Application of Gagné's Instructional Design in Clinical Simulation: Enhancing Learning in Obstetric Emergency...

Simulation-based learning is a critical component in medical education, particularly for high-risk scenarios like obstetric emergencies. This study utilized Gagné's nine-step instructional model to design and evaluate a clinical simulation session on postpartum hemorrhage (PPH) management for fourth-year medical students.

The session was structured using Gagné's instructional events, including engaging case vignettes, multimedia presentations, guided practical activities, and immediate feedback. Pre- and post-tests measured knowledge gains, while a 12-item Likert scale questionnaire assessed student satisfaction. A focus group discussion (FGD) was conducted to explore student perceptions and analyzed thematically to identify key areas for improvement.

The session demonstrated significant knowledge improvement, with post-test scores (mean: 82.9%, 95% CI: 76.8-81.1) significantly higher than pre-test scores (mean: 68.4%, 95% CI: 60.7-66.1; p < 0.001). The instructional activities received high ratings (mean: 5/5), highlighting the alignment of objectives and content. The FGD thematic analysis revealed five key themes: "learning effectiveness", "realism and application", "feedback and improvement", "session challenges", and "recommendations for enhancement". Students suggested more diverse scenarios, extended debriefing sessions, and standardized feedback delivery.

The integration of Gagné's instructional model into simulation-based learning enhanced knowledge acquisition and student satisfaction. Recommendations for improvement include refining feedback mechanisms, increasing session diversity, and extending reflective discussions. This approach supports its utility in teaching critical obstetric skills and highlights opportunities for further enhancement.