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Perinatal Bereavement Simulation for Labor and Delivery Nurses Using a Standardized Patient
Objective:
To assess the interaction and relationship-building skills of nurses caring for an individual experiencing fetal demise, evaluate the effectiveness of simulation to reflect on these skills, and provide recommendations for revision, improvement, and future offerings of simulation experiences.
Design:
Guided by the National League for Nursing Jeffries Simulation Theory, this evidence-based practice project provided labor and delivery nurses with an opportunity to participate in a fetal demise simulation scenario with a standardized patient (SP) and receive real-time, constructive feedback about their communication skills.
Setting:
The project was conducted in a large academic medical center in northern New Jersey that cares for approximately 50 to 60 individuals/families experiencing fetal demises annually.
Participants:
A convenience sample of 23 nurses participated in the experience.
Interventions/Measurements:
A fetal demise simulation was created, implemented, and evaluated. Using the Patient-Professional Interaction Questionnaire and the Provider-Patient Relationship Questionnaire, each participant and the SP evaluated communication skills during the encounter, discussing their interaction and soliciting and receiving feedback. After the patient encounter, participants completed a survey to determine the value of the simulation as an educational experience.
Results:
Nurses with more practice experience demonstrated stronger communication skills, but respondents' self-assessment scores, including several from experienced nurses, were higher than those provided by the SP. Regardless of years of experience, nurses valued the simulation experience, appreciated the SP feedback, and reported that the experience would improve their nursing practice.
Conclusion:
Simulation, especially using SPs and providing structured and open-ended feedback, may improve nursing communication with individuals and families experiencing fetal demise and stillbirth. Future offerings of this and similar scenarios may provide clinicians with opportunities to practice and improve their communication skills, thereby improving the care they provide.
