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NCT Number: NCT07804108

Effect of Mosaic Art on Episiotomy Repair Skills, Anxiety, and Learning Attitudes in Midwifery Students

Objective: The aim of this study is to evaluate the effect of mosaic art in midwifery education on episiotomy repair performance, self-efficacy, and anxiety: a randomized controlled trial. Method/Data Collection Techniques: The study was planned in a two-parallel-group randomized controlled experimental design including pre-test and post-test measurements. The study will be conducted with third-year students studying in the Midwifery Department of the Faculty of Health Sciences at Kahramanmaraş Sütçü İmam University during the fall semester of the 2026-2027 academic year. The sample size was calculated using the G*Power 3.1.9.7 program, and based on Cohen's effect size d=0.55, α=0.05, and 80% power, a total of 106 students were planned to be included in the study, with 53 students in each group. Participants will be assigned to intervention and control groups using a simple randomization method. The intervention group will receive structured mosaic art training for six weeks, with two sessions per week, while the control group will not receive any art-based application during this period. Following the intervention, both groups will receive theoretical and practical training in standard episiotomy repair. Data will be collected using the Participant Information Form, State Anxiety Scale (STAI-TX I), Episiotomy Self-Efficacy Scale, Attitudes Towards Learning Scale, and Episiotomy Repair Skill Assessment Form. Appropriate descriptive statistics and parametric or non-parametric comparison tests will be used in the analysis of the data, with a statistical significance level of p<0.05. Expected Results: This research is expected to provide scientific evidence regarding the use of art-based teaching methods in midwifery education by revealing the effect of mosaic art application on midwifery students' episiotomy repair skills, self-efficacy, attitudes towards learning, and state anxiety levels. It is anticipated that the research results will contribute to the development of effective teaching strategies in psychomotor skills training and the strengthening of midwifery education programs.

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Key information

Conditions

Education Anxiety Disorders Mental Disorders Midwifery Midwifery Education Nursing

Age range

18 year–35 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Being enrolled as a third-year student in the Department of Midwifery, Faculty of -Health Sciences, Kahramanmaraş Sütçü İmam University, during the Fall -semester of the 2026-2027 academic year.
  • Volunteering to participate in the study.
  • Providing written informed consent.
  • Having no previous clinical practice experience in episiotomy repair.
  • Having no previous participation in a structured training program involving mosaic art or similar activities requiring fine motor skills.

Exclusion criteria

  • Having previous clinical practice experience in episiotomy repair.
  • Having previously participated in a structured mosaic art training program or a similar structured program requiring fine motor skills.
  • Having a condition that prevents participation in the mosaic art activities or episiotomy repair simulation practice.
  • Declining or withdrawing consent to participate in the study

Treatment and study plan

Mosaic Art Practice

Behavioral

Participants assigned to the intervention group will participate in a structured mosaic art program for six weeks before episiotomy repair training. The program will consist of two 45-minute sessions per week (12 sessions in total). Participants will engage in mosaic art activities requiring coordinated hand and finger movements and fine motor control. After completion of the mosaic art program, participants will receive the same theoretical and practical episiotomy repair training provided to the control group.

Standard Episiotomy Repair Training

Behavioral

Participants will receive standardized theoretical and practical episiotomy repair training. The training will include 2 hours of theoretical instruction and 6 hours of practical training using a silicone episiotomy repair model. The same standardized episiotomy repair training will be provided to participants in both study groups.

Primary outcomes

  1. Episiotomy Self-Efficacy

    Time frame: Immediately before and immediately after the episiotomy repair training

    Episiotomy self-efficacy will be assessed using the Episiotomy Self-Efficacy Scale developed by Yolcu et al. (2025). The scale consists of 17 items across four subdimensions: cognitive (5 items), affective (5 items), motivation (3 items), and psychomotor (4 items). Each item is rated on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). There are no reverse-scored items. The total score ranges from 17 to 85, with higher scores indicating greater episiotomy self-efficacy.

  2. Episiotomy Repair Skill Performance

    Time frame: Baseline and immediately post-intervention

    Episiotomy repair skill performance will be assessed using the Episiotomy Repair Skill Assessment Form developed by the researchers based on the relevant literature and expert review. The form consists of 20 procedural steps assessing the performance of

Secondary outcomes

  1. State Anxiety (STAI Form TX-I)

    Time frame: Baseline and immediately post-intervention

    State anxiety will be assessed using the State-Trait Anxiety Inventory, State Anxiety Form (STAI Form TX-I). The scale consists of 20 items rated on a 4-point scale. Total scores range from 20 to 80, with higher scores indicating higher levels of state anxiety.

  2. Attitudes Toward Learning

    Time frame: Baseline and immediately post-intervention

    Attitudes toward learning will be assessed using the Attitudes Toward Learning Scale developed by Kara (2010). The scale consists of 40 items and four subdimensions: Nature of Learning (7 items), Anxiety About Learning (13 items), Expectations About Learning (9 items), and Openness to Learning (11 items). Items are rated on a 5-point Likert scale from 1 (Strongly Disagree) to 5 (Strongly Agree). Eleven negatively worded items are reverse scored. Higher scores indicate more positive attitudes toward learning.

Sponsors and collaborators

Lead sponsor

Kahramanmaras Sutcu Imam University

Other

Registry information

Official study title

The Effect of Mosaic Art Practice on Fine Motor Skills, Anxiety Levels, and Learning Attitudes in Episiotomy Repair Among Midwifery Students: A Randomized Controlled Trial

Acronym: MOSAIC-EPI

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Sep 4, 2026
Registry last updated
Sep 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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