Comparing the effect of assessment-simulation-animation-based against traditional education on nursing students' anxiety and self-efficacy in maternity clinical practicum.

Background: The clinical practicum is the practical course that causes the most anxiety in nursing undergraduates. Although high-fidelity simulation education has been demonstrated to boost nursing students' self-efficacy and decrease anxiety in patient care, it is also associated with excessive psychological stress. Assessment-simulation-animation-based (ASA-based) education has been developed to solve the drawbacks of simulation-based education while preserving positive learning outcomes.

Objectives: To compare the effects of ASA-based education and traditional education in reducing anxiety and improving self-efficacy of junior nursing students in their maternity clinical practicum.

Design: This study used a two-group pre-post quasi-experimental design. The comparison group was studied first followed by the experimental group.

Settings: Department of Nursing and affiliated medical center at a medical university in southern Taiwan.

Participants: We enrolled 114 junior nursing students from two different class years.

Methods: A convenience sample of junior nursing students was used in this study, with 55 in the experimental group and 59 in the comparison group. The intervention included online ASA-based education videos with pamphlets and was conducted three days a week for five weeks encompassing the maternity nursing clinical practicum. We developed and applied the Clinical Situation Anxiety Scale (CS-AS) and Clinical Situation Self-Efficacy Scale (CS-SES) before and after the intervention. Qualitative feedback was assessed after the intervention. Data were collected from both the comparison and experimental groups during the fall and spring terms of both the 2019-2020 and 2020-2021 academic years.

Results: Compared with the comparison group, the total CS-AS and CS-SES scores significantly improved from before to after the intervention in the experimental group. The students responded to the intervention by demonstrating clinical consistency, knowing what to do and how to do it and more confidently practicing health education.

Conclusion: Our results suggest that ASA-based education with videos and pamphlets contributed to reducing anxiety and increasing self-efficacy in nursing students during their maternity clinical practicum.