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

Abstract

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
nursingprovide care toexpectant and new mothers before, during and after child birth.Therefore, 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 onMerrill’sfive principles of instruction.The high-fidelity
simulation task was constructed according tothecognitive load theory, controlling for three different
loads.We referred to Tanner’s clinical judgementmodel 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 experiencesas per the Dreyfus model.Relevant papers were reviewed and
scales developed to assess simulation-based education.