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. 2025 Apr 23;25(1):471.
doi: 10.1186/s12884-025-07590-4.

Improving Tanzanian student nurse-midwives' knowledge, skills and attitude in postpartum hemorrhage prevention through simulation-based education: a pre-post quasi experimental study

Rose Faustine  1 , Ingrid Tjoflåt  2 , Eva Christina Furskog Risa  2 , Jane Rogathi  3 , Michael Johnson Mahande  4
Affiliations

Improving Tanzanian student nurse-midwives' knowledge, skills and attitude in postpartum hemorrhage prevention through simulation-based education: a pre-post quasi experimental study

Rose Faustine et al. BMC Pregnancy Childbirth. .

Abstract

Background: Postpartum hemorrhage is a leading cause of maternal deaths in Tanzania, highlighting the critical need for effective training for student nurse-midwives in ordinary diploma programs. The study aimed to determine the changes in knowledge, skills, self-confidence, and satisfaction in preventing and managing postpartum hemorrhage among student nurse-midwives after the simulation-based education method is being used.

Methods: A pre-post quasi-experimental study design without a control group was conducted to assess the impact of simulation-based education on student nurse-midwives' knowledge, skills, self-confidence, and satisfaction regarding the prevention and management of postpartum hemorrhage at one college of health and allied sciences in the northern Tanzania. A total of 55 student nurse-midwives were included. Data were collected using structured self-administered questionnaires related to knowledge, skill check, self-confidence, and satisfaction. Descriptive statistics, bivariate analysis using T-tests and Chi-square tests, as well as multiple regression models, were employed to analyze the data. A p-value of less than 0.05 was used to assess statistically significant differences in the adjusted mean (Beta Coefficient) between the post-intervention and pre-intervention periods.

Results: The results indicated that student nurse-midwives experienced a significant improvement in knowledge and skills after simulation-based education method (p < 0.001). Additionally, the multiple regression analysis revealed that knowledge scores were notably higher at endline of the study compared to the baseline, with an effect size of (AβC = 11.7; 95% CI: 11.0-12.5) and 13.9(12.7-15.1) respectively. Furthermore, students reported high level of self-confidence and satisfaction regarding their abilities in preventing and managing postpartum hemorrhage after simulation, as assessed using the unadjusted Bloom technique.

Conclusion: The results revealed that simulation-based education was an effective pedagogical method for improving student nurse-midwives knowledge, skills, self-confidence, and satisfaction in the prevention and management of postpartum hemorrhage.

Keywords: And satisfaction; Knowledge; Postpartum hemorrhage; Self-confidence; Simulation-based education; Skills.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Kilimanjaro Christian Medical University College on 30/6/2022 number 2582 and the Tanzanian National Health Research Ethics Committee NatHREC/HQ/R.8a/Vol.IX/4275. The study adhered to the declaration of Helsinki [47] by obtaining a written informed consent from the participants prior to the commencement of the study, and the participant’s data were anonymized. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

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