Digital Game and Simulation in Midwifery Education

Official title

The Effect Of Dıgıtal Game-Based Learnıng On Learnıng Motıvatıon And Attıtude In Preeclampsıa-Eclampsıa Educatıon In Mıdwıfery Students: Comparıson Wıth Sımulatıon And Tradıtıonal Educatıon

Overview

Preeclampsia and eclampsia are among the leading causes of maternal death and morbidity, and are obstetric emergencies that lead to serious complications during pregnancy. Preeclampsia affects 2-8% of pregnancies worldwide; approximately 46,000 maternal deaths and approximately 500,000 fetal or neonatal deaths occur annually due to preeclampsia. This situation highlights the importance of well-equipped midwifery care, especially in terms of early diagnosis, accurate assessment, emergency intervention, and effective management. Traditional teaching methods alone are insufficient for midwifery students to develop clinical decision-making skills in life-threatening situations such as preeclampsia and eclampsia, and to translate theoretical knowledge into practice. Therefore, new teaching approaches that support active learning, interaction, and decision-making processes in education are needed. In recent years, digital game-based learning has emerged as an innovative tool in health education with its potential to attract learners' attention, improve problem-solving skills, and increase their motivation. Especially for midwifery students, digital games facilitate experiential learning by providing a safe simulation environment in preparation for information overload and stressful clinical environments. However, the use of digital games in teaching complex clinical processes such as preeclampsia and eclampsia management has been researched to a limited extent. Scientifically examining the effects of such innovative methods on students' learning motivation, attitude, and active participation in the learning process in midwifery education will fill an important gap in the literature. In this context, evaluating digital game-based learning in preeclampsia-eclampsia management education by comparing it with simulation training and traditional teaching will make a significant contribution to both the midwifery education literature and the knowledge base regarding the use of technology in health education.

Detailed description

Original Value of the Thesis This thesis is one of the first comprehensive experimental studies to examine the effect of a digital game-based learning approach on motivation and attitudes in preeclampsia-eclampsia management training for midwifery students.

The original value of the study is highlighted by the following points:

* Originality of scope and subject:

o The application of a digital game-based learning model based on preeclampsia-eclampsia management, one of the obstetric emergency issues in midwifery education, is a subject that has been studied in limited numbers in the literature. * Methodological innovation:

* The comparative examination of three different teaching approaches (digital game, simulation, traditional education) in the research provides the opportunity to comprehensively evaluate the effects of different learning environments. * The experimental design, supported by both quantitative and qualitative data collection methods, will allow for in-depth analysis of the results. * Contribution to educational technologies:

* The digital game, which will be developed specifically for preeclampsia-eclampsia management, is a unique product as an innovative teaching material that can be adapted to the midwifery curriculum. 4. Contribution to midwifery education: * The research results will provide a scientific basis for integrating technology-based approaches into the curriculum that can increase the active participation, motivation, and attitude towards learning of midwifery students.

Research Hypotheses H1: Midwifery students who received training with a digital game-based learning method have significantly higher learning motivation compared to simulation and traditional education groups.

H2: Students who received training with a digital game-based learning method have more positive attitudes towards learning compared to simulation and traditional education groups.

H3: Students who received simulation training have significantly higher learning motivation and attitudes compared to students who received traditional education.

H4: The digital game-based learning method increases students' participation, interest, and satisfaction levels in the learning process.

Research Objective The main objective of this research is to determine the effect of digital game-based learning methods on the learning motivation and attitudes towards learning of midwifery students in preeclampsia-eclampsia management training.

Within the scope of the research, the digital game-based learning method will be compared with simulation-based training and traditional teaching methods, and the effects of these three different teaching approaches on the learning processes of midwifery students will be evaluated comparatively.

This study aims to reveal the effectiveness of using digital game-based learning in teaching processes for obstetric emergencies in midwifery education, and to propose a learning model that will increase students' intrinsic motivation towards learning and support the development of positive attitudes.

It is aimed that the research results will contribute to the modernization of midwifery education, the dissemination of technology-based learning strategies, and the development of innovative methods in teaching obstetric emergencies.

Research Objectives The overall objective of this research is to compare the effects of digital game-based learning, simulation training, and traditional teaching methods on the learning motivation and attitudes towards learning of midwifery students.

In line with this general objective, the following specific objectives are planned to be achieved:

* To evaluate the effect of digital game-based learning on the learning motivation of midwifery students in preeclampsia-eclampsia management training. * To determine the effect of simulation-based training on students' learning motivation and compare it with digital game-based learning. * To examine the effect of traditional teaching methods on students' learning motivation and highlight the differences between them and other methods. * To compare the effects of digital game-based learning, simulation, and traditional teaching methods on students' attitudes towards learning. * To qualitatively analyze the opinions, experiences, and feedback of students participating in the digital game-based learning process regarding the method and to reveal the strengths and areas for improvement of the method. * To develop recommendations regarding the applicability of digital game-based learning in preeclampsia-eclampsia management training and its integration into the midwifery curriculum based on the findings obtained. Expected Contributions of the Research

The results of this research are expected to:

* Provide evidence-based information on the effect of digital game-based learning on learning motivation and attitudes in midwifery students, * Demonstrate the effectiveness of technology-based, student-centered teaching methods in teaching obstetric emergencies, * Create a model for the integration of digital game-based learning approaches into midwifery education programs, * Contribute to the joint evaluation of gamification and simulation in the field of health education.

Interventions

• Behavioral DIGITAL GAME-BASED EDUCATION
  This intervention encompasses an educational program that presents content on the management of preeclampsia and eclampsia using a digital gamification approach. The training is conducted through a digital game platform developed by the researcher. Participants actively engage in the learning process through interactive tasks, decision-making processes, and problem-solving activities based on clinical scenarios. The game content covers the definition of preeclampsia and eclampsia, risk factors,
• Behavioral SIMULATION TRAINING
  Preeclampsia and eclampsia management is simulated through highly realistic clinical scenarios. Students have the opportunity to actively intervene in clinical situations using simulation mannequins. Simulation applications include patient assessment, diagnosis, appropriate intervention planning, and clinical decision-making processes. Participants take an active role during the application and experience scenario-based learning. This method aims to develop practical skills, increase clinical
• Behavioral TRADITIONAL TRAINING
  This intervention comprises standard theoretical training on the management of preeclampsia and eclampsia. Training is conducted through face-to-face lectures, presentations (PowerPoint), and clinical practice guidebooks. Students passively receive information in this instructor-centered process, with limited interaction. The training content covers the definition of preeclampsia and eclampsia, risk factors, clinical findings, diagnostic criteria, complications, and management steps. This inter

Primary outcome measures

• CHANGES IN KNOWLEDGE LEVEL SCORE REGARDING PREECLAMPSIA AND ECLAMPSIA MANAGEMENT [Time frame: 6-8 weeks]
• CHANGES IN ATTITUDE SCORES TOWARDS PREECLAMPSIA AND ECLAMPSIA MANAGEMENT [Time frame: 6-8 weeks]

Eligibility criteria

Inclusion criteria

• Being an undergraduate midwifery student (4th year).
• Giving written consent to the study.

Exclusion criteria

• Having previously received advanced training or clinical assignment in preeclampsia/eclampsia management.
• Regularly using a similar digital game developed on the subject.
• Health or cognitive limitations that prevent continuation of the research process (according to the student's statement).

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Health services research

Study locations

Turkey (Türkiye) · 1 center

• Istanbul Medipol University — Istanbul

Publications

• Odame-Amoabeng S, Akalin A, D'haenens F, Tricas-Sauras S, Chang YS. Immersive insights: A qualitative systematic review and thematic synthesis of views, experiences, health and wellbeing of students and educators using virtual reality in nursing and midwifery education. Nurse Educ Today. 2025 Jul;150:106679. doi: 10.1016/j.nedt.2025.106679. Epub 2025 Mar 11. PMID 40112463
• Mikkonen K, Liaw SY, Spirgiene L, Subocius A, Ignatavicius P, Blazauskas T, Riklikiene O. Multidimensional pedagogical framework for interprofessional education: Blending classroom, high fidelity and extended reality simulation. Nurse Educ Today. 2025 Nov;154:106838. doi: 10.1016/j.nedt.2025.106838. Epub 2025 Jul 29. PMID 40773797
• Gray M, Downer T, Hartz D, Andersen P, Hanson J, Gao Y. The impact of three-dimensional visualisation on midwifery student learning, compared with traditional education for teaching the third stage of labour: A pilot randomised controlled trial. Nurse Educ Today. 2022 Jan;108:105184. doi: 10.1016/j.nedt.2021.105184. Epub 2021 Oct 23. PMID 34717099
• Chen SH, Lin BB, Wang XY, Xu GR, Song JH. Construction and implementation of a comprehensive midwifery skills practice course based on scenario simulation teaching: An action research. Nurse Educ Today. 2025 Sep;152:106754. doi: 10.1016/j.nedt.2025.106754. Epub 2025 Apr 17. PMID 40288241

Identifiers

NCT: NCT07567430 · E-10840098-202.3.02-1266

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗