# Enhancing Episiotomy Skills Through Interactive Online Simulation

## TL;DR

An online simulation helped midwifery students improve their episiotomy skills and confidence during the pandemic.

## Contribution

Interactive online simulation training was shown to enhance clinical skills and self-confidence in midwifery students.

## Key findings

- Students with higher self-confidence had greater readiness for online learning.
- Better training performance was linked to higher exam scores in clinical practice.
- Training performance was a significant predictor of achieving full marks.

## Abstract

Background/Objectives: The COVID-19 pandemic has significantly restricted clinical training for midwifery students, highlighting the need for alternative teaching methods. With the disruption of traditional face-to-face education, online simulation-based training has emerged as an effective alternative for developing essential clinical skills. The acquisition of hands-on skills has a direct impact on students’ self-confidence and clinical performance. Interactive online simulations support the learning process by enhancing both theoretical knowledge and practical competencies. This study aims to evaluate the impact of online simple simulation-based episiotomy repair training on students whose clinical practice was limited due to the COVID-19 pandemic. Methods: A mixed-method approach was used, considering the outcomes from 61 midwifery students. Data were collected via observational questionnaires, which provide an online learning readiness scale and scales for student satisfaction and self-confidence. The analysis included descriptive statistics, McNemar’s, binary logistic regression, and the Mann–Whitney U test. Results: Students who trusted themselves in both opening and repairing an episiotomy after training had more readiness for online learning (t(43) = 2.73, p = 0.009; t(43) = 2.40, p = 0.02). Students with better training performance are more likely to obtain higher scores on the final exam of the Clinical Practice module (rho = 0.33, p = 0.01). Additionally, their performance was a positive and significant predictor of achieving a full mark (b = 0.11, s.e. = 0.05, p = 0.01). Conclusions: Interactive online simulation training improved midwifery students’ hand skills and self-confidence in clinical practice. Such methods should be promoted in circumstances like COVID-19.