Knowledge of Midwifery Instruments Following Use of the Informasi Instrumen Kebidanan Digital Book: A Quasi Experimental Study

Background: A digital book may support learning instrument names and functions, but knowledge scores do not establish practical competence. Objective: To compare immediate posttest instrument knowledge between INSTADAN and lecturer PowerPoint groups after baseline adjustment. Methods: This nonrandomized study analyzed 161 first year midwifery students from four intact classes (INSTADAN, n=78; control, n=83). A 30 item knowledge test was administered before and after teaching. Individual level ANCOVA adjusted for pretest score, age, and information sources with HC3 standard errors. Results: Mean scores rose from 68.72 to 85.04 with INSTADAN and from 68.84 to 79.88 with PowerPoint. The adjusted difference was 6.08 points (95% CI, 3.99 to 8.17; P<0.001), equivalent to approximately 1.82 correct answers. Student stratified bootstrap gave a 95% interval of 4.05 to 8.14 points. Neither method adjusted for class dependence. Conclusion: INSTADAN was associated with higher immediate knowledge scores; four class allocation, baseline imbalance, and incomplete assessment documentation limit causal interpretation. Retention and practical competence were not examined.