A mixed-methods study of a combined modeling video and OSCE-based teaching intervention for prenatal nutrition counseling self-efficacy among nursing–midwifery students

With this study, we examined changes in prenatal nutrition counseling self-efficacy among nursing–midwifery students through a modeling video and Objective Structured Clinical Examination-based intervention during prenatal medical visits. A sequential explanatory mixed-methods design was used to evaluate changes in self-efficacy regarding prenatal nutrition counseling among nursing–midwifery students after exposure to the modeling videos and Objective Structured Clinical Examination-based intervention. Quantitative data were collected before and after the teaching intervention, followed by focus group interviews to explain the quantitative findings. The primary outcome was prenatal nutrition counseling self-efficacy. The Objective Structured Clinical Examination was incorporated into the curriculum as a structured teaching and assessment component. The participants comprised 49 nurse-midwifery students in northern Taiwan recruited between September 2024 and August 2025. Participants completed both assessments, with no loss to follow-up. The Nutrition Care Self-Efficacy Scale, which was developed for this study, contains 10 items rated on a five-point Likert scale (1 = very difficult, 5 = very easy; total score = 50), with higher scores indicating greater self-efficacy. All students completed quantitative questionnaires before and after the intervention to assess changes in prenatal nutrition counseling self-efficacy. Qualitative data were collected through focus group interviews to explore students’ learning experiences and to further contextualize and explain the quantitative findings. The findings indicated a statistically significant improvement in nurse-midwifery students’ prenatal nutrition counseling self-efficacy following the intervention, with the total self-efficacy score increasing from 31.6 ± 5.8 to 36.0 ± 5.4 ( p < 0.001). Significant within-group improvements were also observed in several self-efficacy-related domains, including confidence in understanding the daily nutritional requirements of pregnant women, explaining the recommended range of gestational weight gain, answering nutrition-related questions during pregnancy, discussing healthy food choices, using hand-based portion measures, checking food labels, and assisting pregnant women in making appropriate food substitutions. Three qualitative themes described the students’ learning experiences. Integrating modeling videos with the Objective Structured Clinical Examination may improve nursing–midwifery students’ confidence in nutrition counseling during prenatal medical visits.