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Updated: May 1, 2026

Predicting the Effectiveness of Population Replacement Strategy Using Mathematical Modeling
Published on: July 4, 2007
Designing and evaluating a Merrill model-based educational package to enhance midwives' role in population
Zahra Abbasi1, Ehsan Toofaninejad2, Mahdyeh Zangiabadizadeh1,3
1Department of Medical Education, School of Medical Education and Learning Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction:
Global trends in population aging and declining fertility pose significant challenges to sustainable development. As frontline healthcare professionals, midwives play a pivotal role in addressing these issues through reproductive health education and advocacy. This study aimed to design, implement, and evaluate an educational package based on Merrill's Instructional Design Model to enhance midwives' competencies in promoting population rejuvenation strategies.
Methods:
A cross-sectional study was conducted with 41 midwives from comprehensive health centers (2023). The Merrill-based educational intervention included four in-person sessions focused on demographic policies, counseling techniques, and family support frameworks. Data were collected via validated knowledge tests (pre-/post-intervention), satisfaction surveys, and demographic questionnaires. Statistical analyses (SPSS v.26) employed paired t-tests and Pearson's correlation.
Results:
Post-intervention knowledge scores (17.78 ± 1.89) showed a statistically significant improvement compared to pre-test scores (12.78 ± 2.05; p < 0.0001), with a large effect size (Cohen's d = 2.536). All participants (100%) reported high satisfaction with the training (mean score: 222.5 ± 18.75). A strong positive correlation was observed between knowledge gains and satisfaction levels (r = 0.65, p < 0.001).
Conclusion:
The Merrill Model-based educational package demonstrated effectiveness in improving knowledge and engagement among the 41 participating midwives in North Tehran. Its structured approach shows promise as a context-sensitive strategy for reproductive health training within similar settings, though further research is needed to evaluate its applicability in broader healthcare contexts.
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