Obstetrics & Gynecology · Medical Literature
Effectiveness of online simulation-based versus face-to-face training on episiotomy skills among midwifery students in Turkey.
Abstract
This study evaluated the effectiveness of synchronous online simulation compared with face-to-face instruction in teaching episiotomy repair skills to midwifery students. It also assessed learning satisfaction and self-confidence. A randomized controlled study was conducted with undergraduate students enrolled in a childbirth course. Participants were randomly assigned to either a synchronous online or face-to-face training group. Both groups received structured instruction using standardized simulation models. Outcomes were measured using the Student Satisfaction and Self-Confidence in Learning Scale and the Episiotomy Skill Evaluation Form. Both training formats resulted in similarly high levels of skill performance. The online group demonstrated significantly higher self-confidence and overall learning satisfaction, while skill outcomes were comparable between groups. No significant associations were found between demographic characteristics and study outcomes. Synchronous online simulation is a feasible and effective alternative to face-to-face training for developing procedural skills while also enhancing learner confidence and satisfaction.
Clinical relevance
Is synchronous online simulation-based training as effective as face-to-face simulation instruction for developing episiotomy repair skills, and does it differ in learner self-confidence and satisfaction among undergraduate midwifery students? __SNAPSHOT__ {"studyDesign":"Randomized controlled trial (parallel-group, two-arm)","setting":"Turkey; undergraduate midwifery program (specific institution not reported in abstract)","sampleSize":"Not reported (total n and per-arm allocation not stated in the abstract)","population":"Undergraduate midwifery students enrolled in a childbirth course with no prior specification of year of study, prior simulation exposure, or exclusion criteria stated in the abstract","intervention":"Synchronous online simulation-based training for episiotomy repair using standardized simulation models","comparator":"Face-to-face simulation-based training using standardized simulation models under the same structured instruction framework","primaryOutcome":"Episiotomy repair skill performance assessed via the Episiotomy Skill Evaluation Form; secondary outcomes included student satisfaction (Student Satisfaction and Self-Confidence in Learning Scale) and self-confidence","followUp":"Not reported","fundingSource":"Not reported"}
Key findings
Both synchronous online and face-to-face training groups achieved similarly high episiotomy skill performance scores on the Episiotomy Skill Evaluation Form, with no statistically significant difference between groups in procedural skill outcomes (specific scores, p-values, confidence intervals, and effect sizes not reported in the abstract). The online group demonstrated significantly higher self-confidence and overall learning satisfaction on the Student Satisfaction and Self-Confidence in Learning Scale compared to the face-to-face group; however, the magnitude of this difference, associated confidence intervals, and p-values are not reported in the abstract. No significant associations were identified between demographic characteristics and any study outcome. NNT/NNH cannot be calculated from the available data.
Practice implications
This RCT suggests that synchronous online simulation is non-inferior to face-to-face simulation for the acquisition of episiotomy repair procedural skills in midwifery students, and may confer additional benefit in learner self-confidence and satisfaction. However, the clinical and educational importance of these findings cannot be fully assessed because the abstract does not report sample size, effect sizes, confidence intervals, p-values for the primary skill outcome, or duration of follow-up. It is not established whether skill equivalence persists beyond the immediate post-training period or translates to competent clinical performance on actual patients. The findings apply specifically to undergraduate midwifery students in a structured simulation curriculum in Turkey and may not generalize to other health professions, countries, or less-resourced training environments. Since only an abstract was available for review, conclusions should be interpreted with caution pending full-text evaluation. __LIMITATIONS__ Sample size not reported in the abstract, precluding assessment of statistical power or risk of Type II error,Specific statistical values (p-values, confidence intervals, effect sizes) not reported for either the primary skill outcome or the satisfaction/self-confidence outcomes,Follow-up duration not reported; no assessment of skill retention beyond the immediate post-training period,Blinding of participants to group allocation is inherently impossible in educational intervention trials, introducing performance and expectation bias,Restricted to a single course at Turkish midwifery programs, limiting generalizability to other educational or cultural contexts,Self-reported satisfaction and self-confidence scales measure learner perception, not objective competence or real-world clinical performance,No assessment of skill transfer to clinical practice or patient outcomes,Demographic characteristics were assessed but the range of variables examined is not specified, limiting interpretation of generalizability,Funding source not reported; potential conflicts of interest cannot be evaluated,Only abstract available for review; full methodological rigor, randomization procedures, allocation concealment, and blinding details cannot be verified __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ This Turkish RCT suggests synchronous online simulation may be a feasible and effective alternative to face-to-face instruction for teaching episiotomy repair skills in midwifery students, with potentially superior learner satisfaction and self-confidence. However, the absence of reported effect sizes, confidence intervals, sample size, and follow-up duration in the available abstract significantly limits confidence in these conclusions. Educators may consider online simulation as a supplementary or contingency delivery method, but full-text review is essential before incorporating this finding into curriculum policy.