BACKGROUND Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students' clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL. METHODS CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/decision-making. RESULTS The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring. CONCLUSION This study clarified that video and paper case modalities have different influences on learners' clinical decision-making processes. Video case learning encourages midwifery students to have a woman- and family-centred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.

中文翻译：

---

视频案例学习对助产士学生的临床决策有何影响？探索性研究。

背景技术临床决策技能对于提供高质量的患者护理至关重要。为了提高这些技能，全球许多机构都将基于案例的学习（CBL）用作临床前培训的教育策略。然而，迄今为止，尚未充分探讨不同学习方式对学生临床决策过程的影响。这项研究旨在探讨视频和纸质案例模式对CBL期间助产专业学生临床决策过程的影响。方法为45名助产士学生提供涉及正常孕妇的CBL。他们分为12组。六个小组收到了视频形式，六个小组收到了纸质形式。小组讨论被录制下来，在CBL之后进行了焦点小组讨论。根据小组讨论的互动方式分析了小组讨论的笔录，并根据临床决策的三阶段模型（包括线索获取，解释和评估/决策）对焦点小组进行了主题分析。结果视频小组的学生更加关注社会心理而非生物医学方面，并讨论了为该妇女及其家庭成员量身定制的护理。他们避免进行阴道检查和胎儿心脏电监护。相反，论文组的学生则更多地关注生物医学而不是社会心理方面，并讨论了何时进行阴道检查和胎儿心电监护。结论这项研究澄清了视频和纸质案例的形式对学习者的学习有不同的影响。临床决策过程。视频案例学习鼓励助产士学生以妇女和家庭为中心，对劳动和生育保健有一个整体的认识，从而引起对社会心理方面的认真考虑。纸面案例学习鼓励助产士学生以医疗保健提供者为中心的劳动和分娩保健生物医学观点，从而进行全面的生物医学评估。