Development and evaluation of a telehealth-based simulation to improve breastfeeding education and skills among...

The aim of this study was to evaluate undergraduate nursing students' perceptions of using telehealth-based simulations for practicing their breastfeeding education skills.

Telehealth can help bridge the gap between the high need for healthcare services and the limited access to these services, such as breastfeeding mothers in rural settings. However current literature suggests that there is lack of telehealth education among healthcare providers, as well as, a shortage of adequately trained nurses on breastfeeding, making it difficult to provide new mothers with the support they need to successfully breastfeed. Telehealth simulation has shown to be acceptable and helpful in teaching clinical reasoning, increasing exposure to telehealth experiences, and preparing nursing students for real interaction experiences with patients.

For this cross-sectional descriptive study, two breastfeeding telehealth simulation scenarios were developed and delivered through Zoom for Bachelor of Science in Nursing students in a high-level institution in Florida. Selected students interacted over Zoom as healthcare providers with a female simulated patient who played as a mother with a breastfeeding concern. Students in their role of healthcare providers assessed the breastfeeding needs of the mother and conducted breastfeeding education as appropriate. After debriefing, students received feedback from faculty and students who observed the simulation and completed an optional evaluation about their telehealth simulated experience.

A total of 205 students completed the evaluation. Most students (n = 136, 66.3%) were not familiar with telehealth prior to the simulation. Most students (n = 199, 97.1%) also found the simulation helpful for supporting breastfeeding mothers and wanted more telehealth simulations in the future (n = 162, 79%). Feedback for improving the simulations included: improving the technical setup (n = 17, 8.3%), increasing the time that students interacted with the mother (n = 16, 7.8%), and observing the correct performance of the simulation after debriefing (n = 16, 7.8%).

Telehealth simulation is a promising modality for clinical competency assessment, thus it is essential to integrate telehealth education into nursing curriculum. It is evident that telehealth-based breastfeeding simulations can be used to address the exposure/knowledge gap among nursing students who are missing or have limited exposure to breastfeeding content and telehealth use in their nursing curriculum.