{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:58:40Z","timestamp":1790657920070,"version":"4.1.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n \n Postpartum hemorrhage is a time-sensitive obstetric emergency that requires rapid assessment and coordinated management. This study evaluated the effects of simulation-based education on midwifery students' postpartum hemorrhage management knowledge, skill performance, and self-efficacy\n .<\/jats:bold>\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n An assessor-blinded randomized controlled trial was conducted with 45 third-year midwifery students. Participants were randomly allocated to an intervention group that received traditional theoretical education followed by simulation-based education (\n n<\/jats:italic>\n \u2009=\u200923) or a control group that received traditional theoretical education only (\n n<\/jats:italic>\n \u2009=\u200922). Knowledge and self-efficacy were assessed before, immediately after, and four weeks after the intervention; skill performance was assessed immediately after and at four weeks.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Knowledge scores increased in both groups. A significant between-group difference was observed immediately after the intervention (\n p<\/jats:italic>\n \u2009=\u20090.047), whereas the between-group difference at four weeks was not statistically significant (\n p<\/jats:italic>\n \u2009=\u20090.541). In the linear mixed-effects analysis, the overall group\u2009\u00d7\u2009time interaction for knowledge was not significant [Wald\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n (2)\u2009=\u20092.56,\n p<\/jats:italic>\n \u2009=\u20090.279]. Skill performance was substantially higher in the intervention group at both post-intervention assessments (both\n p<\/jats:italic>\n \u2009&lt;\u20090.001); the post-test mean difference was 8.83 points (95% CI 4.85\u201312.81; Cohen's\n d<\/jats:italic>\n \u2009=\u20091.358), and the group\u2009\u00d7\u2009time interaction from post-test to four weeks was not significant (\n p<\/jats:italic>\n \u2009=\u20090.742), indicating stability of the between-group difference over follow-up. Self-efficacy increased in both groups, with no significant overall group\u2009\u00d7\u2009time interaction [Wald\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n (2)\u2009=\u20093.10,\n p<\/jats:italic>\n \u2009=\u20090.212].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Simulation-based education was associated with a short-term between-group advantage in PPH-related knowledge and with a large, stable post-intervention advantage in skill performance across four weeks. No clear additional effect on self-efficacy was demonstrated. Because skill performance was not measured at baseline, the skill findings should be interpreted with appropriate caution.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n ClinicalTrials.gov<\/jats:ext-link>\n NCT07618442,\n https:\/\/clinicaltrials.gov\/study\/NCT07618442<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1939595","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:37:17Z","timestamp":1790656637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Simulation-based education improves postpartum hemorrhage management knowledge and skills: a randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"\u00d6mercan","family":"Aksoy","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Department of Midwifery, Istanbul Topkapi University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erg\u00fcl","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Women's Health and Gynecologic Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","volume-title":"Consolidated Guidelines for the Prevention, Diagnosis and Treatment of Postpartum hemorrhage","year":"2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e168","DOI":"10.1097\/AOG.0000000000002351","article-title":"Practice bulletin no. 183: postpartum hemorrhage","volume":"130","year":"2017","journal-title":"Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/ijgo.14116","article-title":"FIGO recommendations on the management of postpartum hemorrhage 2022","volume":"157","author":"Escobar","year":"2022","journal-title":"Int J Gynecol Obstet"},{"key":"B4","volume-title":"WHO Recommendations on the Assessment of Postpartum blood Loss and use of a Treatment bundle for Postpartum hemorrhage","year":"2023"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.81532","article-title":"Impact of an obstetrical emergency simulation learning module on midwifery students\u2019 competency: a non-randomized control study","volume":"17","author":"Kannappan","year":"2025","journal-title":"Cureus"},{"key":"B6","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ecns.2021.08.009","article-title":"Healthcare simulation standards of best practice\u2122 simulation design","volume":"58","author":"Watts","year":"2021","journal-title":"Clin Simul Nurs"},{"key":"B7","doi-asserted-by":"publisher","first-page":"549","DOI":"10.3390\/healthcare13050549","article-title":"Transforming postpartum care: the efficacy of simulation training in hemorrhage management among nurses","volume":"13","author":"Almutairi","year":"2025","journal-title":"Healthcare"},{"key":"B8","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1186\/s12884-025-07590-4","article-title":"Improving Tanzanian student nurse-midwives\u2019 knowledge, skills and attitude in postpartum hemorrhage prevention through simulation-based education: a pre-post quasi experimental study","volume":"25","author":"Faustine","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"key":"B9","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1186\/s12909-025-07393-3","article-title":"An assessment of the effects of simulation training on management of postpartum hemorrhage: short- and long-term impact on knowledge retention, skills and teamwork in the Democratic Republic of Congo","volume":"25","author":"Cikwanine","year":"2025","journal-title":"BMC Med Educ"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1186\/s12909-024-06080-z","article-title":"The effectiveness of simulation-based learning (SBL) on students\u2019 knowledge and skills in nursing programs: a systematic review","volume":"24","author":"Alharbi","year":"2024","journal-title":"BMC Med Educ"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: updated guideline for reporting randomized trials","volume":"389","author":"Hopewell","year":"2025","journal-title":"Br Med J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"405","DOI":"10.46237\/amusbfd.940905","article-title":"The effects of simulation-based training on midwifery student malpractice trends and student perceptions of care behaviors: a randomized controlled trial","volume":"6","author":"Durmaz","year":"2022","journal-title":"Adnan Menderes \u00dcniv Sa\u011fl\u0131k Bilim Fak Derg"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14178","article-title":"Prevention and management of postpartum hemorrhage","volume":"124","year":"2017","journal-title":"BJOG"},{"key":"B14","first-page":"8","volume-title":"Acil Obstetrik Bak\u0131m Y\u00f6netim Rehberi","year":"2022"},{"key":"B15","first-page":"4","volume-title":"WHO Recommendations on Prevention and Treatment of Postpartum Hemorrhage and the WOMAN Trial. Sexual and Reproductive Health","year":"2017"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e176","DOI":"10.1016\/j.teln.2023.10.009","article-title":"Effect of a high-fidelity simulation-based teaching-learning experience (SBTLE) on maternal health nursing students\u2019 knowledge of postpartum hemorrhage, confidence, and satisfaction","volume":"19","author":"Alsaraireh","year":"2024","journal-title":"Teach Learn Nurs"},{"key":"B17","doi-asserted-by":"publisher","first-page":"388","DOI":"10.12691\/ajnr-6-6-6","article-title":"Effect of simulation based training on maternity nurses\u2019 performance and self-confidence regarding primary postpartum hemorrhage management","volume":"6","author":"Abd Elhakm","year":"2018","journal-title":"Am J Nurs Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"101926","DOI":"10.1016\/j.ecns.2026.101926","article-title":"Effect of simulation-based postpartum hemorrhage management on midwifery students\u2019 skill levels: a randomized controlled trial","volume":"114","author":"Aker","year":"2026","journal-title":"Clin Simul Nurs"},{"key":"B19","doi-asserted-by":"publisher","first-page":"951","DOI":"10.37989\/gumussagbil.1224338","article-title":"Using in situ simulation to develop knowledge and skills of midwives in postpartum hemorrhage management: amasya-\u015eanl\u0131urfa example","volume":"12","author":"\u00d6zt\u00fcrk","year":"2023","journal-title":"G\u00fcm\u00fc\u015fhane Univ J Health Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1939595\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:37:33Z","timestamp":1790656653000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1939595\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":19,"alternative-id":["10.3389\/fmed.2026.1939595"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1939595","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1939595"}}