<![CDATA[Postpartum breast and external genitalia assessments are essential for early detection of complications. However, they are difficult to practice on real patients, and high-fidelity obstetric simulators are often too costly. This study aims to develop a low-cost “SMART” simulator and to evaluate its effectiveness on the clinical competence of midwifery students in performing postpartum physical examinations. This study utilized a Research and Development (R&D) design integrated with a quasi-experimental approach. The research was conducted in four phases: (1) needs assessment and conceptual design; (2) prototype development using locally available silicone, ballistics gel, and 3D-printed frameworks; (3) face and content validation by clinical experts; and (4) an educational evaluation using a quasi-experimental design. A total of 120 midwifery students were divided equally into an intervention group (n=60) and a control group (n=60). Baseline characteristics were homogeneous between the groups. Overall competence in postpartum physical examination was achieved by 65.0% of the intervention group and 60.0% of the control group (p=0.044; OR=0.441; 95% CI: 0.211–0.919). The intervention group performed better in hand hygiene (48.3% vs 33.3%) and communicating results to the patient (90.0% vs 73.3%). Student characteristics, lecturer support, and practicum credit compliance were not significantly associated with competence. The SMART simulator is a valid, low-cost training tool that effectively supports and enhances postpartum assessment competence in midwifery education. Larger multi-site studies are recommended to confirm these findings.]]>
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