Mixed Reality Training for Teaching Cervical Effacement and Dilation

The Effect of Mixed Reality Application in Teaching Cervical Effacement and Dilatation on Cognitive Load, Sense of Presence, and Midwifery Professional Perception

The aim of this educational research is to determine whether a mixed reality-based training program is effective in teaching midwifery students how to assess cervical effacement and dilation. The study also examines the impact of mixed reality on students' cognitive load, sense of presence, and midwifery professional perception.

The main questions the study seeks to answer are:

Does mixed reality training reduce students' cognitive load?

Does mixed reality increase the students' sense of presence?

How does mixed reality-based training influence students' professional perception of midwifery?

Do students who receive mixed reality training perform better in assessing cervical effacement and dilation on real pregnant women compared with the control group?

Study Overview

• Status: Recruiting
• Conditions: Labor; Poor, Primary
• Intervention / Treatment: Other: mixed reality education; Other: Standard Education Group

Detailed Description

The aim of this educational research is to determine whether a mixed reality-based training program is effective in teaching midwifery students how to assess cervical effacement and dilation. The study also examines the impact of mixed reality on students' cognitive load, sense of presence, and midwifery professional perception.

The main questions the study seeks to answer are:

Does mixed reality training reduce students' cognitive load?

Does mixed reality increase the students' sense of presence?

How does mixed reality-based training influence students' professional perception of midwifery?

Do students who receive mixed reality training perform better in assessing cervical effacement and dilation on real pregnant women compared with the control group?

How the research will be conducted:

Researchers will compare a mixed reality intervention group with a control group receiving traditional training. Students in both groups will evaluate five different pregnant women to assess cervical effacement and dilation in real clinical settings.

Participants will:

Receive either mixed reality-based training (intervention) or traditional instruction (control)

Complete the Cognitive Load Scale, Sense of Presence Scale, and Midwifery Professional Perception Scale

Perform cervical effacement and dilation assessments on five pregnant women during clinical practice

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ülkin Gündüz Aruser, Ph.D; Phone Number: +905314592113; Email: ulkingunduz@artuklu.edu.tr
• Study Contact Backup: Name: Hacer Ünver Koca, Assoc. Prof.; Phone Number: +905446799899; Email: hacer.unver@inonu.edu.tr

Study Locations

• Turkey (Türkiye)
  • Mardin, Turkey (Türkiye), 47200
    • Recruiting
    • Mardin Training and Research Hospital
    • Contact: Ülkin Gündüz Aruser, Ph.D; Phone Number: +905314592113; Email: ulkingunduz@artuklu.edu.tr

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Enrolled in the Midwifery Department at Mardin Artuklu University,
• Taking the course "Normal Birth and Postpartum Care,"
• Who have not previously received any structured training (practical training, simulation, etc.) related to vaginal examination or cervical dilation/effacement procedures,
• Who do not feel confident in assessing cervical effacement and dilation,
• Who volunteer to participate in the study will be included,
• Pregnant women who are in the first stage of labor and have no obstetric complications.

Exclusion Criteria:

• Individuals who are graduates of health vocational high schools,
• Have disabilities in their eyes, hands, arms, or fingers,
• Those who do not complete the training will not be included.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Mixed Reality Training Group; Students will participate in a mixed reality (MR)-based training program.	Other: mixed reality education; Students will participate in a mixed reality (MR)-based training program. The program is designed to teach cervical effacement and dilation assessment. During the training, students will interact with three-dimensional virtual cervical models. They will be able to practice repeatedly in a safe, error-free environment to enhance their clinical skills. After completing MR training, students will perform vaginal examinations on 10 virtual patient scenarios. The accuracy of each assessment will be automatically evaluated by the system. Following MR training, students will conduct vaginal examinations on five pregnant women under researcher supervision in a real clinical setting. The following scales will be administered to participants: Cognitive Load Scale Sense of Presence Scale Midwifery Professional Perception Scale These measures will be used to determine the cognitive and professional effects of MR-based learning.
Active Comparator: Standard Education Group; Students in the control group will receive traditional theoretical instruction.	Other: Standard Education Group; Students in the control group will receive traditional theoretical instruction. The training content will cover the principles of cervical effacement and dilation assessment. After completing the theoretical training, students will complete the Cognitive Load Scale and the Midwifery Professional Perception Scale. Under researcher supervision, students will perform vaginal examinations on five pregnant women to assess cervical effacement and dilation. These evaluations will be used to examine the effects of traditional training on students' cognitive load, professional perception, and practical assessment skills.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accuracy of Cervical Dilation Measurement (cm)	Accuracy of cervical dilation measurement will be assessed by calculating the absolute difference (in centimeters) between the student's measurement and the researcher's reference measurement. Each participant will perform one vaginal examination on five different pregnant women. The mean absolute difference across all five assessments will be reported as the participant's cervical dilation measurement accuracy. Smaller values indicate higher accuracy.	4 month
Accuracy of Cervical Effacement Measurement (%)	Cervical effacement accuracy will be assessed by calculating the absolute difference (in percentage points) between the student's effacement measurement and the researcher's reference measurement. Each participant will perform one vaginal examination on five different pregnant women. The mean absolute difference across all five assessments will be reported as the participant's cervical effacement measurement accuracy. Smaller values indicate higher accuracy.	4 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of Cognitive Load	Cognitive load will be assessed using the Cognitive Load Scale, a 9-point Likert-type measure. Participants will respond to the question "How much mental effort did you invest in completing the task?" by selecting a score between 1 (low) and 9 (high). The midpoint of the scale is 5; participants scoring above this value will be considered to have experienced higher levels of cognitive load.	4 months
Assessment of Presence Experience	The sense of presence will be assessed using the Presence Scale (PS) adapted to a 5-point Likert scale. Participants will rate their virtual reality experience from 1 (strongly disagree) to 5 (strongly agree). Higher subscale scores indicate that the virtual environment is perceived as more realistic and that the sense of presence is stronger.	Immediately after MR training (within 1 day)
Assessment of Midwifery Professional Perception	Midwifery professional perception will be assessed using the Midwifery Professional Perception Scale (MPPS). Participants will rate statements reflecting their perceptions of the midwifery profession on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate a more positive perception of the midwifery profession.	4 months

Collaborators and Investigators

• Sponsor: Mardin Artuklu University
• Investigators: Principal Investigator: Ülkin Gündüz Aruser, Ph.D, Mardin Artuklu University; Study Director: Hacer Ünver Koca, Assoc. Prof., Inonu University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): February 1, 2026

Study Registration Dates

• First Submitted: September 12, 2025
• First Submitted That Met QC Criteria: November 15, 2025
• First Posted (Actual): November 20, 2025

Study Record Updates

• Last Update Posted (Actual): November 20, 2025
• Last Update Submitted That Met QC Criteria: November 15, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Labor; Cervical Dilatation; First Stage
• Other Study ID Numbers: MAU-Midwifery-UG-01

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