New veterinary graduates are challenged by problem calvings often presenting as emergencies out of hours when support might not be readily on hand despite veterinary accrediting bodies stating that calving a cow is a day one competence. Simulation has been increasingly used in veterinary education and there are numerous reports of its success. Integrating simulation into the curriculum using a blended approach with online material has more limited evidence within the literature. The main aim of this study was to explore whether student confidence levels (CL) and competence (CO) in calving cows are enhanced by a blended learning approach.

Over three academic study years, 347 eligible fourth year veterinary students were allocated to one of four teaching groups: lectures only (LEC, n = 60) computer assisted learning (CAL, n = 59), calving model simulator (SIM, n = 96) and CAL&SIM (n = 85). Students were asked to complete a questionnaire (before and after teaching) and were also assessed in a formative calving OSCE.

For CL, students self-rated with higher confidence after exposure to the SIM (42.3, 95% CI 40.9 – 43.8) alone or blended with the CAL (44.3, 95% CI 42.8 – 45.7) when compared to both the LEC (33.3, 95% CI 31.2 – 35.5) and CAL (35.4, 95% CI 33.5 – 37.4). Multiple logistic regression identified teaching group as influencing overall CL after teaching. For CO, the proportion of pass and excellent students in the LEC teaching group (40%) was lower compared to all other teaching groups (CAL 73%, SIM 84%, CAL&SIM 87%). Regression identified that teaching group and OSCE assessor influenced OSCE pass rates.

In conclusion, the implementation of a SIM as part of a blended learning approach when teaching students how to calve cows has a very positive impact on self-assessed student confidence and on competence assessed by a formative OSCE exam.