13 Midwifery students’ experiences of competency-based education: a comparative case study of high-fidelity simulation and traditional laboratory demonstration

Speaker:- Amina Suleiman Rajah & Halima Musa Abdul

Facilitator:- Fabella Elisa Cahyaningtyas

Abstract:- Background: Competency-based education (CBE) emphasises learner’s demonstration of integrated clinical competence in authentic contexts. Although simulation-based learning is widely used to support competency development, limited qualitative evidence exists Methods: A QUAL-dominant comparative case study design was used to explore student’s experiences of competency-based education across two instructional approaches among fourth-year midwifery students (N = 28) at Bayero University Kano, Nigeria. Cohort 1 received laboratory demonstration (n = 14) and Cohort 2 completed high-fidelity simulation at the ACEPHAP Simulation Laboratory (n = 14) over a period of 6 weeks. Data included performance observations and semi-structured interviews, which were analysed using directed content analysis guided by competency-based education principles. Results: Overall competency scores were higher in Cohort 2 than Cohort 1 (C1: 3.2 [0.4] vs C2: 3.8 [0.3], d = 1.70). Domain differences favoured simulation for communication (C1: 3.0 [0.6] vs C2: 3.8 [0.5], d = 1.45) and clinical judgment (C1: 2.9 [0.7] vs C2: 3.7 [0.6], d = 1.23), with a smaller difference in technical skills (C1: 3.6 [0.5] vs C2: 3.9 [0.4], d = 0.66). Six themes emerged describing contrasting learning mechanisms: (1) structured competency development and clarity of expectations; (2) procedural sequencing versus clinical judgment and readiness for complex situations; (3) pseudo-realistic versus controlled and simplified experience; (4) feedback quality and assessment transparency; (5)psychological safety, confidence, and learning from error; and (6) preparedness for real clinical practice. Conclusion: Traditional laboratory demonstration provided foundational exposure to clinical skills, whereas high-fidelity simulation supported the development of integrated clinical competence.

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