The Proposal of an Instructional Design Modelformaternity Nursing in Japan-Simulation-based Education for Improving Clinical Judgement

Kido, Kumiko Uemura Yuko Matsumura Keiko

Clinical judgement is a prerequisite for nurses for extending efficient health care based on their education, knowledge, reasoning, intuitive thinking and experience. Nurses involved in maternity nursing provide care to expectant and new mothers before, during and after child birth. There fore, effective nursing education plays a very important role in increasing the nurses' professional competencies and improving the quality of care provided by them. However, the spread of COVID-19 in Japan and the changing social conditions surrounding perinatal care have made it necessary to introduce simulation education to improve clinical judgement skills. In this paper, we propose an instructional design for effective simulation education for maternity nursing as an alternative to practical training in a clinical setting. The design was developed based on Merrill's five principles of instruction.The high-fidelity simulation task was constructed according to the cognitive load theory, controlling for three different loads. We referred to Tanner's clinical judgement model and discussed relevant references on 'intuition' or 'tacit knowledge' as a component of clinical reasoning patterns.We also discussed the importance of 'intuition' and debriefing on experiences as per the Dreyfus model. Relevant papers were reviewed and scales developed to assess simulation-based education.