This study was conducted to determine the structural empowerment of midwifery students after simulation-based training in the management of obstetric emergencies. As the results showed, the mean structural reinforcement score was significantly higher in the intervention group immediately after the intervention and one year after the intervention than before the intervention. Prior to the intervention, both groups were at an average level of empowerment. However, the intervention was able to raise the empowerment of participants in the intervention group to a high level, indicating the success of the intervention. No significant difference was observed in the level of feeling that they were structurally strengthened during the study in the control group. A review of the relevant literature showed that simulation led to positive results in different target groups. Carolan-Olah et al. conducted a qualitative assessment of midwifery students after participating in the newborn resuscitation simulation. According to the results, these students improved their knowledge, confidence, and skills to manage this emergency, and they unanimously believed that active participation in longer simulation sessions would strengthen their knowledge and self-confidence [18]. Kato and Kataoka showed that simulation-assisted postpartum hemorrhage management training improves midwives' knowledge and performance with a clinical trial of 2 or 3 years [19]. Participating in three simulation scenarios for managing shoulder dystocia, breech delivery, and postpartum hemorrhage has enhanced the skills and abilities of a multidisciplinary group of healthcare professionals, resulting in very satisfying experiences for them [20]. Opportunity is a fundamental construct in achieving empowerment. Therefore, providing the opportunity to acquire knowledge and clinical work skills and gain clinical experience is one of the factors that facilitates the acquisition of competency to manage midwifery emergencies. However, according to midwives, the increase in students from different disciplines in clinical settings leads to competition between midwifery students and other students in obtaining learning opportunities. Furthermore, the differences in clinical settings in providing learning and experience opportunities, and the different approaches to birth management in these settings , raise concerns about reduced learning opportunities for midwifery students, especially non-midwifery students. common conditions [21]. According to Changuiti et al., simulation provided the opportunity for midwifery students to learn from simple to complex clinical situations in a safe and semi-real environment [22]. Yucel et al. He stated that simulation as an educational tool improves the application of technical skills in educational and clinical settings. In addition, simulation led to better implementation of techniques and maneuvers for shoulder dystocia and postpartum hemorrhage at shorter times, and ultimately improved neonatal outcomes [23]. For students, gaining practical experience, gaining self-confidence, having equal learning opportunities for all, having enough time, possibility of trial and error, and bridging theory and practice are vantages of simulation-based education programs in the field. midwifery [24]. The simulation also allows students to interact with classmates, peers and professors. In these calm environments, they learn communication and teamwork skills so that they can make good use of their previous experiences in turbulent emergencies. Simulation, which provides the opportunity to focus on communication skills and practice delegated responsibilities in stressful situations, leads to the evolution of professional roles for individuals [25]. Therefore, in our study, it is seen that simulation contributes to the structural empowerment of individuals by providing opportunities for personal and professional development in the field of midwifery emergency management. Also, opportunities were facilitated to gain awareness of important issues in midwifery emergency management, to have enough time to learn midwifery emergency management, to share experience and skills with classmates and professors in current interactions between individuals, to gain knowledge and resources, and finally to achieve structural reinforcement. with simulation. Active participation of students in simulation sessions and facing related challenges, receiving feedback, helpful reminders and encouragement by the instructor, at the end of the sessions, analyzing and filming the performance of individuals in the simulated situation by the students themselves and by the professor, the support of their classmates, sharing the effort and learning alongside them, In our study, there were other facilitating factors that provided structural reinforcement. Since the basis of gaining informal power is interaction with peers, and obtaining formal power is gaining personal and professional power, the application of the simulation program in our study also provided the opportunity to interact and gain achievements with the instructors and classmates. their ability to communicate with others formed the basis of informal power. In this environment, the students experienced the support of the instructors and their classmates, and the opportunity to gain formal power by gaining proficiency in the midwifery job was also provided. Accordingly, strengthening formal and informal power, along with access to resources, support and information, provided the context for improving the structural empowerment of intervention group subjects. According to the results of our study in the intervention group, the average of the students' structural reinforcement scores one year after the intervention was significantly lower than the one right after the intervention. One year after the intervention, the mean structural reinforcement score of the intervention group was higher than that of the control group, but the difference was not statistically significant. In this context, simulation courses in the field of shoulder dystocia management and single l breech delivery were organized for obstetricians and midwives in Hong Kong. The results showed that although the participants' knowledge and skills increased immediately after the simulation and one year later, their knowledge and skills decreased over time. In these studies, participants' knowledge and skills in managing the clinical situation decreased one year after simulation, which our study's results were consistent with these results [26, 27]. Therefore, repetition of training courses based on simulation of midwifery emergency management can stimulate the empowerment of students. limitations This study may not have enough power to detect differences in structural reinforcement at one year, as our participants were a suitable sample for two consecutive years.