Effects of a Digital Game-Based Educational Intervention on Midwifery Students' Perceptions of Respectful Maternity Care and Empathy

Fourth-year midwifery students will receive education on respectful childbirth care through a web-based digital game consisting of four levels (admission, labor, birth and postpartum care) with scenario-based clinical situations, decision-making options and immediate feedback.

A web-based digital educational game on respectful childbirth care consisting of four levels (admission, labor, birth and postpartum care). Each level includes scenario-based clinical situations in which students choose the most appropriate approach and receive immediate feedback.

Fourth-year midwifery students will receive face-to-face education on respectful childbirth care using a PowerPoint presentation covering the same content as the digital game. After the posttest, students in this group will also be offered the digital game-based education.

Face-to-face lecture on respectful childbirth care delivered with a PowerPoint presentation, covering the same content as the digital game.

Measured with the Students' Perceptions of Respectful Maternity Care (SP-RMC) Scale developed by Dhakal et al.; Turkish validity and reliability study by Camlibel and Uludag (2023). The scale consists of 18 items and three subscales (respectful care, safety and comfort, supportive care) rated on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree); items 1-10 are reverse-scored. Total scores range from 18 to 90; higher scores indicate more positive perceptions of respectful maternity care.

Measured with the Jefferson Scale of Empathy (JSE) developed by Hojat (2002); Turkish version: "Jefferson Empati Olcegi" (Yanik and Saygili, 2013). The scale consists of 20 items and three subscales (perspective taking, compassionate care, standing in the patient's shoes) rated on a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). Total scores range from 20 to 140; higher scores indicate a higher level of empathy.

Measured with the Respectful Childbirth Care Knowledge Form ("Saygili Dogum Bakimina Iliskin Bilgi Formu") developed by the researchers based on WHO, ICM, White Ribbon Alliance and FIGO guidelines. The form consists of 41 statements answered as "Yes/No"; correct answers are scored 1 and incorrect or blank answers 0. Total scores range from 0 to 41; higher scores indicate a higher level of knowledge. Content validity will be assessed by at least five academic experts in women's health and childbirth.

Measured with the Gameful Experience Scale (GAMEX) developed by Eppmann et al. (2018); Turkish version: "Oyun Deneyimi Olcegi" (Donmez et al.). The scale consists of 27 items and six subscales (enjoyment, absorption, creative thinking, activation, absence of negative affect, dominance) rated on a 5-point Likert scale; items of the absence of negative affect subscale are reverse-scored. Total scores range from 27 to 135; higher scores indicate a better gameful experience. Applied only to the intervention group.