Effect of a Blended Clinical Learning Model on Delivery Care Competency Among Professional Midwifery Students

Abstract

Delivery care competency is a fundamental ability that midwifery professional students must master to provide safe, effective, and high-quality maternal health services. Conventional clinical education alone does not consistently build this competency, creating a need for learning models that combine structured self-paced preparation with supervised hands-on practice. This study aimed to analyze the effectiveness of a blended clinical learning model, compared with conventional clinical learning, in improving delivery care competency scores among professional midwifery students. Novelty: Unlike previous studies that examined blended learning in general nursing or midwifery theory courses, this study evaluates a structured seven-stage blended clinical learning model specifically designed for intrapartum (delivery) care practicum, integrating a Learning Management System (LMS), video demonstration, laboratory simulation with formative OSCE, bedside teaching, and structured clinical reflection. A quasi-experimental design with a pretest-posttest control group approach was used. Sixty midwifery professional students undergoing clinical practice in maternity care were allocated by purposive sampling into an intervention group (n = 30) and a control group (n = 30). The intervention group received a four-week blended clinical learning program; the control group received conventional clinical learning. Delivery care competency was measured with an Objective Structured Clinical Examination (OSCE) checklist and a clinical competency observation sheet (content validity by three experts). Data were analyzed with paired t-tests and independent t-tests after Shapiro-Wilk normality tests and Levene’s tests for homogeneity of variance confirmed the assumptions for parametric testing. Delivery care competency scores in the intervention group increased significantly from 68.45 ± 5.21 to 87.32 ± 4.11, compared with an increase from 69.11 ± 5.10 to 75.24 ± 5.42 in the control group. The between-group difference in post-intervention scores was statistically significant (p < 0.001; mean difference = 12.08, 95% CI 9.59–14.57; Cohen’s d = 2.51). Blended clinical learning produced a significantly greater improvement in delivery care competency—including labor assessment, clinical decision-making, delivery skills, therapeutic communication, documentation, and clinical reasoning—than conventional learning. These findings support blended clinical learning as a practical strategy for strengthening intrapartum clinical education in midwifery professional programs, provided it is implemented with adequately trained preceptors and structured reflection sessions.

Keywords: Blended Clinical Learning, Delivery Care Competency, Midwifery Students; Clinical Reasoning, Maternity Care.