Effects of Blended Learning with Antenatal Education Practice on Nursing Students’ Communication Competence: A Mediation Model of Self-Management

Abstract Background Blended learning is widely used in nursing education, yet its effect on students’ competence in health science communication remains underexplored. This study investigated the impact of integrating antenatal education class practice—a form of community-based maternal health education— practice into blended learning and examined the mediating role of self-management ability. Methods A randomized controlled trial was conducted with 163 third-year undergraduate nursing students assigned to either an intervention group (blended learning plus antenatal education sessions practice, n = 87) or a control group (blended learning only, n = 76). Pre- and post-intervention surveys assessed health science communication competence, self-management ability, and attitudes toward communication skills. Final examination scores measured academic performance. Mediation analysis was performed using the bootstrap method with 5000 resamples. Results Post-intervention, the intervention group scored significantly higher than the control group in health science communication competence (Z = 9.875, P < 0.001), self-management ability (Z = 4.245, P < 0.001), and communication skill attitudes (Z = 5.493, P < 0.001). Their final exam scores were also significantly higher (Z = 9.875, P < 0.001). Mediation analysis confirmed a partial mediating effect of self-management ability on the relationship between the intervention and communication competence (indirect effect = 1.8233, 95% CI: 0.6352–3.2506). Conclusions Integrating antenatal education sessions practice into blended learning significantly enhances nursing students’ communication competence, academic performance, and self-management. This approach offers an innovative model for bridging theoretical instruction and real-world health education practice. Clinical trial number Not applicable.