Effect of Gamified Neonatal Initial Care Education on Midwifery Students: A Randomized Controlled Trial

This randomized controlled trial aims to evaluate the effectiveness of a gamified neonatal initial care educational intervention on knowledge, clinical skills, and self-efficacy among undergraduate midwifery students. Neonatal initial care requires appropriate clinical knowledge, practical skills, and timely decision-making. Gamification-based educational approaches may support active learning and provide opportunities to practice clinical decision-making in simulated environments. The study is planned to include 68 undergraduate midwifery students at KTO Karatay University in Türkiye. Participants will be randomly assigned to an intervention group (n=34) or a control group (n=34). Both groups will receive theoretical education on neonatal initial care. The intervention group will additionally participate in a hybrid escape room activity combining a web-based digital game with hands-on simulation using neonatal mannequins and clinical equipment. The control group will continue with conventional theoretical education without the additional gamified activity. The primary outcome will be neonatal initial care clinical skills, assessed through an Objective Structured Clinical Examination (OSCE) before and shortly after the intervention. Secondary outcomes will include neonatal initial care knowledge and general self-efficacy, assessed at baseline, shortly after the intervention, and at one-month and three-month follow-up. The study will examine whether adding a gamified hybrid escape room activity to conventional theoretical education improves learning outcomes among midwifery students.

Inclusion Criteria: * Being an undergraduate student enrolled in a midwifery program in the fifth semester or higher. * Having no courses that need to be repeated. * Voluntarily agreeing to participate in the study and providing informed consent. Exclusion Criteria: * Currently working or having previously worked in a neonatal unit or delivery room. * Having attendance-related absences from the educational activities required for the study. * Holding a certificate related to neonatal initial care practices. * Not having sufficient Turkish language proficiency in reading, listening, writing, speaking, or comprehension. * Having a hearing or visual impairment.