Developing clinical leadership through high-fidelity obstetric simulation : a multimethods study in Thai nursing students

Abstract

Background: Effective clinical leadership is essential for healthcare, particularly in high-stakes environments like obstetrics. Simulation-Based Learning (SBL) offers a controlled, replicable setting for students to engage in leadership roles. This study evaluates the effectiveness of SBL in enhancing clinical leadership skills among nursing students and explores how they apply leadership competencies within high-fidelity obstetric scenarios. Methods: A multimethod study was conducted with 23 fourth-year undergraduate nursing students attending two leadership simulation scenarios. Quantitative data comprised a validated clinical leadership skills assessment tool, with pre- and postintervention scores analyzed using paired t-tests. Focus group discussions provided qualitative insights into students' learning experiences. Results: The SBL yielded statistically significant improvements in cognitive competency, interpersonal competency and intrinsic competency (all p < .001). Thematic analysis identified “Building Leadership Resilience through Obstetric Nursing SBL” as the core theme and four accompanying themes. Conclusion: The SBL intervention seems an effective method for enhancing clinical leadership among nursing students in obstetrics. Thematic analysis identified that leadership resilience is fostered through decision-making under pressure, team trust and delegation, and emotional composure.