An interventional study of Digital Game-Based Education on Respectful Maternity Care and Traditional Education on Respectful Maternity Care in Respectful Maternity Care, Midwifery Education and Empathy, sponsored by Cukurova University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-13.
Sponsored by Cukurova University · Not applicable, Interventional, and Other
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This study aims to evaluate the effects of a digital game-based educational intervention developed to teach respectful maternity care on midwifery students' perceptions of respectful maternity care and empathy skills.
The study is designed as an interventional study involving fourth-year midwifery students. Participants will be assigned to an intervention group or a control group according to the study protocol. Students in the intervention group will receive digital game-based education focusing on respectful maternity care, including effective communication, informed decision-making, privacy, dignity, and supportive care during childbirth. Students in the control group will not receive the digital game-based intervention during the study period.
Participants' perceptions of respectful maternity care and empathy skills will be assessed before and after the intervention using the measurement instruments specified in the study protocol.
The findings are expected to provide evidence regarding the potential contribution of digital game-based education to respectful maternity care training in midwifery education.
This study employs a mixed-methods design and consists of three phases.
Phase 1 - Digital Game Development
A web-based digital educational game focusing on respectful maternity care will be developed based on the World Health Organization recommendations on intrapartum care for a positive childbirth experience, the International Confederation of Midwives' principles of respectful care, the White Ribbon Alliance Respectful Maternity Care Charter, and relevant FIGO guidelines.
The game will consist of four levels covering admission, labor, birth, and postpartum care. Each level will include scenario-based clinical situations, decision-making options, and immediate feedback. Content validity will be evaluated through expert review, and the game will be finalized following pilot testing.
Phase 2 - Randomized Controlled Trial
Fourth-year midwifery students enrolled at Cukurova University Faculty of Health Sciences will be randomly allocated to an intervention group (n=49) or a control group (n=49). Simple randomization will be performed using randomizer.org by an independent statistician.
The sample size was calculated using G\*Power software, assuming an effect size of 0.5, a significance level of 0.05, and a statistical power of 80%, with an additional 10% allowance for potential data loss.
The intervention group will receive digital game-based education on respectful maternity care. The control group will receive traditional face-to-face education delivered through a PowerPoint presentation covering the same educational content. Following completion of the posttest assessments, students in the control group will also be offered access to the digital game-based education.
Outcome measures will be assessed before and immediately after the educational intervention.
Phase 3 - Qualitative Interviews
Qualitative interviews will be conducted with students from the intervention group to explore their experiences and perceptions of digital game-based learning.
Statistical Analysis
Quantitative data will be analyzed using SPSS version 22.0. The Shapiro-Wilk test will be used to assess normality. Depending on the distribution of the data, independent-samples and paired-samples t-tests or their nonparametric alternatives (Mann-Whitney U and Wilcoxon signed-rank tests) will be applied. Statistical significance will be set at p \< 0.05.
Cukurova University is the lead sponsor of 260 studies on the registry; 51 are open to participants now.
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Exclusion Criteria:
- Being a first-, second- or third-year midwifery student
Fourth-year midwifery students will receive education on respectful childbirth care through a web-based digital game consisting of four levels (admission, labor, birth and postpartum care) with scenario-based clinical situations, decision-making options and immediate feedback.
Behavioral: Digital Game-Based Education on Respectful Maternity Care
Fourth-year midwifery students will receive face-to-face education on respectful childbirth care using a PowerPoint presentation covering the same content as the digital game. After the posttest, students in this group will also be offered the digital game-based education.
Behavioral: Traditional Education on Respectful Maternity Care
A web-based digital educational game on respectful childbirth care consisting of four levels (admission, labor, birth and postpartum care). Each level includes scenario-based clinical situations in which students choose the most appropriate approach and receive immediate feedback.
Face-to-face lecture on respectful childbirth care delivered with a PowerPoint presentation, covering the same content as the digital game.
Students' Perceptions of Respectful Maternity Care (SP-RMC) Scale Score
Measured with the Students' Perceptions of Respectful Maternity Care (SP-RMC) Scale developed by Dhakal et al.; Turkish validity and reliability study by Camlibel and Uludag (2023). The scale consists of 18 items and three subscales (respectful care, safety and comfort, supportive care) rated on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree); items 1-10 are reverse-scored. Total scores range from 18 to 90; higher scores indicate more positive perceptions of respectful maternity care.
Time frame: Baseline (before the education) and immediately after the education
Jefferson Scale of Empathy (JSE)
Measured with the Jefferson Scale of Empathy (JSE) developed by Hojat (2002); Turkish version: "Jefferson Empati Olcegi" (Yanik and Saygili, 2013). The scale consists of 20 items and three subscales (perspective taking, compassionate care, standing in the patient's shoes) rated on a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). Total scores range from 20 to 140; higher scores indicate a higher level of empathy.
Time frame: Baseline (before the education) and immediately after the education
Respectful Childbirth Care Knowledge Form Score
Measured with the Respectful Childbirth Care Knowledge Form ("Saygili Dogum Bakimina Iliskin Bilgi Formu") developed by the researchers based on WHO, ICM, White Ribbon Alliance and FIGO guidelines. The form consists of 41 statements answered as "Yes/No"; correct answers are scored 1 and incorrect or blank answers 0. Total scores range from 0 to 41; higher scores indicate a higher level of knowledge. Content validity will be assessed by at least five academic experts in women's health and childbirth.
Time frame: Baseline (before the education) and immediately after the education
Gameful Experience Scale (GAMEX) Score
Measured with the Gameful Experience Scale (GAMEX) developed by Eppmann et al. (2018); Turkish version: "Oyun Deneyimi Olcegi" (Donmez et al.). The scale consists of 27 items and six subscales (enjoyment, absorption, creative thinking, activation, absence of negative affect, dominance) rated on a 5-point Likert scale; items of the absence of negative affect subscale are reverse-scored. Total scores range from 27 to 135; higher scores indicate a better gameful experience. Applied only to the intervention group.
Time frame: Immediately after the education
Plan to share: No
No publications or documents are linked to this record.
Start is estimated for Feb 2027; primary completion for Jun 2027, 4 months later.
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This study is not yet recruiting, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.
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