Self-directed learning about normal birth with web-based support for nurse-midwife students in Thailand: A mixed methods study

Background: Online learning platforms enable students to access their lessons anywhere and at any time, gain knowledge continuously, and become lifelong learners. This study aimed to explore the effectiveness of a web based normal birth learning support platform, and to investigate nurse-midwife students' self-directed learning and attitudes towards online learning. Methods: This study was performed using a sequential explanatory mixed methods design, with a total of 190 nurse-midwife students who voluntarily agreed to study normal birth on the web-based learning support platform. After the web-based learning, 36 students participated in focus groups to share their experience. Knowledge data were analysed using repeated measures analysis of variance, and interview data were analysed thematically. Results: Normal birth knowledge results indicated a positive significant difference between the pre-test and posttest scores. Compared with the post-test scores, no difference was found 2 weeks after the web-based learning. However, 4 weeks after the web-based learning, test scores decreased slightly, but the difference was only marginally significant compared with the scores obtained immediately post-test and 2 weeks later. Four main themes emerged from the qualitative data collection: (1) being challenging and flexible; (2) increasing confidence and positive attitudes; (3) having an interesting web-based support design; and (4) enhancing responsibility, self-directed learning and self-regulation. Key conclusion: Learning about normal birth on the web-based learning support platform can improve nurse midwife students' self-discipline and self-directed learning, leading to sustainable knowledge and personal development. This was particularly significant and full of implications for learning and practice during the coronavirus disease 2019 pandemic. Acquired insights about web-based learning processes can be applied in other situations to further develop nursing and midwifery instruction, enhancing the learners' ability to apply theoretical knowledge to practice and provide effective care for women during childbirth.