Core Palliative Care Competencies for Undergraduate Nursing Education: International Multisite Research Using Online Nominal Group Technique.

Background: Nurses should have appropriate education and required competencies to provide high-quality palliative care. The aim of this international multisite study was to list and evaluate core palliative care competencies that European nurses need to achieve in their education to provide palliative care. Methods: The Nominal Group Technique (NGT) was used as a data collection method. NGT meetings were organized in four European countries. Targeted groups of palliative care professionals with diverse contextual and professional backgrounds participated in the NGTs. The research question was: "What are the core competencies in palliative care that need to be achieved during undergraduate nursing education?" Data analysis was done in two stages: grouping the top 10 answers based on similarities and thematic synthesis based on all the ideas produced during the NGTs. Results: Palliative care core competencies based on the research were (1) competence in the characteristics of palliative care; (2) competence in decision-making and enabling palliative care; (3) symptom management competence in palliative care; (4) competence in holistic support in palliative care; (5) active person- and family-centered communication competence in palliative care; (6) competence in empathy in palliative care; (7) spiritual competence in palliative care; (8) competence in ethical and legal issues in palliative care; (9) teamwork competence in palliative care; and (10) self-awareness and self-reflection competence in palliative care. Conclusions: It was possible to find differences and similarities in the top 10 palliative care core competencies from different countries. Thematic synthesis of all the data showed that there were various competencies needed for nursing students to provide quality palliative care.

Descriptive study of general practitioner's practices and knowledge about Parkinson's disease in the north of France.

BACKGROUND: Parkinson's disease (PD), the second most frequent neurodegenerative disease, constitutes a major public health challenge. A guide published by the French National Authority for Health in 2012 and revised in 2016 put forward recommendations for general practitioners (GP) planning care pathways for parkinsonian patients. It is well known that PD can be difficult to diagnose, and that when patients consult their GP, symptoms are often still limited and embedded in clinical uncertainty. This means the pathway to confirmed diagnosis of PD can be lengthy and uncertain. Consequently, it is important to identify the difficulties GPs encounter when caring for PD patients in order to help them better close the gaps in care strategies. METHODS: We conducted a descriptive cross-sectional survey in northern France to evaluate GP practices and knowledge about PD and their accordance with care pathway recommendations. The survey was conducted using a 30-item questionnaire sent to a sample of GPs. RESULTS: There were 164 GPs who responded to the study questionnaire. The responding GPs generally followed current care pathway recommendations. In presence of a parkinsonian syndrome, 93.3% of the GPs reported systematically looking for an iatrogenic cause; 57.4% did not announce the diagnosis without the advice of a neurologist; 97.6% referred patients to a neurologist when they suspected PD; and 80.5% asked the neurologist to modify treatments. Our findings also revealed some difficult aspects of GP practices: only 2.5% had had additional training in neurology; only 53.6% felt comfortable with the diagnosis of PD; 63.6% prescribed additional exams for the diagnosis; most of the GPs were unaware of second-line treatments and their indications, and finally existence of PD expert centers was unknown for 85.2%. CONCLUSIONS: These findings could be useful to guide implementation of new measures supporting more holistic care for PD patients; PD expert centers in France could provide complementary information and training for GPs.

Application Progress of the Case Teaching Method in Standardized Training for Rehabilitation Nurses.

Context: In China, the dearth of adept rehabilitation nurses has escalated into a pressing concern. Conventional nursing education has stymied nurses' autonomous scholarly pursuits. The case-teaching methodology can augment students' competencies and zeal, culminating in the enrichment of educational excellence. Objective: The study intended to elucidate the principles, taxonomy, and enactment of the case-teaching methodology and examine its salutary impacts on nursing practitioners and educators. Design: The research team performed a narrative review by searching BMJ Best Practice, OVID EBM, NGC et al databases. The search used the keywords 'Rehabilitation nursing', 'nursing', 'case teaching method'. Setting: The study took place at the Rehabilitation Medicine Center at West China Hospital of Sichuan University in Chengdu, China. Results: The current study scrutinizes the assimilation of the case-teaching methodology within the realm of nursing, dissects emerging paradigms in the standardized training of rehabilitation nursing staff, and furnishes precedents for the evolution of training frameworks in the field of rehabilitative care. Conclusions: The case-teaching methodology not only serves as an instructional tool but also embodies a fundamental transformation in the modernization of nursing education, embodying the aspiration for excellence, the desire for continuous improvement, and a dedication to the highest standards of patient care.

Reaffirming the value of continuing professional development.

With advances in clinical knowledge and changing norms for health services delivery, lifelong learning is essential for practitioners of sexual and reproductive health. Clinical topics should be complemented by various items, such as communications and management, to optimise the provision of care. Aiming to update knowledge, improve skills and enhance competence, professional development can take the form of diverse modalities ranging from the reading of professional journals through attendance at meetings to formal participation in schemes organised by licensing authorities. Already mandatory in numerous countries in Africa, continuing professional development is assuming more importance for medical, nursing, and midwifery practitioners.

Avec les progrès des connaissances cliniques et l'évolution des normes en matière de prestation de services de santé, l'apprentissage tout au long de la vie est essentiel pour les praticiens de la santé sexuelle et reproductive. Les sujets cliniques doivent être complétés par divers éléments, tels que la communication et la gestion, pour optimiser la prestation des soins. Visant à mettre à jour les connaissances, à améliorer les compétences et à améliorer les compétences, le développement professionnel peut prendre la forme de diverses modalités allant de la lecture de revues professionnelles à la participation à des réunions en passant par la participation formelle à des programmes organisés par les autorités chargées des licences. Déjà obligatoire dans de nombreux pays d'Afrique, la formation professionnelle continue prend de plus en plus d'importance pour les praticiens médicaux, infirmiers et obstétricaux.

The effect of a midwifery continuity of care program on clinical competence of midwifery students and delivery outcomes: a mixed-methods protocol.

BACKGROUND: The midwifery continuity of care model is one of the care models that have not been evaluated well in some countries including Iran. We aimed to assess the effect of a program based on this model on the clinical competence of midwifery students and delivery outcomes in Ahvaz, Iran. METHODS: This sequential embedded mixed-methods study will include a quantitative and a qualitative phase. In the first stage, based on the Iranian midwifery curriculum and review of seminal midwifery texts, a questionnaire will be developed to assess midwifery students' clinical competence. Then, in the second stage, the quantitative phase (randomized clinical trial) will be conducted to see the effect of continuity of care provided by students on maternal and neonatal outcomes. In the third stage, a qualitative study (conventional content analysis) will be carried out to investigate the students' and mothers' perception of continuity of care. Finally, the results of the quantitative and qualitative phases will be integrated. DISCUSSION: According to the nature of the study, the findings of this research can be effectively used in providing conventional midwifery services in public centers and in midwifery education. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1401.460). Also, the study protocol was registered in the Iranian Registry for Randomized Controlled Trials (IRCT20221227056938N1).

Beyond competence and retention: Developing a comprehensive evaluation framework for a rural primary care nurse practitioner residency program.

ABSTRACT: With the rise in nurse practitioner (NP) residency programs, evaluations have largely focused on retention and competency completion for residents. There is a need for expanded evaluation to ensure the sustainability of NP residency programs, to ensure timely adaptations to address resident satisfaction, and to solidify a long-term pathway of NPs well prepared for rural practice. We created a family nurse practitioner (FNP) residency program with a comprehensive evaluation framework to prepare residents for practice in rural settings. The evaluation framework was developed through collaborative engagement of an external evaluation team, program leadership, and clinical site representatives. The evaluation framework of the FNP residency program combined resident assessment and holistic program evaluation, using a rapid continuous quality improvement (QI) approach. The evaluation considered three distinct perspectives: the resident, the peer coach, and the clinical site. The rapid continuous QI approach allowed program leadership to respond swiftly to programmatic challenges, improve the residency program in response to residents' reported experiences, and emphasize sustainability for continued program impact, while assessing residents' learning and performance. The program's data-driven evaluation approach has demonstrated its success in meeting the goals of the Health Resources and Services Administration funding by increasing the number of primary care providers in rural settings. The program's expansion and continued success have further validated the efficacy of this evaluation framework in assessing, improving, and ensuring the sustainability of APRN residency programs. This article calls for the adoption of similar evaluation strategies in future residency programs to promote their long-term success and impact in rural health care settings.

Improving patient safety through mandatory quality improvement (QI) education in a family medicine residency programme.

Although the American College of Graduate Medical Education (ACGME) requires that medical trainees acquire competencies in patient safety and quality improvement (QI), no standard curriculum exists. We envisaged that a sustainable QI curriculum would be a pragmatic way to improve residents' skills and competence in patient safety. Our aim was to develop and evaluate a patient safety-oriented QI curriculum in an established family medicine residency programme. A patient safety curriculum fulfilling ACGME requirements was developed and implemented in a family residency programme. The curriculum comprised didactics, self-paced online modules, experiential learning through individual QI projects, and mortality and morbidity conferences. The programme was evaluated using a survey at the end of its first year. We assessed knowledge on patient safety and QI, confidence in discussing safety concerns with peers, and ability to recognise safety gaps and initiate corrective actions. We also assessed the perception of the programme's relevance to the residents' training. All 36 residents participated, 19 completed the evaluation survey. Fifteen (79%) respondents reported learning more about the causes of medical errors, 42% could report safety concerns and 26% could recognise quality gaps. In addition, 58% felt the curriculum increased their confidence in discussing patient safety concerns with peers while 74% found the curriculum very relevant to their training. Some participants described the programme as 'very productive'. Embedding a QI curriculum into the ongoing residency training may be a realistic approach to training family medicine residents with no prior formal QI training.

The Influence of Online and Offline Mixed Teaching Mode Based on TPACK on the Theoretical Knowledge and Comprehensive Ability Level of Tumor Gynecology Postgraduates.

Aim: To explore the influence of online and offline mixed teaching modes based on TPACK on theoretical knowledge and comprehensive ability of tumor gynecology postgraduates. Methods: In this study, a prospective randomized controlled study model was used to select 60 masters of oncology and gynecology who were interned in the Affiliated Hospital of the First Affiliated Hospital of Bengbu Medical College from September 2019 to April 2022 as the research objects. They were divided into a study group and a control group by random number table, with 30 cases in each group. The control group adopted the traditional teaching mode, while the study group adopted the mixed online and offline teaching mode based on TPACK to implement the teaching. The knowledge mastery, problem analysis ability and total ability of the two groups were compared before and after the practice. Results: After the practice, the scores of theoretical knowledge, clinical operation skills and case analysis ability of both groups were improved compared with those before the practice, and the scores of the study group were higher than those of the control group (P < .05). After practice, the scores of problem analysis and clinical work competence in both groups were significantly higher than those before practice, and the study group was higher than the control group (P < .05). After practice, the scores of professional technical knowledge, doctor-patient communication ability, clinical operation skill, disease observation ability and clinical first-aid ability of both groups were improved compared with those before practice, and the scores of the study group were higher than those of the control group (P < .05). Conclusion: In clinical teaching, the online and offline mixed teaching mode based on TPACK has obvious effects on improving the theoretical and clinical operation level of tumor gynecology postgraduates and the total ability of medical staff.

The holistic nursing competence and transition shock of newly graduated nurses as the determinants of missed nursing care: The mediation analysis.

AIMS AND OBJECTIVE: To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. BACKGROUND: Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. DESIGN: Descriptive and correlational design. METHODS: The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1-12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. RESULTS: The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. CONCLUSIONS: Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. RELEVANCE TO CLINICAL PRACTICE: The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education.

Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine.

Emergency physicians are expected to learn and maintain a large and varied set of competencies for clinical practice. These include high acuity, low occurrence procedures that may not be encountered frequently in the clinical environment and are difficult to practice with high fidelity and frequency in a simulated environment. Mental practice is a form of a cognitive walk-through that has been shown to be an effective method for improving motor and cognitive skills, with literature in sports science and emerging evidence supporting its use in medicine. In this article, we review the literature on mental practice in sports and medicine as well as the underlying neuroscientific theories that support its use. We review best-known practices and provide a framework to design and use mental imagery scripts to augment learning and maintaining the competencies necessary for physicians at all levels of training and clinical environments in the practice of emergency medicine.

Origami-Based Haptic Syringe for Local Anesthesia Simulator.

Although medical simulators have benefited from the use of haptics and virtual reality (VR) for decades, the former has become the bottleneck in producing a low-cost, compact, and accurate training experience. This is particularly the case for the inferior alveolar nerve block (IANB) procedure in dentistry, which is one of the most difficult motor skills to acquire. As existing works are still oversimplified or overcomplicated for practical deployment, we introduce an origami-based haptic syringe interface for IANB local anesthesia training. By harnessing the versatile mechanical tunability of the Kresling origami pattern, our interface simulated the tactile experience of the plunger while injecting the anesthetic solution. We present the design, development, and characterization process, as well as a preliminary usability study. The force profile generated by the syringe interface is perceptually similar with that of the Carpule syringe. The usability study suggests that the haptic syringe significantly improves the IANB training simulation and its potential to be utilized in several other medical training/simulation applications.

The Perceived Impact of Substance Use Education on Social Work Students' Knowledge, Attitudes, and Skills.

BACKGROUND: In 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) published a report revealing that over 46 million individuals in the United States had a substance use disorder (SUD). In the same year, a record number of drug-related overdose deaths were reported. Social workers play an important role in connecting with people who use substances and providing adequate care and treatment; yet, negative attitudes and lack of holistic knowledge about individuals who use substances create challenges in providing effective care. Social work curricula that integrates substance use content has been identified as one way to address this. METHODS: A 14-week course was introduced in one institution's Master of Social Work curriculum with the goal of providing students with a comprehensive education on SUDs. Foundational knowledge and practical skill development were covered. Seventeen trained instructors taught a total of 1204 students between May 2020 and January 2022. Quantitative and qualitative data were collected to explore changes in student's self-perceived knowledge, attitudes, and skills related to substance use. RESULTS: Among those who completed the survey (N = 553), the majority felt that the course would have a positive impact on their future work and professional development. Specifically, 96.4% reported being satisfied or very satisfied with the course overall. Among those who completed a 30-day follow-up survey (n = 69), data revealed an increase in students' self-perceived knowledge, accompanied by a shift in attitudes and positive changes in self-perceived client-centered care skills. CONCLUSIONS: Findings from this article support the development, implementation, and evaluation of evidence-based substance use content within social work curricula. This has implications for improving knowledge, attitudes, and skills among social workers who work with people who use substances.

Evaluation of dental students' clinical communication skills from three perspective approaches: A cross-sectional study.

INTRODUCTION: The communication skills of clinicians are very crucial in providing better health outcomes for patients. Therefore, this study aimed to assess undergraduate dental students' communication skills in relation to their demographics and clinical setting using a three-perspective approach; the student, the patient and the clinical instructor perspective. METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI) and Clinical Communication Assessment Instruments (CCAI) which included four communication domains. One hundred and seventy-six undergraduate clinical year students were recruited in this study whereby each of them was assessed by a clinical instructor and a randomly selected patient in two settings: Dental Health Education (DHE) and Comprehensive Care (CC) clinic. RESULTS: Comparing the three perspectives, PCAI yielded the highest scores across all domains, followed by SCAI and CCAI (p < .001). SCAI exhibited a better score in Year 5 compared to Year 3 and Year 4 (p = .027). The male students perceived they performed better than females in all domains (p < .05). Patients rated the students higher in the DHE clinic as compared to the CC clinic for the team interaction domain. CONCLUSION: There was an upward pattern of the communication skills score rated from the clinical instructor perspective to the student and patient perspectives. The use of PCAI, SCAI and CCAI collectively gave a complementary view of students' communication performance in all the domains assessed.

Acute care nurses' experience in providing evidence-based care for patients with laparotomy wounds: A scoping review.

To systematically search and synthesise available literature on barriers and enablers to evidence-based care for patients with laparotomy wounds reported by acute care nurses. Specifically, we focused on wound assessment, infection control techniques, wound products used, escalation of care, dressing application, documentation and holistic care. The Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews Checklist and explanation documents directed the review. The methodology framework created by Arksey and O'Malley, updated by Levac et al., and the Joanna Briggs Institute were utilised to assist the scoping review process. Data synthesis was guided by the Theoretical Domains Framework. Six qualitative and mixed methods studies were selected for the review. Most reported barriers and enablers were mapped to knowledge, skills, beliefs about consequences, environmental context and resources and beliefs about capability domains. The main barriers were limited access to and utilisation of wound assessment tools and clinical practice guidelines for wound management and suboptimal time management skills. Inconsistent management of laparotomy wounds was related to ward culture and nurses' lack of knowledge and skills in surgical wound assessment and aseptic technique during wound encounters. The reported enablers were knowledge of multi-factorial risk factors for surgical wound recovery, valuing education and reflective practice and believing that protocols should be utilised alongside comprehensive wound assessments. Holistic wound care included patient education on the role of mobilisation and nutrition in wound healing. Acute care nurses do not routinely incorporate comprehensive, evidence-based care recommendations for laparotomy wound management. Further research on evidence-based care behaviours in managing laparotomy wounds is required. The results indicate a need for standardising the practice of laparotomy wound management while acknowledging the current challenges faced in the ward environment.

A novel research competency framework for clinical research nurses and midwives.

BACKGROUND: Clinical research nurses and midwives (CRN/Ms) are highly specialised registered nurses. They combine their clinical nursing expertise with research knowledge and skills to aid in the delivery of rigorous, high-quality clinical research to improve health outcomes, the research participant's experience and treatment pathways ( Beer et al 2022 ). However, there is evidence that the transition into a CRN/M role is challenging for registered nurses. AIM: To discuss the development of a competency framework for CRN/Ms. DISCUSSION: The authors identified a gap in their organisation for standards that would support the development of CRN/Ms new to the role. The standards needed to be clear and accessible to use while encompassing the breadth of scope of CRN/Ms' practice. The authors used a systematic and inclusive process drawing on Benner's ( 1984 ) theory of competence development to develop a suitable framework. Stakeholders engaged in its development included research participants, inclusion agents and CRN/Ms. CONCLUSION: The project identified 15 elements that are core to the CRN/M role and the knowledge, skills and behaviours associated with it. IMPLICATIONS FOR PRACTICE: A large NHS trust has implemented the framework. It is also being shown to national and regional networks. Evaluation is under way.

Systems-Based Practice in Graduate Medical Education: Evolving Toward an Ideal Future State.

ABSTRACT: Systems-based practice (SBP) was first introduced as a core competency in graduate medical education (GME) in 2002 by the Accreditation Council for Graduate Medical Education as part of the Outcomes Project. While inclusion of SBP content in GME has become increasingly common, there have also been well-documented stumbling blocks, including perceptions that SBP has eroded the amount of curricular time available for more medically focused competencies, is not relevant for some practice contexts, and is not introduced early enough in training. As a result, SBP learning experiences often feel disconnected from medical trainees' practical reality. In this commentary, the authors provide guidance regarding potential changes that may facilitate the evolution of SBP toward an ideal future state where graduates bring a systems science mindset to all aspects of their work. Specific suggestions include the following: (1) expanding the SBP toolbox to reflect current-day health system needs, (2) evolve the teaching methodology, (3) broadening the scope of relevant SBP content areas, and (4) emphasizing SBP as an integrated responsibility for all health care team members. Levers to enact this transformation exist and must be used to influence change at the learner, faculty, program, and clinical learning environment levels.Physicians operate within an increasingly complex health care system that highlights the intersection of health care with complex social, environmental, and relational contexts. Consequently, the role of SBP in both physician work responsibilities and educational requirements continues to expand. To meet this growing demand, GME must adapt how it supports and trains the next generation of systems thinkers, ensuring they understand how levers in the health care system directly affect health outcomes for their patients, and integrate SBP into the foundation of GME curricula in an inclusive, holistic, and unrestrained way.

[Construction and application of virtual simulation teaching platform for in-hospital emergency nursing of craniofacial injury patients].

PURPOSE: To construct a virtual simulation teaching platform for in-hospital emergency nursing of craniofacial injury patients by virtual simulation technology, and to evaluate its application effect. METHODS: Through virtual reality, animation, human-computer interaction and other technologies, a 3D experiment scene based on high simulation virtual human was constructed to reproduce the virtual rescue scenes of craniofacial injury patients, such as emergency reception, first-aid cooperation, massive hemorrhage rescue cooperation, and tracheotomy cooperation in emergency rescue of sudden airway obstruction, and exercise modules and assessment modules were set. In the virtual simulation platform, the students used the holistic nursing theory and the PDCA cycle method to observe, evaluate and care for craniofacial injury patients. Preliminary evaluation of the platform was carried out in the training of 62 dental nurses. RESULTS: The virtual simulation platform could improve students' comprehensive first-aid ability for craniofacial injury patients. The item with the highest satisfaction rate for the virtual simulation platform was the consistency between the content of the virtual simulation platform and the theoretical course (the satisfaction rate was 91.9%), and the lowest satisfaction rate was the convenience of the virtual simulation platform operation and the page setting (the satisfaction rate was 80.6%). The evaluation module of the virtual simulation platform showed that the highest score of the comprehensive evaluation was 97, the lowest score was 56, and the average score was 80.2. CONCLUSIONS: The virtual simulation teaching platform for in-hospital first aid of craniofacial injury patients can create an immersive learning mode, provide an intuitive rescue experience to the students, and improve their comprehensive first-aid ability.

Teaching spirituality to Canadian medical students: students' perceptions of a spiritual history taking clinical skills session.

Spirituality involves one's sense of purpose, connection with others, and ability to find meaning in life. We implemented a three-year pilot of a spiritual history taking (SHT) clinical skills session. In small groups, medical students discussed and practiced SHT with clinical scenarios and the FICA framework and received preceptor and peer feedback. Post-session focus groups and interviews demonstrated student perceptions of improved comfort, knowledge, and awareness of discussing spirituality with patients. This innovation may support improved clinical skills teaching across other health professions institutions to better prepare students to recognize patients' spiritual needs and provide more holistic, culturally competent care.

La spiritualité touche au sentiment d'avoir une raison d'être, à la relation à l'autre et à la capacité de trouver un sens à la vie1. Nous avons mis en place, comme projet pilote de trois ans, une séance visant l'acquisition de compétences cliniques portant sur l'anamnèse spirituelle (AS). En petits groupes, les étudiants discutaient de l'anamnèse spirituelle et la mettaient en pratique au moyen de scénarios cliniques et du questionnaire d'anamnèse spirituelle FICA2, puis recevaient des commentaires de la part de leur précepteur et de leurs pairs. Les groupes de discussion et les entretiens après les séances ont montré que les étudiants se sentaient mieux informés, plus à l'aise et plus conscients de la nécessité de parler de spiritualité avec les patients. Cette innovation peut contribuer à améliorer l'enseignement des compétences cliniques dans d'autres professions de la santé pour mieux préparer les étudiants à reconnaître les besoins spirituels des patients et à fournir des soins plus holistiques et culturellement adaptés.

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

BACKGROUND: Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in Ethiopia. METHODS: A quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020. RESULT: The age of the respondents varies from 24 to 34 years, with the control group's mean age being 28.8 (± 2.3) years and the intervention group's mean age being 27.2 (± 2.01) years. The intervention and control groups' pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these. CONCLUSIONS: The study showed that simulation-based education improved students' procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.