Full title: The effect of competency-based education in obstetric emergencies on 2 midwifery students in clinical skill lab, based on Kirkpatrick evaluation model: A 3 randomized controlled trial 4 Short title: the effect of competency-based education in obstetric emergencies and 5 midwifery students 6 Abstract 22Background: 23 Obstetric emergency is one of the most important causes of maternal and neonatal 24 mortality, and competency-based education is one of the efficient approaches to cover 25 this. Objective structured clinical examination is one of the valid methods in measuring 26 students' competency and performance. Kirkpatrick evaluation model is a great method 27 to assess a training impact. 28Objectives: This study was designed to determine the effect of competency-based 29 education on midwifery students based on Kirkpatrick evaluation model. 30 Design: Randomized controlled trial 31 Setting: Nursing and Midwifery School in Islamic Republic of Iran (Iran University of 32 Medical Sciences) 33 Participants: eighty students in third to fifth term of associate and bachelor's degree in 34 midwifery (intervention group=40, control group=40) 35 Methods: 36 Using stratified random sampling, research team trained learners of intervention group 37 in 4 sessions, 5 hours/day in a month in emergency obstetric cares. Both groups had 38 been receiving the routine schedule of the faculty. Knowledge, skills, and self-39 confidence were assessed three times, before, immediately and 6 weeks after training 40 by researcher made questionnaire, Objective Structured Clinical Examination (OSCE) 41 and self-reported questionnaire respectively. Data were analyzed with descriptive, 42 inferential statistics.43 Results: 44 The level of knowledge, skills, and self-confidence increased significantly in the 45 intervention group, in immediate and 6 weeks after intervention (P<0.001). In 46 intervention group, Mean ± S.D of all variables were 5.05±2.074, 143.30±12.146 and 47 11.65±2.045, which increased to 10.17±1.318, 527.70±19.995 and 18.97±1.980 and 48 remained at the same levels 6 weeks later, 9.37±2.215, 521.80±19.784 and 49 19.00±2.631; in the control group, this trend was not significant (P=0.380, P=0.455 and 50 P=0.191).51 Conclusion: Competency-based education can be used in midwifery education and in-52 service training. We need to use new educational approaches such as competency-53 based to have a valuable impact on knowledge skills and self-confidence. This may 54 affect health indexes indirectly. 3 55 Keywords: competency-based education, learning (knowledge and skill), behavior 56 (self-confidence), clinical skill, midwifery 57 58 65 related to birth and 99 percent of them occurred in developing countries (2, 3). In 2017, 66 the maternal mortality rate (MMR) in Iran and Afghanistan were 23.3 and 299.1 per 67 100000 live births, respectively (4). 68 One of the most important instructions to constraint maternal and neonatal death is 69 promoting the quality of obstetric care (5). In order to achieve this goal, midw...

Introduction: Successful sex is one of the greatest behavioral needs of couples, especially those who marry at an early age. The best way to access information is education and learning. Face to face training is one of the most common methods, with the advancement of technology, multimedia training can be a good alternative method to sex education. This study was designed to comparison between two educational method Multimedia and Face to face on sexual function of Afghan Migrant Adolescent Women. Methods: The study was a quasi-experimental educational intervention conducted in selected charity centers in Mashhad. The selected centers were randomly chosen as face to face intervention ( n = 36), multimedia intervention ( n = 36) and control ( n = 36) groups. Our method of sampling was convenient at each center. Intervention groups received four one-hour sessions of sex education using various face to face and multimedia methods. Sexual function were measured using female sexual function index (FSFI) before, immediately and 8 weeks after the intervention. Data were analyzed with SPSS version 16. Results: The level of sexual function did not show a significant difference in groups before the intervention, but these increased significantly immediately ( P = 0.005) and 8 weeks later ( P < 0.001). Conclusion: Because of the taboo of sexual issues and the lack of difference between the two methods in improving sexual function, multimedia method is a good alternative educational method.

Background: First-day neonate death has the highest rate in infant mortality. Using modern educational methods such as simulation and competency can be effective in improving learners' performance and subsequently their confidence. Material and Method: This study was a quasi-experimental intervention on 80 midwifery students of semester 3, 4, and 5 undergraduate degrees. Eighty-six students registered after the researcher's explanations. The learners were randomly assigned into two groups while they were receiving routine midwifery education according to the midwifery curriculum. The learners in the intervention group (in seven groups) received a 7-hour session about neonate resuscitation. The theory session was conducted using PowerPoint presentation, lecture, video, and pictures. The practical session was conducted using simulation with manikins of skill laboratory. The skill practice continued until the learners achieved competency (performing 90% of resuscitation steps). The learners were assessed before, immediately, and 6 weeks after training using questionnaires and a checklist. The data were analyzed using SPSS, descriptive, and inferential statistics. Results: The knowledge, skill, and self-confidence scores increased significantly immediately after the training (P < 0.001), from 5.05 ± 2.07 (out of 12) to 10.17 ± 1.31, 18.90 ± 3.14 to 68.45 ± 2.05, and 1.50 ± 0.55 to 2.02 ± 0.57, respectively. The changes were retained 6 weeks after the training. These changes were not observed in the control group. Conclusion: Competency-based, simulation-based, and objective structured clinical examination (OSCE) were effective in students learning to manage initial neonatal resuscitation in the skills' lab, and this increase was retained 6 weeks after the training.