Midwives are expected to support women with lactation initiation and maintenance. Midwifery students engaged in a simulation-based exercise (LactSim OSCE) where they role-played the clinician and the breastfeeding patient by wearing a high-fidelity breast model. We provided participants opportunities for reflecting in and on practice to compare their perceived self-confidence in clinical lactation skills to actual clinical performance. We also describe feasibility of implementing the LactSim OSCE with an emphasis on preparation and time spent on tasks during the OSCE.
Audio-video recordings from the LactSim OSCE were viewed and assessed using a technical skills checklist by an independent rater and by the study participants as part of the self-reflection. Mixed data on participants’ self-efficacy in clinical lactation, experience with the LactSim OSCE, and self-assessment of clinical performance were collected in survey instruments and a focus group. Time spent on each component and clinical lactation skill during the LactSim OSCE was documented.
Immediately following the LactSim OSCE, participants’ confidence in clinical lactation was high (5.7/7), but after a guided video reflection exercise, their self-efficacy was 4.4/7. Participants spent approximately 2 of the allotted 10 min per case scenario discussing the OSCE logistics due to inadequate preparation. Participants spent approximately 2 min of the total encounter performing hands-on clinical lactation skills by touching, looking at, or using the high-fidelity breast model worn by their peer.