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Effects of Bundled Presimulation Training on Maternal Care Performance and Interruption Response
Peggy P Hill1, Desiree A Díaz2, Amara N Holobaugh3
1University of Central Florida, College of Nursing, Orlando, Florida.
The Journal of Nursing Education
|June 5, 2026
Summary
Effective nursing education for maternal mortality requires simulation-based learning (SBL) with strong pretraining. Just-in-time reflection enhances task completion and reduces cognitive load, improving critical care skills.
Area of Science:
- Nursing Education
- Critical Care
- Simulation-Based Learning
Background:
- Maternal mortality necessitates nurses skilled in managing critical care within challenging, interruption-prone settings.
- Simulation-based learning (SBL) provides a realistic environment for practicing interruption management.
- The efficacy of SBL is contingent upon robust pretraining strategies.
Purpose of the Study:
- To investigate the impact of varying pretraining levels on nursing students' performance in SBL.
- To assess task completion, cognitive load, and interruption management skills.
- To compare outcomes across different learner roles: active participants (AP), passive observers (PO), and active observers (AO).
Main Methods:
- A randomized, between-subjects design was employed.
- Nursing students were assigned to different pretraining conditions and observer roles (AP, PO, AO).
- Data collected included task completion rates, self-reported cognitive load, and observed interruption management strategies.
Main Results:
- Pretraining combined with just-in-time (JIT) reflection led to higher SBL task completion and reduced cognitive load.
- Active observers (AOs) experienced cognitive load comparable to active participants (APs).
- Interruption management strategies were utilized more frequently by intervention groups compared to the control group, with varied application across different clinical tasks.
Conclusions:
- Interruption management skills are crucial across all nursing tasks, not solely medication administration.
- Nurse educators should integrate structured pretraining and JIT reflection into SBL curricula.
- Active observation is a valuable strategy for promoting equitable learning outcomes among nursing students in SBL environments.
