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The aim of this educational research is to determine whether a mixed reality-based training program is effective in teaching midwifery students how to assess cervical effacement and dilation. The study also examines the impact of mixed reality on students' cognitive load, sense of presence, and midwifery professional perception.
The main questions the study seeks to answer are:
Does mixed reality training reduce students' cognitive load?
Does mixed reality increase the students' sense of presence?
How does mixed reality-based training influence students' professional perception of midwifery?
Do students who receive mixed reality training perform better in assessing cervical effacement and dilation on real pregnant women compared with the control group?
The aim of this educational research is to determine whether a mixed reality-based training program is effective in teaching midwifery students how to assess cervical effacement and dilation. The study also examines the impact of mixed reality on students' cognitive load, sense of presence, and midwifery professional perception.
The main questions the study seeks to answer are:
Does mixed reality training reduce students' cognitive load?
Does mixed reality increase the students' sense of presence?
How does mixed reality-based training influence students' professional perception of midwifery?
Do students who receive mixed reality training perform better in assessing cervical effacement and dilation on real pregnant women compared with the control group?
How the research will be conducted:
Researchers will compare a mixed reality intervention group with a control group receiving traditional training. Students in both groups will evaluate five different pregnant women to assess cervical effacement and dilation in real clinical settings.
Participants will:
Receive either mixed reality-based training (intervention) or traditional instruction (control)
Complete the Cognitive Load Scale, Sense of Presence Scale, and Midwifery Professional Perception Scale
Perform cervical effacement and dilation assessments on five pregnant women during clinical practice
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mixed Reality Training Group | Experimental | Students will participate in a mixed reality (MR)-based training program. |
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| Standard Education Group | Active Comparator | Students in the control group will receive traditional theoretical instruction. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| mixed reality education | Other | Students will participate in a mixed reality (MR)-based training program. The program is designed to teach cervical effacement and dilation assessment. During the training, students will interact with three-dimensional virtual cervical models. They will be able to practice repeatedly in a safe, error-free environment to enhance their clinical skills. After completing MR training, students will perform vaginal examinations on 10 virtual patient scenarios. The accuracy of each assessment will be automatically evaluated by the system. Following MR training, students will conduct vaginal examinations on five pregnant women under researcher supervision in a real clinical setting. The following scales will be administered to participants: Cognitive Load Scale Sense of Presence Scale Midwifery Professional Perception Scale These measures will be used to determine the cognitive and professional effects of MR-based learning. |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of Cervical Dilation Measurement (cm) | Accuracy of cervical dilation measurement will be assessed by calculating the absolute difference (in centimeters) between the student's measurement and the researcher's reference measurement. Each participant will perform one vaginal examination on five different pregnant women. The mean absolute difference across all five assessments will be reported as the participant's cervical dilation measurement accuracy. Smaller values indicate higher accuracy. | 4 month |
| Accuracy of Cervical Effacement Measurement (%) | Cervical effacement accuracy will be assessed by calculating the absolute difference (in percentage points) between the student's effacement measurement and the researcher's reference measurement. Each participant will perform one vaginal examination on five different pregnant women. The mean absolute difference across all five assessments will be reported as the participant's cervical effacement measurement accuracy. Smaller values indicate higher accuracy. | 4 month |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of Cognitive Load | Cognitive load will be assessed using the Cognitive Load Scale, a 9-point Likert-type measure. Participants will respond to the question "How much mental effort did you invest in completing the task?" by selecting a score between 1 (low) and 9 (high). The midpoint of the scale is 5; participants scoring above this value will be considered to have experienced higher levels of cognitive load. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ülkin Gündüz Aruser, Ph.D | Contact | +905314592113 | ulkingunduz@artuklu.edu.tr | |
| Hacer Ünver Koca, Assoc. Prof. | Contact | +905446799899 | hacer.unver@inonu.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Ülkin Gündüz Aruser, Ph.D | Mardin Artuklu University | Principal Investigator |
| Hacer Ünver Koca, Assoc. Prof. | Inonu University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mardin Training and Research Hospital | Recruiting | Mardin | 47200 | Turkey (Türkiye) |
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Randomized, parallel-group controlled trial including an intervention group receiving mixed reality training and a control group receiving standard education.
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Participants were blinded to group allocation, and the outcomes assessor was blinded to the intervention received by each participant to prevent assessment bias.
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| Standard Education Group | Other | Students in the control group will receive traditional theoretical instruction. The training content will cover the principles of cervical effacement and dilation assessment. After completing the theoretical training, students will complete the Cognitive Load Scale and the Midwifery Professional Perception Scale. Under researcher supervision, students will perform vaginal examinations on five pregnant women to assess cervical effacement and dilation. These evaluations will be used to examine the effects of traditional training on students' cognitive load, professional perception, and practical assessment skills. |
|
| 4 months |
| Assessment of Presence Experience | The sense of presence will be assessed using the Presence Scale (PS) adapted to a 5-point Likert scale. Participants will rate their virtual reality experience from 1 (strongly disagree) to 5 (strongly agree). Higher subscale scores indicate that the virtual environment is perceived as more realistic and that the sense of presence is stronger. | Immediately after MR training (within 1 day) |
| Assessment of Midwifery Professional Perception | Midwifery professional perception will be assessed using the Midwifery Professional Perception Scale (MPPS). Participants will rate statements reflecting their perceptions of the midwifery profession on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate a more positive perception of the midwifery profession. | 4 months |