This randomized controlled trial evaluated the incremental effect of adding a web-based serious game to standard theoretical instruction on third-year nursing students' postpartum hemorrhage management knowledge, task-specific self-efficacy, and self-regulated learning. Using census recruitment, all 159 eligible students were invited, and 120 students consented and were randomly allocated in a 1:1 ratio to the intervention or control group (60 participants per group) using randomly permuted blocks of four. Both groups received the same three 40-minute theoretical sessions. The intervention group additionally completed an individual, self-paced, 30-50-minute browser-based serious game featuring a single branching postpartum hemorrhage scenario, clinical decision-making, and immediate physiological feedback. The control group received no additional educational activity before the immediate posttest assessment. Outcomes were assessed at baseline before randomization and immediately after the intervention or control condition. Outcome data were analyzed by an independent analyst blinded to group coding.Data will be collected using the PPK Management Knowledge and Skills Assessment Form and the PPK Management Self-Confidence Scale.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
120
A browser-based serious game (Version 1.0) comprising a single branching clinical scenario on the recognition and management of primary postpartum hemorrhage. Participants made clinical decisions, observed the physiological consequences of their choices, and received immediate formative feedback. The game was completed individually in a single continuous attempt lasting approximately 30-50 minutes.
Sakarya University
Adapazarı, Sakarya, Turkey (Türkiye)
Postpartum Hemorrhage Management Knowledge Assessment Form (PHM-KAF)
The researcher-developed PHM-KAF is a 15-item multiple-choice assessment of knowledge and clinical decision-making accuracy related to postpartum hemorrhage risk assessment, etiology (the 4Ts), and evidence-based management. Each correct response is scored as 1 and each incorrect response as 0, yielding a total score ranging from 0 to 15. Higher scores indicate greater postpartum hemorrhage management knowledge. Content validity was evaluated by nine academic experts specializing in women's health and obstetric nursing (S-CVI/Ave = 0.96).
Time frame: At baseline before randomization and immediately after the intervention or control condition.
Postpartum Hemorrhage Management Self-Efficacy Assessment Form (PHM-SEAF)
The researcher-developed PHM-SEAF is a 10-item, task-specific assessment form measuring nursing students' perceived self-efficacy in postpartum hemorrhage management. Items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), yielding a total score ranging from 10 to 50. Higher scores indicate greater task-specific self-efficacy. Content validity was evaluated by nine academic experts specializing in women's health and obstetric nursing (S-CVI/Ave = 0.94).
Time frame: At baseline before randomization and immediately after the intervention or control condition.
Self-Regulated Learning Scale for Clinical Nursing Practice
The Self-Regulated Learning Scale for Clinical Nursing Practice is a 16-item, 5-point Likert-type instrument comprising two subdimensions: Motivation and Learning Strategies. Total scores range from 16 to 80, with higher scores indicating stronger self-regulated learning.
Time frame: At baseline before randomization and immediately after the intervention or control condition.
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