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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.
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:
Contribution to educational technologies:
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:
The results of this research are expected to:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| traditional education | Active Comparator | In the traditional approach to preeclampsia management, standard face-to-face lectures, presentations, and guidebooks are used. This method is classically lecture-focused, with students in a passive listening position. Interaction is generally limited. This approach represents the most basic and traditional form of education. |
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| simulation training | Experimental | In the simulation training component, preeclampsia management is simulated with clinical scenarios that closely resemble real life. Students have the opportunity to practice critical situations firsthand using simulation mannequins or virtual environments. This method reinforces practical skills, provides immediate feedback, and strengthens students' clinical decision-making abilities. Simulation ensures safe learning by providing experience in a controlled environment. |
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| DIGITAL GAME-BASED EDUCATION | Experimental | In the digital game-based education component, preeclampsia management is presented through a gamification approach. Students actively participate in the learning process through interactive scenarios, problem-solving, and tasks. This method encourages learning in a fun and motivating environment. Progress, feedback, and competition elements in the game increase student engagement and strengthen their learning motivation. This component offers a modern and technology-focused learning experience. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DIGITAL GAME-BASED EDUCATION | Behavioral | 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, clinical findings, diagnostic criteria, and management steps. The intervention utilizes: a level-based structure that monitors participant progress, instant feedback mechanisms, and a task completion and achievement-based scoring system. These elements aim to increase learning motivation and support knowledge acquisition. This intervention represents an innovative and technology-based educational approach to be compared with other training methods used in the study |
| Measure | Description | Time Frame |
|---|---|---|
| CHANGES IN KNOWLEDGE LEVEL SCORE REGARDING PREECLAMPSIA AND ECLAMPSIA MANAGEMENT | Description: The primary outcome measure of this study is the change in the knowledge level of midwifery students regarding the management of preeclampsia and eclampsia. Knowledge level will be assessed using the Preeclampsia and Eclampsia Management Knowledge Test developed by the researcher. The test is scored on a scale of 0-100 points. Higher scores indicate a higher knowledge level. The knowledge test will be administered to all participants: before the intervention (baseline), immediately after the intervention, and again 4 weeks after the intervention. The analysis will evaluate the difference between the pre-test, post-test, and control test (4 weeks after the intervention) scores. | 6-8 weeks |
| CHANGES IN ATTITUDE SCORES TOWARDS PREECLAMPSIA AND ECLAMPSIA MANAGEMENT | Description: One of the key outcome measures of this study is the change in midwifery students' professional attitudes towards the management of preeclampsia and eclampsia. The level of attitude will be assessed using the Attitude Scale Towards Preeclampsia and Eclampsia Management, developed by the researcher. The scale is scored between 20 and 100 points. Higher scores indicate a more positive professional attitude. The scale will be administered to all participants: before the intervention (baseline), immediately after the completion of the intervention, and 4 weeks after the completion of the intervention. In the analysis, the difference between the pre-test, post-test, and control test (4 weeks after the completion of the intervention) scores will be evaluated. Time Frame: Before the intervention, immediately after the completion of the intervention (0 weeks), and 4 weeks after the completion of the intervention | 6-8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Seçil Topaloğlu Eti | Contact | +905513851091 | secil.topaloglu@medipol.edu.tr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medipol University | Istanbul | Istanbul | 34083 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40112463 | Background | 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. | |
| 40773797 |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Apr 3, 2026 | Apr 22, 2026 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D011225 | Pre-Eclampsia |
| D004461 | Eclampsia |
| ID | Term |
|---|---|
| D046110 | Hypertension, Pregnancy-Induced |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| SIMULATION TRAINING | Behavioral | 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 decision-making competence, and reinforce learning in a controlled and safe environment. |
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| TRADITIONAL TRAINING | Behavioral | 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 intervention represents a standard control approach for comparison with other training methods used in the study. |
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| 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. |
| 34717099 | Background | 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. |
| 40288241 | Background | 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. |