; 2014. pp. 55.
16. Lee SH, Chun YE, Kim KM, Park HJ. Effects of integrated simulation (delivery-operation-newborn) practice program for nursing students. J Learn Cent Curric Instr 2015;15(9):577–599.
17. Yang JJ. Effects of a simulation-based education on the knowledge and clinical competence for nursing students. J Korean Acad Soc Nurs Educ 2012;18:14–23. [doi: 10.5977/jkasne.2012.18.1.014]
18. Kim JS, Kim YH. The effects of simulation practice education applying problem-based learning on problem solving ability, critical thinking and learning satisfaction of nursing students. J Korea Contents Assoc 2016;16(12):203–212. [doi: 10.5392/JKCA.2016.16.12.203]
19. 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.
20. Kim MN, Cho Chung HI, Kim YA. A meta-analysis of the effect of simulation-based education for delivery nursing in Korea. J Korean Soc Matern Child Health 2016;20(3):297–309. [doi: 10.21896/jksmch.2016.20.3.297]
21. Michaelsen LK, Parmelee DX, McMahon K, Levine RE. In: Team based learning for health professions education. Sterling: Stylus Publishing; 2007. pp. 256.
22. Kim HR, Choi EY, Kang HY. Simulation module development and team competency evaluation. J Korean Acad Fundam Nurs 2011;18(3):392–400.
23. Roh YS, Ryoo EN, Choi DW, Baek SS, Kim SS. A survey of student perceptions, academic achievement, and satisfaction of team based learning in a nursing course. J Korean Acad Soc Nurs Educ 2012;18(2):239–247. [doi: 10.5977/jkasne.2012.18.2.239]
24. Clark MC, Nguyen HT, Bray C, Levine RE. Team-based learning in an undergraduate nursing course. J Nurs Educ 2008;47(3):111–117. [doi: 10.3928/01484834-20080301-02]
25. Choi KO, Park YM. The effects of team-based learning on problem solving ability, critical thinking disposition and self-directed learning in undergraduate nursing students. J East West Nurs Res 2014;20(2):154–159. [doi: 10.14370/jewnr.2014.20.2.154]
26. Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nurs Educ Perspect 2005;26(2):96–103. [doi: 10.5480/1536-5026-26.2.96]
27. Levine AI, DeMaria JrS, Schwartz AD, Sim AJ. In: The comprehensive textbook of healthcare simulaion. 2nd ed. New York: Springer; 2014. pp. 697.
28. Marken PA, Zimmerman C, Kennedy C, Schremmer R, Smith KV. Human simulators and standardized patients to teach difficult conversations to inter professional health care teams. Am J Pharm Educ 2010;74(7):120.
29. Taekman JM, Shelley K. Virtual environments in healthcare: Immersion, disruption, and flow. Int Anesthesiol Clin 2010;48(3):101–121. [doi: 10.1097/AIA.0b013e3181eace73]
30. Weaver A. High-fidelity patient simulation in nursing education. Nurs Educ Perspect 2011;32(1):37–40. [doi: 10.5480/1536-5026-32.1.37]