Simulated Practice in surgical reconstruction of the perineum after delivery: a pedagogical activity

  • Luísa Sotto-Mayor
  • Maria Anabela Ferreira dos Santos
  • Irene Soares
  • Teresa Félix
  • Maria João Delgado
  • Isabel Serra
Keywords: Simulated Practice; Nursing Midwifery Student; Perineal Reconstitution; Suture; Nursing Education.


Introduction: This is a pedagogical activity with students of the Masters in Maternal Health Nursing and Midwifery, applying the principles of simulated practice in the perineal repair after delivery. This procedure generates great insecurity and anxiety in the nursing midwifery students, when they begin their clinical practice in delivery room. The ethical aspects of practicing the procedure in clients also raises some concerns. Simulated practice is nowadays considered a very important pedagogical resource to the education of health professionals, including nursing and midwifery students (Martins et al., 2012; Baptista, Martins, Pereira, & Mazzo, 2014).

Methodology: This pedagogical activity was included in the curricular unit “Clinical Practice in Delivery Room”, and took place during the first week of the internship. Mixed methodology: use of an online questionnaire with 22 items on a Likert scale of 5 hypotheses, and 3 open questions; a focus group session and filming. The aim of the questionnaire was to listen to the student’s opinion about the usefulness of the teaching method, the suitability, similarity with reality and pertinence of the scenario. The participants of this activity were 18 students in the fourth and last semester of the Masters course. They were all female and had a minimal prior 2 year professional experience as general care nurses at the start of the course. Analysis of the results: descriptive of responses to the 22 items and content analysis of the open questions and the focus group verbatim (Bardin, 2007; Streubert & Carpenter, 2013).  Given the small size of the current sample, the answers to this questionnaire, still in the collection phase, will be subsequently subjected to a descriptive analysis, where the percentages, averages, fashion and median will be determined. These quantitative data will complete, a posteriori, the present study.

Results: The students emphasized the importance of this pedagogical activity in a safe environment, allowing them the acquisition of suturing skills, reinforcement of self-confidence and reduction of initial anxiety, reducing the gaps between theory and practice. This will contribute to better, safer care to the clients in delivery room. They also mentioned that it allowed them to experience and anticipate difficulties, and to develop critical thinking about their attitudes and practice.

Conclusions: Simulated Practice proved to be a pedagogical strategy with high potential in the training of nurses, allowing a student-centered learning in a controlled and safe environment. This technique also provided the oportunity for students to develop critical-reflexive thinking, professional responsibility and to become aware of the ethical issues involved. The surplus value felt by the students through this formative strategy is in line with the perception of both the teachers involved in this activity and the tutors in clinical context.