Evaluation of the Effectiveness of High-Fidelity Simulation-Based Breech Birth Management Education on Midwifery Students: A Randomized Controlled Study

This randomized controlled educational intervention study was designed to evaluate the effectiveness of high-fidelity simulation-based breech birth management education on undergraduate midwifery students' knowledge, clinical skill performance, and satisfaction with the simulation-based learning experience.

Breech presentation and breech birth management are important topics in midwifery education because they require rapid clinical assessment, appropriate decision-making, effective teamwork, and correct application of obstetric skills. Although vaginal breech birth is encountered less frequently in contemporary obstetric practice, midwives are expected to understand the principles of breech birth management and to be prepared to respond appropriately in situations where breech birth occurs. However, undergraduate midwifery students may have limited opportunities to observe or actively participate in the management of breech birth during clinical practice. This limitation may affect their ability to develop confidence, decision-making ability, and psychomotor skills related to rare but critical obstetric events.

Simulation-based education provides a structured and safe learning environment in which students can practice clinical skills and decision-making without risk to mothers or newborns. High-fidelity simulation allows learners to experience a more realistic clinical scenario by using a simulator and environment that more closely resemble real clinical conditions. In contrast, low-fidelity mannequin-based practice generally focuses on procedural steps and psychomotor skill development with a simpler training model. This study was planned to compare these two educational approaches in the context of breech birth management education.

The study was conducted with undergraduate midwifery students who met the eligibility criteria. Students were eligible to participate if they had completed the normal birth course, had not yet taken the high-risk birth course, and had no previous experience with breech birth. These criteria were used to ensure that participants had a basic foundation in normal birth while limiting the potential influence of previous education or clinical experience related to high-risk birth and breech birth management. Students who did not meet the eligibility criteria, who had previous experience with breech birth, or who did not agree to participate were not included in the study.

A total of 102 eligible midwifery students were included in the study. Participants were randomly assigned to two parallel groups using a simple randomization method. The experimental group consisted of 51 students who received theoretical education followed by high-fidelity simulation-based breech birth management training. The control group consisted of 51 students who received the same theoretical education followed by low-fidelity mannequin-based practice. The theoretical content was provided to both groups in order to ensure that all students received comparable baseline instruction before the practical training component.