A qualitative analysis of undergraduate nursing students in a breast-feeding simulation that utilized standardized patients

Background and objective: Breastfeeding is an essential aspect of infant and maternal health, offering a multitude of short-term and long-term benefits. It provides infants with essential nutrients, antibodies, and immune protection, contributing to reduced rates of infectious diseases and promoting healthy growth and development. According to a policy statement form the American Academy of Pediatrics (Younger-Meek & Noble, 2022) some of the benefits of breastfeeding for infants are improved neurological developmental outcomes and many other benefits. Nursing students often do not have the opportunity to practice hands-on lactation management. Using Standardized Patients (SPs) during simulation as an educational strategy provides realistic clinical situations and allows the opportunity to practice and learn in a safe environment (Madriz et al., 2023). This study recognized the pivotal role that healthcare professionals play in promoting and supporting breastfeeding among new mothers. By equipping healthcare students with the knowledge and skills necessary to engage in effective breastfeeding teaching and support, this study addressed the lived experiences of baccalaureate nursing students in a breast-feeding simulation experience using SPs. Including SPs in breastfeeding nursing student/patient experience in the curriculum for pre licensure nursing students increased knowledge of the benefits of breast feeding and help to prioritize teaching new mothers. The purpose of this study was to enhance student understanding of breastfeeding by employing SPs. Benefits of this research included improvement of the students' competence in breastfeeding, providing effective breastfeeding teaching to new mothers through empathizing and providing support in challenging breastfeeding issues. The results may also contribute to the advancement of healthcare education and the promotion of breastfeeding as a fundamental component of maternal and infant well-being via SPs. The knowledge gained by the researchers will be disseminated in peer reviewed journals and presented at professional conferences.
Methods: This research employed a descriptive phenomenological approach and qualitative design. Recruitment was through convenience and snowball sampling of pre licensure undergraduate nursing students at a New York City college nursing department, nine participants in junior year. Qualitative data collection was done one-on-one with an interview lasting approximately 30 minutes via Zoom until saturation. The interviews were done post interaction of the participant (student) with an SP prepared as a new breastfeeding mother. Data analysis was done using NVivo software and inter-rater reliability to search for codes and themes. A hermeneutic approach and bracketing were used.
Results: The participants all revealed that education in breastfeeding during coursework was adequate, however the SP experience was beneficial to student knowledge development, patient education and decreasing anxiety in the students. Being able to educate an SP in a safe environment was favorable to the participants. The SP experience improved student/patient teaching outcomes. NVivo data analysis and researcher coding revealed four main themes: preparedness, confidence, lower anxiety and knowledge increase.
Conclusions: Pre licensure nursing students verbalized feeling more prepared, knowledgeable, confident and less anxious interacting with new mothers regarding breastfeeding education after participating in a simulation using SPs. The new mothers need more lactation education, and the students were able to provide it. One concept that some of the participants revealed and is worth noting was cultural preferences. Although not an emerged theme, some of the participants mentioned cultural humility was important to be aware of during the breastfeeding patient education process. The implications for these results include need for nursing curriculum to include using SPs in simulation, need for hospitals to employ more lactation education with new mothers and more research with practicing nurses in postpartum to explore their confidence in teaching breastfeeding to new mothers.