Related Experiment Video
Updated: Oct 15, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Simulation-based education improves postpartum hemorrhage management knowledge and skills: a randomized controlled
1Faculty of Health Sciences, Department of Midwifery, Istanbul Topkapi University, Istanbul, Türkiye.
Background:
Postpartum hemorrhage is a time-sensitive obstetric emergency that requires rapid assessment and coordinated management. This study evaluated the effects of simulation-based education on midwifery students' postpartum hemorrhage management knowledge, skill performance, and self-efficacy.
Methods:
An assessor-blinded randomized controlled trial was conducted with 45 third-year midwifery students. Participants were randomly allocated to an intervention group that received traditional theoretical education followed by simulation-based education (n = 23) or a control group that received traditional theoretical education only (n = 22). Knowledge and self-efficacy were assessed before, immediately after, and four weeks after the intervention; skill performance was assessed immediately after and at four weeks.
Results:
Knowledge scores increased in both groups. A significant between-group difference was observed immediately after the intervention (p = 0.047), whereas the between-group difference at four weeks was not statistically significant (p = 0.541). In the linear mixed-effects analysis, the overall group × time interaction for knowledge was not significant [Wald χ 2(2) = 2.56, p = 0.279]. Skill performance was substantially higher in the intervention group at both post-intervention assessments (both p < 0.001); the post-test mean difference was 8.83 points (95% CI 4.85-12.81; Cohen's d = 1.358), and the group × time interaction from post-test to four weeks was not significant (p = 0.742), indicating stability of the between-group difference over follow-up. Self-efficacy increased in both groups, with no significant overall group × time interaction [Wald χ 2(2) = 3.10, p = 0.212].
Conclusion:
Simulation-based education was associated with a short-term between-group advantage in PPH-related knowledge and with a large, stable post-intervention advantage in skill performance across four weeks. No clear additional effect on self-efficacy was demonstrated. Because skill performance was not measured at baseline, the skill findings should be interpreted with appropriate caution.
Clinical Trial Registration:
ClinicalTrials.gov NCT07618442, https://clinicaltrials.gov/study/NCT07618442.