The effect of repeated high-fidelity in situ simulation-based training on self-efficacy, self-perceived leadership qualities and team performance : a quasi-experimental study in a NICU-setting

Background: Simulation-based training has been widely used in various disciplines and has increasingly been recognized as useful in healthcare education during the past decade. In nursing schools, simulation-based training was initially used to train nursing students. However, there is a growing trend to use simulationbased training for continuing education and lifelong learning among professional healthcare workers. Objectives: To investigate if simulation-based training has an effect on self-efficacy, self-perceived leadership qualities and team performance in a neonatal intensive care unit. Design: Time series design. Setting: One referral neonatal intensive care unit in a general hospital in Flanders, Belgium. Participants: Convenience sample of 71 nurses and midwives. Methods: Participants were involved in a series of three simulation-based training sessions. Before and after these series, a set of validated questionnaires was completed to measure the self-efficacy and self-perceived leadership qualities of the participants. Each session was videotaped and assessed for team performance (n = 8). Results: Participating in repeated high-fidelity in situ simulation-based training resulted in a significant increase in self-efficacy (p < 0.001) and self-perceived leadership qualities (p < 0.001). The intervention did not lead to a significant improved team performance (p = 0.209). Conclusion: Repeated high-fidelity in situ simulation-based training in the NICU had a positive effect on selfefficacy and self-perceived leadership abilities in registered nurses and midwives in acute care situations. Repeated participation in simulation-based training had a positive effect on these outcomes, regardless of the number of years of NICU experience. The effect on team performance could not be confirmed in this study