Effect of the MERCI Model in Gamified Disaster Midwifery Education

NCT07090642 | Completed

• 1 other identifier: SBU-AYDINKARTAL-AKER
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Midwives play important societal roles during the post-crisis transition and recovery phase. Specific guidelines regarding the roles and responsibilities of midwives, who constitute a significant majority among healthcare professionals, in disaster management need to be developed, and the concept of disaster midwifery needs to be developed. Providing midwife candidates with disaster awareness throughout their undergraduate education will also positively impact individuals' self-efficacy. In recent years, educational plans for emergency obstetric care and management have evolved from traditional theoretical and clinical training to game-based learning, gamification, and training using mannequins and simulators. It is suggested that using different learning strategies in the training of healthcare professionals in emergency obstetric situations will improve the quality of care and reduce maternal mortality rates. Natural disasters such as disasters can cause serious obstetric emergencies requiring immediate intervention and management. Supporting the professional training of midwives, who play important roles and responsibilities in disaster management, with diverse teaching strategies is crucial for enhancing their individual competencies. This study was planned to investigate the effects of gamified disaster midwifery education on midwifery students' knowledge, self-efficacy in disaster response, and levels of self-confidence and anxiety in clinical decision-making. This experimental study, designed with a randomized pretest, posttest, and follow-up design and a control group, will be conducted with third- and fourth-year midwifery students in the Department of Midwifery at the Health Sciences University (SBU), Hamidiye Faculty of Health Sciences (HSBF), during the spring semester of the 2025-2026 academic year. The sample size was determined using Koca and Arkan's study. Based on a Cohen's d = 1.35 effect size and a power level of 95%, a total of 90 participants were planned, with 45 students in each group. The intervention group will receive a 4-week gamified disaster midwifery training featuring core task cycles, interactive digital escape room games, and bonus tasks. The control group will receive case-based learning on the same subject. Participants included in the study will be administered the "Informed Consent Form," "Introductory Information Form," "Disaster Midwifery Information Form," "Disaster Intervention Self-Efficacy Scale," "Self-Confidence and Anxiety Scale in Clinical Decision Making," and "Gamified Disaster Midwifery Experience Form". Discussions and conclusions of the study will be written based on the findings.

Conditions

Digital Escape Room; Gamification; Disaster; Midwifery Education

Keywords

Disaster midwifery; digital escape room; clinical decision making; self-efficacy; gamification

Outcome Measures

Primary Outcomes (4)

• Introductory Information Form

  This form, created by researchers based on literature, includes questions about the participants' age, high school graduation, their self-sufficiency against disasters, etc.

  10 minitus

• Disaster Midwifery Information Form

  This form was developed by researchers based on literature and based on the content of the disaster midwifery module used as a theoretical training module. The final version will be finalized based on expert opinion. Twenty multiple-choice questions were prepared, deemed appropriate for the research purpose and educational content. The form's performance will be evaluated out of 100 points. For this purpose, students' total success scores are calculated as five times the number of correct answers. Students will be evaluated by assigning "5" points for each correct answer and "0" points for each incorrect answer. The highest possible score for students on the information form is "100," and the lowest is "0."

  20 minitus

• Disaster Response Self-Efficacy Scale

  Developed by Hong-Yan Li and his colleagues in 2017 and its Turkish validity safety studies were conducted by Koca et al. in 2018, the Disaster Response Self-Efficacy Scale consists of 19 items and 3 sub-dimensions and the responses were taken using a 5-point Likert scale. A high score on the scale indicates a high level of disaster response self-efficacy. The scale has three sub-factors. Sub-factors are: "On-Site Rescue Competence (Items 1 - 11)", "Disaster Psychological Nurse Competence (Items 12 - 15)" and "The nature of the role undertaken in disaster and adaptation adequacy (Items 16 - 19)". The Cronbach alpha coefficient for the entire scale is 0.96. The Cronbach alpha values obtained for the sub-dimensions are; On-site rescue competence was determined as 0.93, psychological nurse competence in disaster was determined as 0.93, and the quality of the role undertaken in the disaster and adaptation competence was determined as 0.93 (Bennur et al., 2020).

  20 minitus

• Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) Scale

  The scale, which provides separate scores for self-confidence and anxiety, is a 6-point Likert-type scale consisting of 27 questions. The scale has three subscales for both the self-confidence and anxiety sections: "using sources to obtain information and listening fully," "using available information to identify the problem," and "knowing and taking action." Increasing scores in the self-confidence and subscales indicate increasing students' self-confidence in clinical decision-making. Low scores in the anxiety section and its subscales indicate low anxiety levels in clinical decision-making. The lowest possible score for the self-confidence and anxiety sections is 27, and the highest is 162. The total Cronbach alpha coefficient of the self-confidence section of the scale is 0.97, and the total Cronbach alpha coefficient of the anxiety section is 0.96 (Bektaş et al., 2017).

  20 minitus

Secondary Outcomes (4)

• Disaster Midwifery Information Form

  20 minitus

• Disaster Response Self-Efficacy Scale

  20 minitus

• Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale

  20 minitus

• Gamified Disaster Midwifery Experience Form (Only the intervention group)

  20 minitus

Other Outcomes (1)

• Disaster Midwifery Information Form

  20 minitus

Study Arms (2)

İntervention group

EXPERIMENTAL

Participants will complete a 4-week gamified disaster midwifery program based on the MERCI model. The program incorporates digital escape room games, bonus task cycles, and gamification elements including leaderboards, heroes of the week and badges.

Other: Gamified Disaster Midwifery Training (MERCI Model)

Control group

NO INTERVENTION

In addition to standard theoretical modules, participants in the control group will receive case-based learning applications over a 4-week period.

Interventions

Gamified Disaster Midwifery Training (MERCI Model) OTHER

Participants will receive a 4-week gamified disaster midwifery training based on the MERCI model, provided alongside standard theoretical modules. The intervention incorporates digital escape room games, bonus task cycles, and gamification elements such as leaderboards, heroes of the week and badges.

İntervention group

Eligibility Criteria

• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Volunteering to participate in the study.
• Having internet access.
• Having a smartphone.
• Having successfully completed a course on normal birth and postpartum.
• Being an active third-year student in the Midwifery Department of Hamidiye Faculty of Health Sciences, University of Health Sciences.
• Being an active fourth-year student in the Midwifery Department of Hamidiye Faculty of Health Sciences, University of Health Sciences.

You may not qualify if:

• Being a 4th-year inactive student in the Midwifery Department of Hamidiye Faculty of Health Sciences, University of Health Sciences.
• Being a 3rd-year inactive student in the Midwifery Department of Hamidiye Faculty of Health Sciences, University of Health Sciences.

Sponsors & Collaborators

• Saglik Bilimleri Universitesi: lead

Study Sites (1)

University of Health Sciences

Istanbul, Turkey (Türkiye)

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the educational nature of the intervention, blinding of the primary investigator conducting the application and the participating students was not feasible during the implementation process. However, allocation concealment was strictly maintained to prevent selection bias. The randomization sequence for assigning participants to the intervention and control groups was generated via randomizer.org by an independent second researcher who was completely uninvolved in the implementation and data collection phases. The primary investigator remained blinded to the group assignments until the allocation list was finalized by the independent researcher.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr.

Model Details: Randomized controlled experimental study

Study Record Dates

• First Submitted: July 21, 2025
• First Posted: July 29, 2025
• Study Start: February 1, 2026
• Primary Completion: June 30, 2026
• Study Completion: July 31, 2026
• Last Updated: August 5, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)