Abstract
<title>Abstract</title> <p>Background Cardiotocography (CTG) is the basic method of fetal monitoring during childbirth, which allows for the early recognition of fetal distress and timely obstetrical intervention. But poor performance and varied interpretation of fetal heart rate traces by maternity nurses are a major problem that can jeopardize the safety of mothers and babies. A competency-based education program has been suggested as an appropriate strategy to enhance competence in CTG practice. Aim This research work attempted to assess the impact of the structured education program for CTG on maternity nurses' competence. Methods Quasi-experiment with control was conducted involving 64 maternity nurses who work at the labor and obstetric wards of Al Thagher General Hospital in Saudi Arabia. Nurses were divided into two groups, intervention and control, each consisting of 32 participants. The information was collected through a CTG Performance Observational Checklist and a Fetal Trace Interpretation Assessment Tool. The program for the intervention included theoretical presentations, practical demonstrations, simulations, clinical practice, and discussion of cases over three weeks. Evaluations were conducted before the intervention, right after it, and after three months. Descriptive statistics, independent t-test, Chi-square test, and mixed repeated measures ANOVA were used to analyze data. Results There were significant differences in all CTG competency domains between the intervention group and the control group (p < .001). The overall CTG competency was significantly higher at post-intervention than at the pre-intervention stage (5.43 ± 2.11 vs. 7.81 ± 1.28). The improvement in fetal trace interpretation was also seen (6.34 ± 1.88 vs. 8.72 ± 0.58), along with overall practical CTG performance (4.96 ± 2.65 vs. 6.61 ± 1.62). Mixed repeated measures ANOVA indicated that there were significant time and group interaction effects, particularly for fetal trace interpretation (Partial η² = 0.522). Conclusion Competency-based CTG training enhanced the practical skills and competence in CTG interpretation among maternity nurses, and the effect was maintained for up to 3 months post-training. The incorporation of structured CTG training into continuing professional development programs may enhance intrapartum care practices.</p>