Partograf E-Öğrenme Aracının Geliştirilmesi ve Türkiye'deki Öğrenci Ebeler Üzerinde Etkinliğinin Değerlendirilmesi: Randomize Kontrollü Deneysel Çalışma

Abstract

Amaç: Bu çalışma, Türkiye'deki öğrenci ebeler üzerinde bir partograf e-öğrenme aracı geliştirmek ve etkinliğini değerlendirmek amacıyla yürütülmüştür. Yöntem: Bu randomize kontrollü deneysel çalışma, 2019–2022 yılları arasında Türkiye’de Aydın Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Ebelik Bölümünde yürütülmüştür. Çalışmanın evrenini üçüncü sınıf ebelik öğrencileri oluşturmuş ve toplam 93 katılımcı (eğitim grubunda 46, kontrol grubunda 47) çalışmaya dahil edilmiştir. Eğitim grubuna, standart müfredatlarına ek olarak, bir ay boyunca yeni geliştirilen e-öğrenme sistemine erişim sağlanmış, kontrol grubuna ise yalnızca rutin eğitim verilmiştir. Bulgular: Analiz, eğitim grubunda toplam akademik başarı testindeki son test ortalama puanının (45,54±8,86), ön test ortalama puanından (29,50±12,96) anlamlı derecede yüksek olduğunu ortaya koymuştur (Z=-5,767, p<0,001). Ayrıca, eğitim grubunun post-test puan ortalaması (45,54±12,96), kontrol grubunun puan ortalamasından (34,51±14,19) yüksek ve bu fark istatistiksel olarak anlamlı olduğu bulunmuştur. Sonuç: Partograf e-öğrenme aracıyla verilen eğitim, öğrencilerin partograf bilgi, beceri ve sentez çıktılarını geliştirmiştir. Kullanımı kolay ve etkili olan bu araç, sınıf, laboratuvar ve klinik eğitimde geleneksel eğitime alternatif olarak kullanılabilir.

Keywords

• Ebelik
• E-öğrenme
• E-partograf
• Partograf

Supporting Institution

Bu araştırma, Aydın Adnan Menderes Üniversitesi Bilimsel Araştırma Projeleri Birimi (Proje No: 20002) ve Öğretim Elemanı Yetiştirme Programı (Proje No: 16015) tarafından desteklenmiştir.

Project Number

Project No: 20002 No: 16015

Ethical Statement

Araştırma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür. Araştırmanın yürütülmesi ve verilerin toplanması için Aydın Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu'nun onayı (Sayı: 27/07/2019-E.45598) ve Üniversite Sağlık Bilimleri Fakültesi Dekanlığı'nın yazılı izni (Sayı: 20/11/2019-E.71937) alınmıştır. Çalışma Clinical-Trials.gov (NCT05909306) adresine kaydedilmiştir.

Thanks

Çalışmamızda geliştirdiğimiz e-öğrenme aracının oluşturulması ve tasarımına katkılarından dolayı Aydın Adnan Menderes Üniversitesi Mühendislik Fakültesi Bilgisayar Donanımı Bölümü Öğretim Üyesi Dr. Mahmut SINECEN'e teşekkür ederiz. Ayrıca, bu araştırmanın hazırlanmasındaki değerli katkılarından dolayı Prof. Dr. Zekiye KARAÇAM, Doç. Dr. Yıldız DENAT ve çalışmaya katılan tüm öğrencilerimize teşekkür ederiz.

Development of A Partograph E-Learning Tool and Evaluation of Efficiency in Student Midwives in Turkey: A Randomized Controlled Experimental Study

Abstract

Objective: This study was conducted to develop a partograph e-learning tool and evaluate its effectiveness in student midwives in Turkey. Methods: This randomized controlled experimental study was conducted between 2019 and 2022 at the Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Turkey. The population comprised third-year midwifery students, and a total of 93 participants were included (46 in the education group and 47 in the control group). In addition to their standard curriculum, the education group was provided with access to the newly developed e-learning system for one month, whereas the control group continued solely with routine instruction. Results: Analysis revealed that the mean post-test score on the total academic achievement test in the education group (45.54± 8.86) was significantly higher than their mean pre-test score (29.50±12.96) (Z=−5.767, p<0.001). Furthermore, the post-test mean score of the education group (45.54±12.96) exceeded that of the control group (34.51±14.19), and this difference reached statistical significance. Conclusion: Education delivered through the partograph e-learning tool improved students’ partograph knowledge, skills, and synthesis outcomes. This easy-to-use and effective tool may be used as an alternative to traditional instruction in classroom, laboratory, and clinical education.

Keywords

• Midwifery
• E-learning
• E-partograph
• Partograph

Supporting Institution

This research was supported by Aydın Adnan Menderes University Scientific Research Projects Unit (Project No: 20002) and Faculty Member Education Program (No: 16015).

Project Number

Project No: 20002 No: 16015

Ethical Statement

The research was conducted in accordance with the principles of the Declaration of Helsinki. Approval of the Ethics Committee of Non-Interventional Clinical Research of Aydin Adnan Menderes University Faculty of Health Sciences (Number: 27/07/2019-E.45598) and the written permission of The University Faculty of Health Sciences Dean's Office (Number: 20/11/2019-E.71937) were obtained for the implementation of the research and the collection of data. The study was registered at Clinical-Trials.gov (NCT05909306).

Thanks

We would like to express our gratitude to Dr. Faculty Member Mahmut SINECEN of Aydın Adnan Menderes University, Faculty of Engineering, Computer Hardware Department, for his contributions to the creation and design of the e-learning tool that we developed in our study. In addition, we would like to thank Prof. Dr. Zekiye KARAÇAM, Assoc. Dr. Yıldız DENAT, and all our students who participated in the study for their valuable contributions to the preparation of this research.

References

1. Abhari FR, Andarieh MG, Ledari FM, Soleiman A. (2014). A study to assess the effectiveness of planned teaching program on knowledge regarding partogram among fourth year B.Sc. nursing students of Karnataka College of Nursing at Bangalore. Bulletin of Environment, Pharmacology and Life Sciences, 3, 24-36.
2. Andarieh MG, Abhari FR, Shabani M, Mirabi P. (2014). Comparing the pre- and post-test level of knowledge on partogram among fourth year B.Sc. nursing students. Journal of Applied Environmental and Biological Sciences, 4, 30-38.
3. Arianggara AW, Baso YS, Ramadany S, Manapa ES, Usman AN. (2021). Web-based competency test model for midwifery students. International Journal of Medical and Health Sciences, 4(1), 1-7. doi:10.31295/ijhms.v4n1.380
4. Ayenew AA. (2021). Incidence, causes, and maternofetal outcomes of obstructed labor in Ethiopia: Systematic review and meta-analysis. Reproductive Health, 18(1), 61. doi:10.1186/s12978-021-01103-0
5. Bedwell C, Levin K, Pett C, Lavender DT. (2017). A realist review of the partograph: When and how does it work for labour monitoring? BMC Pregnancy and Childbirth, 17(1), 31. doi:10.1186/s12884-016-1213-4
6. Carter AG, Sidebotham M, Creedy DK, Fenwick J, Gamble J. (2014). Using root cause analysis to promote critical thinking in final year Bachelor of Midwifery students. Nurse Education Today, 34(6), 1018-1023. doi:10.1016/j.nedt.2013.10.020
7. Dalbye R, Blix E, Frøslie KF, Zhang J, Eggebø TM, Olsen IC, et al. (2020). The Labour Progression Study (LaPS): Duration of labour following Zhang’s guideline and the WHO partograph-A cluster randomised trial. Midwifery, 81, 102578. doi:10.1016/j.midw.2019.102578
8. Downer T, Gray M, Capper T. (2021). Online learning and teaching approaches used in midwifery programs: A scoping review. Nurse Education Today, 103, 104980. doi:10.1016/j.nedt.2021.104980

9. Effland KJ, Hays K. (2018). A web-based resource for promoting equity in midwifery education and training: Towards meaningful diversity and inclusion. Midwifery, 61, 70-73. doi:10.1016/j.midw.2018.02.008
10. Hadi SPI, Kuntjoro T, Sumarni S, Anwar MC, Widyawati MN, Pujiastuti RSE. (2017). The development of e-partograph module as a learning platform for midwifery students: The ADDIE model. Belitung Nursing Journal, 3(2), 148-156. doi:10.33546/bnj.77
11. Haeriah M, Ahmad M, Sinrang W, Syarif S. (2020). The use of partograph Bugis midwives application as a learning media for normal labor care by lecturers and land preceptor. Journal La Edusci, 1(3), 11-16. doi:10.37899/journallaedusci.v1i3.159
12. Jou M, Lin YT, Wu DW. (2016). Effect of a blended learning environment on student critical thinking and knowledge transformation. Interactive Learning Environments, 24(6), 1131-1147. doi:10.1080/10494820.2014.961485
13. Lavender T, Bernitz S. (2020). Use of the partograph-Current thinking. Best Practice & Research Clinical Obstetrics & Gynaecology, 67, 33-43. doi:10.1016/j.bpobgyn.2020.03.010
14. Lavender T, Cuthbert A, Smyth RM. (2018). Effect of partograph use on outcomes for women in spontaneous labour at term and their babies. Cochrane Database of Systematic Reviews, 2018(8), CD005461. doi:10.1002/14651858.CD005461.pub5
15. Lavender T, Hart A, Smyth RM. (2013a). Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database of Systematic Reviews, 2013(7), CD005461. doi:10.1002/14651858.CD005461.pub4
16. Lavender T, Omoni G, Laisser R, McGowan L, Wakasiaka S, Maclean G, et al. (2019). Evaluation of an educational board game to improve use of the partograph in sub-Saharan Africa: A quasi-experimental study. Sexual & Reproductive Healthcare, 20, 54-59. doi:10.1016/j.srhc.2019.03.001
17. Lavender T, Omoni G, Lee K, Wakasiaki S, Campbell M, Watiti J, et al. (2013b). A pilot quasi-experimental study to determine the feasibility of implementing a partograph e-learning tool for student midwife training in Nairobi. Midwifery, 29(8), 876-884. doi:10.1016/j.midw.2012.10.003
18. Lavender T, Omoni G, Lee K, Wakasiaka S, Watiti J, Mathai M. (2011). Students’ experiences of using the partograph in Kenyan labour wards. African Journal of Midwifery and Women’s Health, 5(3), 117-122. doi:10.12968/ajmw.2011.5.3.117
19. Linawati L. (2016). Blended learning approach of the flipped model for partograph short course. Journal of Education and Learning, 10(3), 255-264. doi:10.11591/edulearn.v10i3.3987
20. Litwin LE, Maly C, Khamis AR, Hiner C, Zoungrana J, Mohamed K, et al. (2018). Use of an electronic partograph: Feasibility and acceptability study in Zanzibar, Tanzania. BMC Pregnancy and Childbirth, 18(1), 147. doi:10.1186/s12884-018-1760-y
21. Mezmur H, Semahegn A, Tegegne BS. (2017). Health professionals’ knowledge and use of the partograph in public health institutions in eastern Ethiopia: A cross-sectional study. BMC Pregnancy and Childbirth, 17(1), 291. doi:1186/s12884-017-1477-3
22. National Collaborating Centre for Women’s and Children’s Health (UK). (2014). Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. National Institute for Health and Care Excellence (NICE).
23. O’Neal K, Jones WP, Miller SP, Campbell P, Pierce T. (2007). Comparing web-based to traditional instruction for teaching special education content. Teacher Education and Special Education, 30(1), 34-41. doi:10.1177/088840640703000104
24. Okokon IB, Oku AO, Agan TU, Asibong UE, Essien EJ, Monjok E. (2014). An evaluation of the knowledge and utilization of the partograph in primary, secondary, and tertiary care settings in Calabar, South-South Nigeria. International Journal of Family Medicine, 105853. doi:10.1155/2014/105853
25. Patabendige M, Wickramasooriya DJ, Dasanayake DLW. (2021). WHO Labor Care Guide as the next generation partogram: Revolutionising the quality of care during labor. European Journal of Midwifery, 5, 26. doi:10.18332/ejm/138597
26. Salleh SM, Tasir Z, Shukor N. (2012). Web-based simulation learning framework to enhance students’ critical thinking skills. Procedia-Social and Behavioral Sciences, 64, 372-381. doi:10.1016/j.sbspro.2012.11.044
27. Scamell M, Hanley T. (2017). Innovation in preregistration midwifery education: Web-based interactive storytelling learning. Midwifery, 50, 93-98. doi:10.1016/j.midw.2017.03.016
28. Schweers J, Khalid M, Underwood H, Bishnoi S, Chhugani M. (2016). mLabour: Design and evaluation of a mobile partograph and labor ward management application. Procedia Engineering, 159, 35-43. doi:10.1016/j.proeng.2016.08.061
29. Shahri SB, Setar KK. (2017). The effect of a structured teaching programme on partograph among midwifery students. E-Jurnal Penyelidikan dan Inovasi, 4(1), 151-159.
30. Singh S, Khalid A, Paul K, Haider Y, Prasad S. (2016). PrasavGraph: An Android-based E-partograph. In 2016 International Conference on Systems in Medicine and Biology (ICSMB) (pp. 106–109). IEEE.
31. Swart R. (2017). Critical thinking instruction and technology enhanced learning from the student perspective: A mixed methods research study. Nurse Education in Practice, 23, 30-39. doi:10.1016/j.nepr.2017.02.003
32. Taber KS. (2018). The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48, 1273-1296. doi:10.1007/s11165-016-9602-2
33. Tayade S, Jadhao P. (2012). The impact of use of Modified WHO partograph on maternal and perinatal outcome. International Journal of Biomedical and Advance Research, 3(4), 256-362. doi:10.7439/ijbar.v3i4.398
34. Türkmen H, Yörük S. (2021). Determination of midwives and nurses knowledge level who were given partograph training. Journal of Anatolia Nursing and Health Sciences, 24(2), 148-155. doi:10.17049/ataunihem.611598
35. Ulfa SM, Sinrang A, Syarif S, Usman AN. (2020). The use of digital partograph as a learning media for normal childbirth care. European Journal of Molecular & Clinical Medicine, 7(3).
36. Vogel JP, Comrie-Thomson L, Pingray V, Gadama L, Galadanci H, Goudar S, et al. (2021). Usability, acceptability, and feasibility of the World Health Organization Labour Care Guide: A mixed-methods, multicountry evaluation. Birth, 48(1), 66-75. doi:10.1111/birt.12511
37. Wannapiroon P. (2014). Development of research-based blended learning model to enhance graduate students’ research competency and critical thinking skills. Procedia-Social and Behavioral Sciences, 136, 486-490. doi:10.1016/j.sbspro.2014.05.361
38. Wardani DK, Martono T, Pratomo LC, Rusydi DS, Kusuma DH. (2018). Online learning in higher education to encourage critical thinking skills in the 21st century. International Journal of Educational Research Review, 4(2), 146-153. doi:10.24331/ijere.517973
39. Women’s Refugee Commission. (2023). Basic Emergency Obstetric and Newborn Care in Humanitarian Settings: Select Signal Functions-Facilitator’s Guide. Women’s Refugee Commission.
40. World Health Organization (WHO). (1994). Preventing Prolonged Labour: A Practical Guide: The Partograph (No. WHO/FHE/MSM/93.8). World Health Organization.
41. World Health Organization (WHO) (2010). WHO Partograph E-learning Tool. Department of Making Pregnancy Safer, World Health Organization.
42. World Health Organization (WHO). (2019). Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. World Health Organization.