Etamine Processing on Episiotomy Repair Skills, Stress and Learning Attitudes in Midwifery Students

Effect of Etamine Processing on Midwifery Students' Episiotomy Repair Application Ability, Perceived Stress and Learning Attitude: Randomized Controlled Study

Research Hypotheses H1: Midwifery students who practice Etamine have higher episiotomy repair skills than those who do not.

H2: Midwifery students who practice Etamine have lower perceived stress levels than those who do not.

H3: Midwifery students who practice Etamine have higher learning attitudes than those who do not.

Study Overview

• Status: Completed
• Conditions: Episiotomy Repair Skills; Learning Attitude
• Intervention / Treatment: Other: Etamine Application Group /Intervention

• Study Type: Interventional
• Enrollment (Actual): 110
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Selçuklu
    • Konya, Selçuklu, Turkey (Türkiye), 42130
      • Selcuk University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• The inclusion criteria for the study include students who are willing to participate in the study and who do not have any learning or working experience related to episiotomy repair.

Exclusion Criteria:

• Students with diagnosable diseases affecting their learning ability, those who have had accidents during the training and assessment sessions, and foreign nationals will be excluded from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Etamine Application Group /Intervention; Before the intervention, eligible midwifery students who agreed to participate were informed verbally and in writing, and completed the Informed Consent Form, The Participant Information Form, Perceived Stress Scale, and Scale of Attitudes Towards Learning (pre-test). Forms were distributed by a department assistant not involved in the study. During the first two weeks, students in the intervention group received individual 45-minute etamine (cross-stitch) training in the clinical skills laboratory, including introduction to materials and basic techniques, followed by practice of simple patterns. Students continued etamine practice for six weeks (12 sessions, 45 minutes each). Six weeks later, all students received episiotomy education (2-hour theory by the researcher and 6-hour practical training by two independent instructors). Students practiced suturing on a model and were evaluated	Other: Etamine Application Group /Intervention; Before the intervention, eligible midwifery students who agreed to participate were informed verbally and in writing, and completed the Informed Consent Form, The Participant Information Form, Perceived Stress Scale, and Scale of Attitudes Towards Learning (pre-test). Forms were distributed by a department assistant not involved in the study. During the first two weeks, students in the intervention group received individual 45-minute etamine (cross-stitch) training in the clinical skills laboratory, including introduction to materials and basic techniques, followed by practice of simple patterns. Students continued etamine practice for six weeks (12 sessions, 45 minutes each). Six weeks later, all students received episiotomy education (2-hour theory by the researcher and 6-hour practical training by two independent instructors). Students practiced suturing on a model and were evaluated
No Intervention: Control; Control group students completed the Informed Consent Form, The Participant Information Form, Perceived Stress Scale, and Scale of Attitudes Towards Learning (pre-test) distributed by a department assistant not involved in the study, while the researcher was absent. Students did not receive etamine training. Six weeks later, all students received 2-hour theory and 6-hour practical episiotomy training by the researcher and two independent instructors. Groups of ~20 students received 1-hour suturing training, then practiced and were assessed in separate rooms by blinded instructors using the Episiotomy Repair Skill Form (post-test). Final evaluations included the Perceived Stress Scale and Scale of Attitudes Towards Learning (post-test). After the study, etamine training was optionally offered to ensure equal skill opportunities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Episiotomy Repair Skill Form	The form, which was developed by the researcher by scanning the literature and obtaining expert opinions, consists of 16 questions. It will be evaluated under four headings. It consists of "Selection and use of suture material (3 questions)", "Suture Technique and Application (8 questions)", "Equal and Proper Placement of Sutures (2 questions)", "Aesthetic and Functional Results (3 questions)". The steps in the skill form were examined by midwifery faculty members who are experts in the field and finalized. The evaluation form includes the following options: "1. Needs improvement: The step is not applied at all, applied incorrectly or not applied in order, 2. Sufficient: The step is applied correctly and in order, but there are deficiencies and/or the help of the trainer is needed, 3. Mastered: The step is applied correctly and in order without pausing and needing help." High scores obtained from the form indicate good skill.	Fifth week after the start of the application
Perceived Stress Scale	The Perceived Stress Scale (PSS-10), developed by Cohen et al. (1983) and adapted to Turkish by Kaya et al. (2019), consists of 10 items rated on a five-point Likert scale (0-4). Items 4, 5, 7, and 8 are reverse-scored. Scores of 0-13 indicate low, 14-26 moderate, and 27-40 high stress. Cronbach's alpha for self-efficacy and helplessness subscales were 0.68 and 0.85, respectively. The scale was used to assess how stress in the lab setting affects students' skill performance and reflects clinical stress. The lab is a preparatory stage for clinical practice, making stress measurement here significant. Literature shows that lab stress can impact students' skills (Duffy et al., 2021), and tasks requiring fine motor skills like etamine may also influence stress in competitive environments (Ferrara, 2022). Therefore, the PSS will evaluate both lab stress and etamine's impact, contributing valuable insights into skill performance and preparedness.	pre-intervention
Attitude Scale Towards Learning	The scale was developed by Kara (2010) to measure students' attitudes towards learning. It includes 40 items and four sub-dimensions: Nature of Learning (7 items), Anxiety About Learning (13 items), Expectations About Learning (9 items), and Openness to Learning (11 items). It uses a 5-point Likert scale: 1 (Strongly Disagree) to 5 (Strongly Agree). Subscale score ranges are: Nature of Learning (7-35), Anxiety (13-65), Expectations (9-45), and Openness (11-55). The scale provides insights into how students perceive and approach learning. Cronbach's alpha was calculated as 0.73, indicating acceptable reliability (Kara, 2010). It is suitable for assessing both positive and negative attitudes related to the learning process in educational research.	pre-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Stress Scale	The Perceived Stress Scale (PSS-10), developed by Cohen et al. (1983) and adapted to Turkish by Kaya et al. (2019), consists of 10 items rated on a five-point Likert scale (0-4). Items 4, 5, 7, and 8 are reverse-scored. Scores of 0-13 indicate low, 14-26 moderate, and 27-40 high stress. Cronbach's alpha for self-efficacy and helplessness subscales were 0.68 and 0.85, respectively. The scale was used to assess how stress in the lab setting affects students' skill performance and reflects clinical stress. The lab is a preparatory stage for clinical practice, making stress measurement here significant. Literature shows that lab stress can impact students' skills (Duffy et al., 2021), and tasks requiring fine motor skills like etamine may also influence stress in competitive environments (Ferrara, 2022). Therefore, the PSS will evaluate both lab stress and etamine's impact, contributing valuable insights into skill performance and preparedness.	Fifth week after the start of the application
Attitude Scale Towards Learning	The scale was developed by Kara (2010) to measure students' attitudes towards learning. It includes 40 items and four sub-dimensions: Nature of Learning (7 items), Anxiety About Learning (13 items), Expectations About Learning (9 items), and Openness to Learning (11 items). It uses a 5-point Likert scale: 1 (Strongly Disagree) to 5 (Strongly Agree). Subscale score ranges are: Nature of Learning (7-35), Anxiety (13-65), Expectations (9-45), and Openness (11-55). The scale provides insights into how students perceive and approach learning. Cronbach's alpha was calculated as 0.73, indicating acceptable reliability (Kara, 2010). It is suitable for assessing both positive and negative attitudes related to the learning process in educational research.	Fifth week after the start of the application

Collaborators and Investigators

• Sponsor: Selcuk University

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2025
• Primary Completion (Actual): November 30, 2025
• Study Completion (Actual): January 19, 2026

Study Registration Dates

• First Submitted: April 8, 2025
• First Submitted That Met QC Criteria: April 8, 2025
• First Posted (Actual): April 16, 2025

Study Record Updates

• Last Update Posted (Actual): March 10, 2026
• Last Update Submitted That Met QC Criteria: March 7, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: perceived stress; midwifery student
• Additional Relevant MeSH Terms: Investigative Techniques; Methods
• Other Study ID Numbers: 1234567891

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The IPD will be shared with other researchers.
• IPD Sharing Time Frame: starting in April 2024
• IPD Sharing Access Criteria: The IPD will be shared with principal researchers.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No