The Effect of Hand Sewing Practices on Suturing Skills

The Effect of Hand Sewing Practices on Suturing Skills in Midwifery Students.

The overall aim of this study was to evaluate the effects of hand-held suture exercises on non-locking continuous suture skills used in episiotomy repair in midwifery students. The study, conducted with a randomized, single-blind, controlled design, aimed to generate evidence of psychomotor skill transfer using Objective Structured Assessment of Technical Skills based performance scores and secondary indicators (time, number of errors, etc.).

Study Overview

• Status: Not yet recruiting
• Conditions: Suture; Skill Performance; Midwifery Education
• Intervention / Treatment: Other: Hand Sewing Group

• Study Type: Interventional
• Enrollment (Estimated): 83
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Melek Şen Aytekin, Research Assistant Doctor; Phone Number: +905071616044; Email: meleksenaytekin@gmail.com

Study Locations

• Turkey (Türkiye)
  • Tokat Province
    • Tokat Province, Tokat Province, Turkey (Türkiye), 60000
      • Tokat Gaziosmanpaşa Üniversitesi
      • Sub-Investigator: Ayşenur Kahraman, Research Assistant
      • Contact: melek aytekin; Phone Number: 05071616044; Email: mlksn90@gmail.com
      • Principal Investigator: Hatice Acar Bektaş, Assistant Professor
      • Sub-Investigator: Zümrüt Yılar Erkek, Associate Professor
      • Sub-Investigator: Melek Şen Aytekin, Research Assistant

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Volunteers participating in the study,
• Those taking the Normal Birth and Postpartum Term course for the first time,
• Those who have not received suture training before,
• Third-year midwifery students

Exclusion Criteria:

• Students who are absent on the day the course is taught.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Standard Education Group; This group received the standard training provided as part of the Normal Birth and Postpartum Period course. This training used an 80-slide PowerPoint presentation. The training was delivered in two 50-minute sessions. Surgical suture kits and sponges were used to demonstrate suturing skills.
Experimental: Hand Sewing Group; This group received the standard training provided as part of the Normal Birth and Postpartum Period course. An 80-slide PowerPoint presentation was used for this training. The training was delivered in two 50-minute sessions. Surgical suture kits and sponges were used to demonstrate suture skills. Following the standard training, this group received hand suture exercises. Students in this group received instruction in hand suture exercises. Hand suture exercises were practiced with the group for a total of four days, one day apart. Hand suture exercises were demonstrated using fabric, sponge, and paper. Straight stitching and basting techniques were demonstrated.	Other: Hand Sewing Group; Students in this group will be trained in hand-sewing exercises and then be asked to work on sewing skills for one hour three days a week. Hand-sewing exercises will be demonstrated using fabric, sponge, and paper. Straight stitch and basting techniques will be demonstrated.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective Structured Assessment of Technical Skills	It will be used to assess simple running suture skills. The form will include a checklist and a global rating scale. Each general performance criterion is scored from 1 to 5. Each step includes ratings such as "Cannot do," "Can do with little assistance," and "Can do easily." Each scale is scored from 1 to 5. This means the total score can range from 4 to 20. High scores on the scale indicate a good level of general technical skill.	All students will be asked to apply a simple running suture to the sponge after the intervention is completed. Evaluators will evaluate students using this form throughout the application (approximately 30 minutes).
Continue sutur skill evaluation form	This form was created by researchers. It contains 10 items. The items are on a 3-point Likert-type scale, ranging from "performed" to "incorrect" or "incomplete." Participants receive 2 points for performing the skill, 1 point for incomplete performance, and 0 points for not performing or performing it incorrectly. The total score ranges from 0 to 20. Higher scores indicate successful implementation.	The researchers will monitor and complete the student's application as they complete it. The application will take approximately 30 minutes to complete. Students will be monitored throughout the process using this form (approximately 30 minutes).
Episiotomy Skills Self-Efficacy Scale	The Episiotomy Skills Self-Efficacy Scale (ESSES), developed by Hadımlı et al. (2023), was used to assess participants' self-efficacy perceptions regarding episiotomy application and repair. The scale consists of 17 items on a 5-point Likert-type scale (1 = Strongly disagree - 5 = Strongly agree). A two-factor structure (application and repair) was identified in the development study and was reported to explain 63.4% of the total variance. Turkish validity and reliability analyses were conducted within the scope of the same study, and the Cronbach's alpha coefficient was reported as 0.94.	It will be used as a pre-test 5 minutes after the standard training. It will be used as a post-test 5 minutes after students practice the simple running suture.
Perceived Learning Scale	The Perceived Learning Scale, developed by Rovai et al. (2009), was used to measure students' cognitive, affective, and psychomotor perceptions of learning. The scale was adapted into Turkish by Albayrak, Güngören, and Horzum (2014). The Turkish form consists of nine items, and items 2 and 7 are reverse-scored. The scale is scored on a 5-point Likert-type scale (1 = Strongly disagree - 5 = Strongly agree), with higher scores indicating a stronger perception of learning.	It will be used as a pre-test 5 minutes after the standard training. It will be used as a post-test 5 minutes after students practice the simple running suture.
Clinical Skills Self-Efficacy Scale	The Learning Self-Efficacy Scale for Clinical Skills (L-SES), developed by Bayazit, Gonullu, and Dogan (2022) and adapted to Turkish for validity and reliability, was used to assess self-efficacy perceptions related to clinical skills. The scale has a 14-item, single-factor structure and uses a 5-point Likert-type scoring system. The Turkish version's Cronbach's alpha was reported as 0.94.	It will be used as a pre-test 5 minutes after the standard training. It will be used as a post-test 5 minutes after students practice the simple running suture.
State-Trait Anxiety Inventory	The State-Trait Anxiety Inventory (STAI), developed by Spielberger et al. (1983), was used to measure participants' state and trait anxiety levels, along with a form adapted for Turkish by Öner and Le Compte (1985). Two subscales, each consisting of 20 items (STAI-1 = State Anxiety, STAI-2 = Trait Anxiety), are scored on a 4-point Likert-type scale. The total score is calculated by correcting for reverse items.	It will be used as a pre-test 5 minutes after the standard training. It will be used as a post-test 5 minutes after students practice the simple running suture.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Personal Information Form	The Personal Information Form was prepared by the researcher in line with the literature to determine the socio-demographic characteristics of the students (age, education level, employment status, health insurance, parents' education status, parents' occupation, etc.). It consists of 10 questions.	It is filled out as a pre-test 5 minutes after the standard training.

Collaborators and Investigators

• Sponsor: Melek Şen Aytekin

Study record dates

Study Major Dates

• Study Start (Estimated): November 20, 2025
• Primary Completion (Estimated): December 31, 2025
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: September 30, 2025
• First Submitted That Met QC Criteria: November 17, 2025
• First Posted (Actual): November 19, 2025

Study Record Updates

• Last Update Posted (Actual): November 19, 2025
• Last Update Submitted That Met QC Criteria: November 17, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Suture; skill; midwifery education
• Other Study ID Numbers: GaziosmanpasaU-EBE-MŞA-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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