The Effectiveness of Serious Game-Based Training for Nursing Students in Postpartum Haemorrhage Management

NCT07229573 | Completed

• 1 other identifier: 06.10.2025
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Nursing Students; Nursing Care; Nurse Education; Postpartum Hemorrhage; Self-Efficacy; Game-Based Learning

Outcome Measures

Primary Outcomes (1)

• 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).

  At baseline before randomization and immediately after the intervention or control condition.

Secondary Outcomes (2)

• Postpartum Hemorrhage Management Self-Efficacy Assessment Form (PHM-SEAF)

  At baseline before randomization and immediately after the intervention or control condition.

• Self-Regulated Learning Scale for Clinical Nursing Practice

  At baseline before randomization and immediately after the intervention or control condition.

Study Arms (2)

Web-Based Serious Game

EXPERIMENTAL

Participants received three 40-minute standard theoretical sessions on postpartum hemorrhage management and additionally completed an individual, self-paced, 30-50-minute browser-based serious game containing a single branching clinical scenario with clinical decision-making and immediate physiological feedback.

Other: Web-Based Serious Game

Standard Theoretical Instruction Group

NO INTERVENTION

Participants received the same three 40-minute standard theoretical sessions on postpartum hemorrhage management as the intervention group. They received no additional educational content or time- and attention-matched activity before the immediate posttest assessment. Access to the serious game was offered after all post-intervention outcome assessments had been completed.

Interventions

Web-Based Serious Game OTHER

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.

Web-Based Serious Game

Eligibility Criteria

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

You may qualify if:

• Enrollment as a third-year nursing student in the Obstetrics and Gynecology Nursing course.
• Voluntary agreement to participate and provision of electronic informed consent.
• Access to an internet-enabled smartphone, tablet, or laptop for using the web-based serious game.

You may not qualify if:

• Absence during the scheduled intervention session. Incomplete submission of the data collection forms.

Sponsors & Collaborators

• Sakarya University: lead

Study Sites (1)

Sakarya University

Adapazarı, Sakarya, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Postpartum Hemorrhage

Condition Hierarchy (Ancestors)

Obstetric Labor Complications; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Puerperal Disorders; Uterine Hemorrhage; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Model Details: Two-arm, parallel-group randomized controlled trial with 1:1 allocation using randomly permuted blocks with a fixed block size of four. Participants and instructors were not blinded because of the overt nature of the educational intervention. Outcome data were analyzed by an independent analyst blinded to group coding.

Study Record Dates

• First Submitted: November 13, 2025
• First Posted: November 17, 2025
• Study Start: November 5, 2025
• Primary Completion: November 30, 2025
• Study Completion: December 30, 2025
• Last Updated: September 1, 2026

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)