The effect of scenario-based high-fidelity simulation on midwifery students’ knowledge and self-efficacy in electronic fetal monitoring: A randomized controlled trial
Clinical Simulation in Nursing, cilt.113, 2026 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 113
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ecns.2026.101923
- Dergi Adı: Clinical Simulation in Nursing
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL
- Anahtar Kelimeler: Electronic fetal monitoring, High-fidelity simulation, Knowledge, Midwifery students, Self-efficacy
- İstanbul Medipol Üniversitesi Adresli: Evet
Özet
Background: Midwifery students often struggle with electronic fetal monitoring (EFM) due to limited clinical exposure and inconsistencies in instructional methods. Simulation-based experiences (SBE) offer a safe and realistic environment to practice interpretation and management skills, yet evidence on high-fidelity simulation (HFS) specifically for EFM remains limited. Aim: To evaluate the effects of scenario-based high-fidelity simulation on midwifery students’ EFM knowledge, self-efficacy, and performance. Methods: This randomized controlled trial included 96 second-year midwifery students. After theoretical instruction, participants were assigned to either an HFS group using standardized patients and realistic obstetric scenarios (n = 34) or a traditional model-based training group (n = 37). EFM knowledge, self-efficacy, and skills were assessed at baseline, post-training, Days 7 and 15, and at an 8-week follow-up. Data were analyzed with repeated-measures ANOVA, t-tests, Pearson correlation, and regression analysis. Results: The HFS group demonstrated significantly higher EFM knowledge at both follow-ups (mean differences: 7.56 and 9.44; p < .05). Self-efficacy increased significantly after training and remained stable over eight weeks (Cohen's d = 2.26-2.35). Knowledge strongly predicted self-efficacy (R² up to 0.84). Students performed better in basic scenarios than in complex scenarios, suggesting that complexity influences performance. Conclusions: High-fidelity simulation effectively enhances midwifery students’ EFM knowledge, self-efficacy, and applied skills. Progressive scenario complexity supports stronger cognitive and affective learning outcomes. Further research should explore long-term clinical transferability.