This study was planned to determine the effect of simulation-based training using two different reality levels-visually enhanced mental simulation (VEMS) and hybrid simulation-on postpartum haemorrhage (PPH) management skills in nursing students.

This study will be conducted to determine the effect of simulation-based training using two different reality levels-visually enhanced mental simulation (VEMS) and hybrid simulation-on postpartum haemorrhage (PPH) management skills in nursing students. PPH is one of the leading causes of postpartum maternal mortality and its effective management requires the knowledge, skills and coordination of the healthcare team. However, it is difficult for nursing students to acquire these skills directly in the clinical environment due to rare observation and structural limitations in education. Simulation-based education stands out as an important method to develop such critical clinical skills.

In this randomised comparative study, 4th year students studying at Bandırma Onyedi Eylül University, Department of Nursing who have completed the course of Women's Health and Diseases Nursing in the spring semester of the 2024-2025 academic year will be included in the study. The sample size was calculated by G*Power analysis and a total of 64 students were randomly assigned to two groups. One of the intervention groups will receive PPH management training with VEMS method and the other will receive PPH management training with hybrid simulation. The training programme will be conducted within the scope of a structured curriculum including theoretical training, skills training and simulation applications.

'Participant Information Form', "Postpartum Haemorrhage Management Observation Form" and "Student Satisfaction and Confidence in Learning Scale" will be used to collect data. The skill levels of the students will be evaluated by two independent observers, and learning satisfaction and self-confidence levels will be measured through the scales.

The findings of the study are expected to provide important contributions in evaluating the effect of simulation-based training on PPH management skills. In particular, it is investigated whether the low-cost and highly applicable VEMS method is effective in terms of student satisfaction, confidence in learning and skill development as an alternative to traditional simulation approaches. The results obtained from the study may provide evidence-based recommendations to increase the efficiency of simulation applications in nursing education.

Inclusion Criteria:

• Volunteering to participate in the research
• To have a grade point average of 2.00 and above

Exclusion Criteria:

• Not participating in all stages of the training programme
• Incomplete completion of data collection tools
• Wanting to leave the research.

Since the researcher is implementing the educational interventions and the students are aware of the interventions in the study, blinding will not be performed in this study. However, during the data analysis phase, the groups will be named as 1 and 2. Thus, the researcher performing the data analysis will be blinded to the type of intervention applied to the participants.