BACKGROUND:
Strengthening decision-making in labor care is a critical component of midwifery education. Simulation-based learning, particularly through virtual reality (VR), offers a safe and immersive environment to enhance students' clinical reasoning for decision-making regarding physiological birth practices.

OBJECTIVES:
To describe the development and expert validation of a VR scenario for clinical simulation designed to teach decision-making in maternal positioning to promote fetal descent during the first stage of labor.

METHODS:
The scenario was developed in alignment with the Healthcare Simulation Standards of Best Practice™ (INACSL, 2021), focusing on the Simulation Design standard. The process included five steps: (1) defining learning objectives focused on decision-making for labor progression; (2) constructing a clinical case involving fetal non-engagement; (3) designing decision pathways based on biomechanical principles; (4) structuring simulation phases (briefing, self-training, facilitated training, debriefing); and (5) expert validation. An international panel of experts in midwifery, simulation, and educational technology reviewed the scenario for accuracy, pedagogical coherence, and usability. The final version was integrated into the PROGRESSION VR app and tested using Meta Quest 3 headsets.

RESULTS:
The case “Anna” presents a multiparous woman in early labor with fetal occiput posterior and no engagement. Students must analyze the scenario and select one of three appropriate biomechanical positions to support fetal descent and engagement. Each decision pathway provides immediate visual and auditory feedback on pelvic dynamics and fetal movement. Experts confirmed the scenario’s relevance to midwifery decision-making competencies, educational quality, and user acceptability. The immersive design supported both self-directed learning and structured facilitation.

CONCLUSIONS:
This VR-based scenario offers an innovative, standards-based strategy to train decision-making in labor care. Next steps include evaluating feasibility and acceptability with midwifery students and educators.

KEY MESSAGE:
Immersive VR scenarios can strengthen midwifery education by enabling safe, autonomous development of decision-making in physiological labor care. Poster session 3 (Group B)