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Purpose:
This study aims to evaluate the effects of an educational digital escape room game-based Psychological First Aid (PFA) training on the PFA self-efficacy and problem-solving levels of undergraduate midwifery students.
Methods:
The study will be conducted as a randomized controlled trial with a pretest, posttest, and follow-up design at the Health Sciences University (SBU), Hamidiye Faculty of Health Sciences, Department of Midwifery during the spring semester of the 2025-2026 academic year. Second-year midwifery students will be randomly assigned to either the intervention group or the control group using a stratified randomization method based on their Grade Point Average (GPA).
Both groups will receive a standardized theoretical PFA training program. In addition to this training, the intervention group will participate in an interactive digital escape room game developed on the Genially platform, consisting of short web-based scenarios under 20 minutes. The control group will receive only the standard theoretical education. Data will be collected at baseline (Week 1), post-intervention (Week 3), and during follow-up phases using the Psychological First Aid Self-Efficacy Scale and the Problem Solving Inventory to compare the behavioral and educational outcomes between the two groups.
Midwives play a critical role in providing psychosocial and emergency obstetric support during disasters, conflicts, and public health crises. However, healthcare professionals face high psychological risks, secondary trauma, and burnout during these periods. Enhancing their psychological preparedness, self-efficacy, and problem-solving skills is vital for maternal-child survival rates and healthcare quality. Traditional theoretical methods are increasingly being replaced by game-based learning (GBL) and gamification to improve clinical decision-making. This study utilizes an interactive, scenario-based digital escape room to bridge the gap between theoretical psychological first aid and active problem-solving skills.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group (Game-Based PFA Training) | Experimental | Second-year midwifery students in this arm will receive both the standard theoretical training and the interactive digital escape room game. |
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| Control Group (Standard PFA Training) | Active Comparator | Second-year midwifery students in this arm will receive only the standard theoretical training program during the study period. (Note: They will be cross-over given access to the digital game after all data collection is completed for ethical equity). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital Escape Room Game via Genially | Behavioral | An interactive, scenario-based educational digital escape room game developed on the Genially platform. The content consists of clinical and psychological emergency midwifery scenarios tailored to last no longer than 20 minutes per session to prevent cognitive overload. It focuses on active problem-solving, triage, and applying PFA principles under stress. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in Psychological First Aid Self-Efficacy Scale Score Immediately After the Intervention | The Psychological First Aid Self-Efficacy Scale is a 35-item self-report instrument used to evaluate the participants' perceived competence and preparedness in delivering acute psychological first aid during crises. All items are scored on a 5-point Likert-type scale (1 = Strongly Disagree to 5 = Strongly Agree). There are no reverse-scored items. The total score is calculated by summing all responses, ranging from a minimum score of 35 to a maximum score of 175. Higher total scores indicate a superior level of self-efficacy and better psychological readiness in implementing psychological first aid interventions, while lower scores indicate lower self-efficacy. | Baseline (Day 1, prior to the start of the theoretical training) and immediately after the completion of the educational intervention phase (Week 2/Week 3 boundary, right after the last gaming/theoretical session). |
| Outcome Measure Title: Change from Baseline in Problem Solving Inventory (PSI) Score Immediately After the Intervention | The Problem Solving Inventory (PSI), originally developed by Heppner and Petersen, is a 32-item self-report instrument that assesses individuals' cognitive perceptions of their own problem-solving behaviors and coping strategies. Items are scored on a 6-point Likert scale. Total scores on the inventory range from a minimum of 32 to a maximum of 192. In terms of clinical and behavioral interpretation, the scoring is inversely aligned: lower total scores indicate that the student perceives themselves as highly competent, sufficient, and successful in problem-solving skills. Conversely, higher total scores reflect a lower perception of problem-solving confidence and perceived insufficiency in coping with challenges. | Baseline (Day 1, prior to the start of the theoretical training) and immediately after the completion of the educational intervention phase (Week 2/Week 3 boundary, right after the last gaming/theoretical session). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yasemin AYDIN KARTAL Prof. Dr. | Contact | (0216) 777 87 77 | yasemin.aydin@sbu.edu.tr | |
| Sema AKER Res. Ass. | Contact | semanuraker@gmail.com |
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| ID | Term |
|---|---|
| D051183 | Desmoglein 1 |
| ID | Term |
|---|---|
| D051182 | Desmogleins |
| D051181 | Desmosomal Cadherins |
| D015820 | Cadherins |
| D015815 | Cell Adhesion Molecules |
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Randomized controlled double-blind experimental study
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The research process will be conducted with a double-blind design; both participants and data collectors will be unaware of group assignment.
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| Standardized Theoretical Psychological First Aid (PFA) Training | Other | A structured classroom-based theoretical training module developed in accordance with international guidelines and expert opinions. |
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| D008562 |
| Membrane Glycoproteins |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D008565 | Membrane Proteins |
| D000954 | Antigens, Surface |
| D000941 | Antigens |
| D001685 | Biological Factors |
| D001324 | Autoantigens |