Development of Newborn and Umbilical Cord in A Low-cost Model for Teaching and Training

Each year


Introduction
Faculty of Nursing Its main mission is to produce nursing personnel who are knowledgeable in both professional and related sciences.Nursing graduates must be able to apply knowledge in midwifery practice appropriately and efficiently.Have a good attitude towards the profession, morality, ethics, and leadership.Have good judgment in analyzing problems and good decisions.Thailand Nursing and Midwifery Council had Midwifery Practices Standards 2019, which consists of 9 standards as follows: 1) General midwifery practice 2) Antenatal care 3) Intrapartum care 4) Postpartum care 5) Life-saving midwifery practice 6) preserving professional ethics, midwifery service recipients and ethics 7) Standards for improving the quality of midwifery practice 8) Standards care management 9) Standards for recording and reporting.Both theoretical and practical instruction on maternal and newborn nursing and midwifery practicum is provided in Thailand as part of the bachelor's degree program in nursing science compiling a minimum of 12 credits.(Ministry of Education, 2017) Maternal and Newborn Nursing and Midwifery Practicum, the delivery department will serve as a practicum for nursing students.which is required to give nursing care during delivery and newborn.Furthermore, for nursing students practicing in the delivery department, delivery is a crucial and core competency in the practical course evaluation requirements.
The practice of caring for the clients of the service provider is the primary focus of the nursing profession.As a result, the core of the nursing program is practical teaching, where nursing students apply theoretical knowledge to service recipients.Both maternal and newborn nursing care, which calls for specialized knowledge, are required for the midwifery nursing practicum.Nursing students must hone their skills before practicing in the clinic.Thus, before starting their hands-on training in the clinic, nursing students need to hone their nursing skills in all activities.
Nursing students who are enrolled in the maternal and newborn nursing and midwifery practicum must complete clinical practice in the delivery department to deliver care for nursing mothers and newborns.Therefore, before practicing in the clinic, nursing students need to practice operating in nursing laboratories to be proficient in ensuring the safety of service recipients and build confidence for nursing students (Kainer, 2014).It is imperative to set up teaching and learning activities in the laboratory using efficient teaching resources so that students can pick up knowledge quickly and accurately as a result, learners' behavior changes under the teaching objectives correctly and appropriately (Morgan, 2006).Many media are used in laboratories nursing to teach and learn health sciences, including models and computer programs (Wipada, 2015).In nursing laboratories, the model is a popular instructional media that allows students to practice a variety of skills under the learning objectives.Instructor provides close guidance to ensure that nursing skills and abilities are developed under academic principles.Capable of conducting sound, principled analyses and accurate evaluations of nursing practice.In addition to using the understanding acquired from the theory section (Monthathip, 2014).Additionally, it will assist students in developing the right skills because nursing students have the chance to practice skills from models regularly until they become proficient it boosts confidence and lessens anxiety (Umasawan, Nadsuda & Jirawan, 2022).
Each year, nursing schools spend more on classroom supplies at the nursing lab to help nursing students develop their practical skills before clinical internships.To teach nursing students how to prepare for their experience in the clinic, the nursing school needs to purchase a variety of teaching tools, including the newborn model, which is quite expensive.To lower teaching and training costs, it is crucial to develop the newborn model of education.Consequently, to equip nursing students with competent delivery techniques and necessary practice cutting the newborn's umbilical cord to become proficient.To reduce production costs compared to imported mannequins, the researcher created a newborn mannequin with an umbilical cord set.Able to move with ease boosts educational resources while cutting expenses exercise can be repeated by students as needed, and most significantly, it will improve their nursing practice abilities.This has an impact on the hospital's service quality and service recipient satisfaction.

Methods
The device and materials assembled the newborn and umbilical cord in a low-cost model for Teaching and Training, as shown in Figure 1, 2.  2. There are automatic and manual forms of crying and movement.
3. It has remote controls that can change the crying volume and movement speed.

Participating and Methods
The 30 purposive samplings were selected by the Nursing Professor Nurse and Engineering Professor.Data were collected from expert interviews and newborn and umbilical cord model tests using an assessment form.

Data Collection Tools
The instruments used for data collection were the newborn and umbilical cord model assessment a total of 12 items totaling 60 points.These were rated on 5-point Likert scales (1-5 points) with the following ratings: lowest, low, moderate, high, and highest.The interpretation of the scores was divided into the following five levels of skill: lowest (1.00-1.50points); low (1.51-2.50points); moderate (2.51-3.50points); high (3.51-4.50points) and highest (4.51-5.00points).The instruments were examined by five qualified experts who tested for validity and item-objective congruence (IOC).The validity assessment was 0.92.The reliabilities of these instruments were tryout with 30 samples by finding Cronbach's alpha coefficient (α-coefficient), which equaled 0.94.

Data Analysis
Data were analyzed using Descriptive statistics and content analysis.

Ethical Considerations
This research project was considered and certified by the Institutional Review Board on Research Involving Human Subjects, Rajamangala University of Technology Thanyaburi, Project Code: RMUTT_REC No. Exp 72/65 on 17 October 2022.

Results
Data was collected using semi-structured interviews with Nursing Professors 50%, Nursing 33.33%, and Engineering Professors 6.67% conducted in October and November 2022.Demographic data of the participants.The Expert opinions on trying out the newborn and umbilical cord model found that the creativity and possibilities of commercial development to the highest scores and the materials used are appropriate high scores.

Discussion
The newborn and umbilical cord model has operational functions: 1) The arms and legs of the newborn model move with a cry that controls starting and stopping by remote control.2) Movement and cry patterns have two functions: automatic and manual.3) Movement speed and cry volume can be adjusted by remote control.It is made from a hose that is inexpensive and simple to cut, it is like a real umbilical cord and is very low-cost and effective.The Expert opinions about testing the newborn and umbilical cord model discovered that the creativity and possibilities of commercial development to the highest scores and the materials used are appropriate high scores.This result is consistent with research by Rattanapenporn et al., (2022) who found that the developed water-pressure control mannequin revealed a higher statistically significant average score on quality than the original mannequins as a p-value <.05.and, the water-pressure rubber mannequins are suitable for teaching in maternal and newborn nursing and midwifery subjects.It is appropriate for practicing uterine contraction assessment skills for nursing students to prepare before practicing in the hospital.Therefore, the creation of mannequins is encouraging and facilitating learning for nursing students.Because it can be felt and experienced, it operates more effectively.As such, the developed mannequin's cost-effectiveness is an advantage.Furthermore, it was shown that using models to support instruction in practice and demonstration would improve nursing students' achievement and memory permanence (Umasawan, Nadsuda & Jirawan, 2022;Winai, Sarawut, Punnapa & Jadsada, 2017;Patamamas, Kittiporn, Tharinee & Jaroonrat, 2013).
The safety of newborns is a priority, models serve as a medium for simulating nursing practice skills so that nursing students can become proficient before practicing in the clinic.Nursing students' inability to cut the umbilical cord to assist with delivery will result in delays, increase the Maternal and newborn risk (WHO, 2014), and lead to umbilical cord infections if sterile techniques are not good it can be a pathway for bacteria that can cause newborn sepsis and death (Patricia & Siobhan, 2017;Peter et al., 2017;Liu et al., 2015).Acquiring knowledge through diverse methods and approaches not able to read or learn from only textbooks.Observation and practices prior to the nursing student giving the patient nursing care before they have practiced until proficient.Being unconfident can cause issues for a nurse's practice.Nursing students can improve practical skills by using the created models repeatedly for practice (Supalak & Dolrat, 2015).Developing models as teaching media for understanding and practicing important skills is necessary before nursing students begin practicing in the clinic.Therefore, the newborn and umbilical cord in a low-cost model can be used as a medium for demonstration and practice in the nursing laboratory.It can be used as a medium for nursing students to study on their many times to practice their skills until they become proficient.(Tharinee & Pattamamas, 2021& Mahasneh et al., 2021) aligns with the research of Susanha et al., (2018) who developed a vaginal exam simulation box for labor progression assessment training.By using wood and rubber materials to develop a vaginal exam simulation box to practice evaluating the progress of labor.The rubber used makes it flexible and maintains a shape like human tissue can be used for teaching and learning and consistent with the study of Wichaya et al., (2018)  The Expert opinions on trying out the development of newborn and umbilical cord in a low-cost model for Teaching and Training found that: Quality overall average is the highest score.It is made from a hose that is cheaper and simple to cut, like a real newborn umbilical cord, and is very low-cost and effective.As a result, using the newborn and umbilical cord in a low-cost model to improve practice skills for students is another crucial option that is thought to be a valuable experience.Students can practice cutting a newborn's umbilical cord to increase their knowledge, comprehension, and proficiency most importantly, it will give students more confidence when they practice it frequently before using it in the clinic.Additionally, it reduces the cost of importing newborn umbilical cord models from abroad.

Conclusions
The newborn and umbilical cord in a low-cost model can be used in practice.It is made from a hose that is cheaper and simple to cut, like a real newborn umbilical cord and is very low-cost and effective also.Reduce the cost of ordering teaching supplies.

Figure 1 .
Figure 1.Block diagram of movement controller of newborn model

Figure 2 .
Figure 2. Newborn and umbilical cord in a low-cost model

Table 1 .
Demographic data of the participants

Table 2 .
Expert opinions on the newborn and umbilical cord model Susanha (2016)chai (2018)" model for chest compression training among nursing students.Studying the development of the FON CMU breast model for teaching breastfeeding.It was found that breast models can be used as teaching materials for breastfeeding.And aligns with the research ofJiraporn & Somchai (2018)study about Developing simulation model for fetal position assessment training skill found that the quality of the model has the highest average score and can be used as a teaching tool for evaluating rotate the fetus in utero.Including the study ofSusanha (2016)study of developing stimulation model for training clinical skill of health science students found that models are the key to developing and increasing knowledge in health science.