Effect of the Modified Simulation Model on Self-efficacy, Anxiety, Academic Motivation, and Satisfaction in Episiotomy Repair Training: The Three-Arm Randomized Controlled Trial

Year 2025, Volume: 14 Issue: 3, 601 - 609, 31.10.2025

Emine Yıldırım , Neriman Güdücü

Abstract

Objective: This study aims to determine the effects of a modified simulation model on the self-efficacy, anxiety, academic motivation, and satisfaction levels of midwifery students in episiotomy repair training. Materials and Methods: This study used the three-arm randomized controlled experimental design. The study included 90 midwifery students: 30 in the modified beef simulation repair group (MBMSR), 30 in the beef tongue simulation repair group (BTSR), and 30 in the model simulation repair group (MSR). Data were collected through the Personal Information Form, the Perceived Stress Scale, the State Anxiety Inventory, the Academic Self-Efficacy Scale, the Academic Motivation Scale, the Student Responsibility Scale, and Satisfaction Levels Scale. A pretest was administered before students were assigned to groups and a posttest was administered after episiotomy repair. Results: The difference between the mean scores of perceived stress, state anxiety, and academic responsibility was found to be statistically significant at the posttest (p<0.05). A statistically significant difference was found between the mean posttest scores of academic self-efficacy, motivation, and satisfaction between the groups (p<0.05). The MBMSR (8.97) group had the highest satisfaction level (scoring from 0 to 10) compared to the BTSR (5.07) and MSR (2.20) groups. Conclusion: This study found that the use of MBMSR during episiotomy decreased stress and anxiety and increased responsibility, self-efficacy, academic motivation, and satisfaction.

Keywords

Anxiety , Episiotomy , Midwifery , Motivation. , Simulation Training

Ethical Statement

Institution: Osmaniye Korkut Ata University The Scientific Research and Publication Ethics Committee Date: 05.12.2023 Number: 20198

Supporting Institution

This research was not supported.

Thanks

The authors would like to extend their sincere thanks to anyone who contributed to this study.

Epizyotomi Onarım Eğitiminde Modifiye Simülasyon Modelinin Özyeterlilik, Kaygı, Akademik Motivasyona Etkisi: Üç Kollu Randomize Kontrollü Çalışma

Abstract

Amaç: Bu çalışmanın amacı epizyotomi onarım eğitiminde modifiye simülasyon modelinin ebelik öğrencilerinin öz yeterlilik, kaygı, akademik motivasyon ve memnuniyet düzeylerine etkisini belirlemektir. Gereç ve Yöntem: Bu çalışmada üç kollu randomize kontrollü deneysel tasarım kullanıldı Araştırma modifiye edilmiş sığır eti simülasyon onarım grubunda (MBMSR) 30, sığır dili simülasyon onarım grubunda (BTSR) 30 ve model simülasyon onarım grubunda (MSR) 30 olmak üzere toplam 90 ebelik öğrencisi ile tamamlanmıştır. Veriler, Kişisel Bilgi Formu, Algılanan Stres Ölçeği, Durumluk Kaygı Envanteri, Akademik Öz Yeterlilik Ölçeği, Akademik Motivasyon Ölçeği, Öğrenci Sorumluluk Ölçeği ve Doyum Düzeyleri Ölçeği ile toplanmış, öğrenciler gruplara atanmadan önce ön test, epizyotomi onarımı sonrasında da son test olarak uygulanmıştır. Bulgular: Gruplar arasında algılanan stres, durumluk kaygı ve akademik sorumluluk puan ortalamaları arasındaki fark son testte istatistiksel olarak anlamlı bulunmuştur (p<0.05). Gruplar arasında akademik öz yeterlilik, motivasyon ve memnuniyet son test ortalama puanları arasında istatistiksel olarak anlamlı bir fark bulunmuştur (p<0.05). MBMSR (8.97) grubunun, BTSR (5.07) ve MSR (2.20) gruplarına kıyasla en yüksek memnuniyet düzeyine (10 üzerinden) sahip olduğu görülmüştür. Sonuç: Bu çalışmada epizyotomi sırasında MBMSR kullanımının stresi ve kaygıyı azalttığı, sorumluluğu, öz yeterliliği, akademik motivasyonu ve memnuniyeti artırdığı bulunmuştur.

Keywords

Anksiyete , Epizyotomi , Ebelik , Motivasyon. , Simülasyon Eğitimi

Ethical Statement

Kurum: Osmaniye Korkut Ata Universitesi Bilimsel Araştırma ve Yayın Etik Komitesi Tarih: 05.12.2023 Sayı: 20198

Supporting Institution

Bu araştırma desteklenmemiştir.

Thanks

Yazarlar, bu çalışmaya katkıda bulunan herkese içten teşekkürlerini sunarlar.

References

• Ancel, G., Ilhan, S. E., & Gencturk, Z. B. (2015). An analysis of the relationship between self-efficacy beliefs and perceived problem-solving ability among nursing and midwifery students. Turkiye Klinikleri Journal of Nursing Sciences, 7(1), 20-28. http://dx.doi.org/10.5336/nurses.2013-38266
• Brydges, R. Hatala, M. & Mylopoulos, M. (2016). Examining residents' strategic mindfulness during self-regulated learning of a simulated procedural skill. J. Grad. Med. Ed., 8(3), 364-371. http://dx.doi.org/10.4300/JGME-D-15-00491.1
• Cantrell, M. L., Meyer, S. L., & Mosack, V. J. (2017). Effects of simulation on nursing student stress: An integrative review. Nurs Educ, 56(3), 139-144. http://dx.doi.org/10.3928/01484834-20170222-04.
• Demirel, G., Evcili, F., Kaya, N., & Doganer, A. (2020). The effect of episiotomy repair simulation on the anxiety and self-efficacy levels of midwifery students. Journal of Midwifery and Reproductive Health, 8(1), 2050-2057. http://dx.doi.org/10.22038/jmrh.2019.42024.149.
• Eskin, M., Harlak, H., Demirkıran, F., & Dereboy, Ç. (2013). Adaptation of the perceived stress scale into Turkish: Reliability and validity analysis. New Symposium Journal. 51(3), 132-140. https://www.neuropsychiatricinvestigation.org/Content/files/sayilar/pdf/TR-YeniSempozyum-c1d2631c.PDF. (Accessed 04 March 2024).
• Eston, M., Stephenson-Famy, A., McKenna, H., & Fialkow, M. (2020). Perineal laceration and episiotomy repair using a beef tongue model. MedEdPORTAL, 16, 10881. https://doi.org/10.15766/mep_2374-8265.10881
• Grant, S., Mayo-Wilson, E., Montgomery, P., Macdonald, G., Michie, S., Hopewell, S., & Moher, D. (2018). CONSORT-SPI 2018 explanation and elaboration: guidance for reporting social and psychological intervention trials. Trials, 19, 1-18.
• George, D., & Mallery, P. (2016). IBM SPSS Statistics 23 Step by Step: A Simple Guide and Reference (14th ed.). New York: Routledge. https://doi.org/10.4324/9781315545899
• Güler, H., Cetin, P., Yurtsal, Z. B., Cesur, B., Bekar, M., & Uçar, T., et al. (2018). Effect of episiotomy training with beef tongue and sponge simulators on the selfconfidence building of midwifery students. Nurse Education Practice, 30, 1-6. https://doi.org/10.1016/j.nepr.2018.02.004
• Hansen, M. T., Olsen R. M., Brynhildsen, S., & Leonardsen A. L. (2023). Nursing students' perceived stress, self-efficacy, control and evaluation of a course in systematic clinical observation, physical assessment and decision-making: An observational study in Norway. Nurs Open, 10(2), 1007-1015. http://dx.doi.org/10.1002/nop2.1368.
• Jerusalem, M. & Schwarzer, R. (1981). Fragebogen zur Erfassung von Selbstwirksamkeit. Skalen zur Befindlichkeit und Persoenlichkeit In R. Schwarzer (Hrsg.). (Forschungsbericht No. 5). Berlin: Freie Universitaet, Institut fuer Psychologie.
• Kartal, Y. A., & Oskay, U.Y. (2017). Anxiety, depression and coping with stress styles of pregnant women with preterm labor risk. International Journal of Caring Sciences, 10(2), 716. https://www.internationaljournalofcaringsciences.org/docs/9_kartal_original_10_2.pdf. (Accessed 04 March 2024).
• Karagüven Ünal, M. H. (2012). Adaptation of academic motivation scale to Turkish. Educational Sciences in Theory and Practice, 12(4),2599-2620. https://files.eric.ed.gov/fulltext/EJ1002866.pdf. (Accessed 02 March 2024).
• Kaya M., & Doğan U. (2014). Öğrenci Sorumluluk: Ölçek geliştirme, güvenirlik ve geçerlik çalışması. Journal Of European Education, 4(1):11. http://dx.doi.org/10.18656/jee.22471
• Montgomery, P., Grant, S., Mayo-Wilson, E., Macdonald, G., Michie, S., Hopewell, S., & Moher, D. (2018). Reporting randomised trials of social and psychological interventions: the CONSORT-SPI 2018 Extension. Trials, 19, 1-14.
• Oliveira Silva, G., Oliveira, F. S. E., Coelho, A. S. G., Cavalcante, A.M.R.Z., Vieira, F.V.M., Fonseca, L.M.M., Campbell, S.H., & Aredes, N.D.A. (2022). Effect of simulation on stress, anxiety, and self-confidence in nursing students: Systematic review with meta-analysis and meta-regression. International Journal Of Nursing Studies, 133, 104282. http://dx.doi.org/10.1016/j.ijnurstu.2022.104282
• Ozkahraman, S., & Yildirim B. (2012). Determination of nursing and midwifery students’ core competencies. Journal of Nursing Research and Development, 3, 53-65.
• Öner, N. Le Compte, A. 1983. Trait-Trait Anxiety Inventory Manual Istanbul: Boğaziçi University Publications.
• Sotto-Mayor, L. dos Santos M.A.F., Soares, I.M.T., Félix M.T.S., Delgado, M.J., & de Rogado Serra IMGG. 2021. Surgical reconstitution of the perineum after delivery: a qualitative study of a pedagogical practice. Ciênc. Saúde Colet, 26 (02). https://doi.org/10.1590/141381232021262.40752020.
• Schantz, C., Sim, K.L., Ly, E.M., Barennes, H., Sudaroth, S., & Goyete, S. (2015). Reasons for routine episiotomy: a mixed-methods study in a large maternity hospital in Phnom Penh, Cambodia. Reproductive Health Matters, 23(45), 68-77. http://dx.doi.org/10.1016/j.rhm.2015.06.012
• Silf, K. Woodhead, N., Kelly, J., Fryer, A., Kettle, C., & Ismail K.M.K. (2015). Evaluation of accuracy of mediolateral episiotomy ıncisions using a training model. Midwifery, 31 (1), 197-200. http://dx.doi.org/10.1016/j.midw.2014.08.009
• Uppal, S., Harmanli, O., Rowland, J., Hernandez, E., & Dandolu, V., (2010). Resident competency in obstetric anal sphincter laceration repair. Obstet. Gynecol. 115 (2), 305–309. http://dx.doi.org/10.1097/AOG.0b013e3181c8b4f7
• World Health Organization Regional Office for Europe (2018, October 11). Simulation in nursing and midwifery education. https://iris.who.int/bitstream/handle/10665/345156/WHO-EURO-2018-3296-43055-60253-eng.pdf?sequence=2
• Yılmaz M., Gürçay, D., & Ekici, G. (2007). Adaptation of academic self-efficacy scale to Turkish. Hacettepe University Faculty of Education Journal, 33(33), 253-259.
• Yılar Erkek, Z., & Öztürk Altınayak. S. (2021). The Effect of Simulation Teaching Technique on the Improvement of Episiotomy Performance Skills and State Anxiety of Midwifery Students in Turkey: RCT. Clin. Simul. Nurs. 54, 62–69. https://doi.org/10.1016/j.ecns.2021.01.014