Intervention Model: Parallel Assignment

Model Description: Cluster-randomized by preceptor (30 clusters; 15 OMP/15 control). Outcomes at student level; 15 students per cluster.

Adequate OMP exposure is defined a priori as ≥2 structured OMP feedback encounters (≥5 minutes each) delivered across ≥2 separate weeks of the rotation.

Masking: Outcomes Assessor

Inclusion Criteria:

• A. Student participants (outcome level):

Aged ≥18 years at enrollment.

Enrolled Year 4-medical students assigned to one of the participating preceptor-led bedside teaching groups during the study period.

Expected to attend the rotation for 8-12 weeks (or the site's standard rotation length).

Able to provide informed consent (and agree to be observed/assessed via mini-CEX).

- B. Preceptor clusters (randomized units):

Resident physicians serving as bedside teaching preceptors in participating departments.

Will supervise approximately 15 students during the study period.

Agree not to cross over to teach students in the opposite trial arm during the trial period.

Able to attend OMP training and permit fidelity observation (checklist) if allocated to the intervention.

Exclusion Criteria:

• A. Student participants:

Prior exposure to formal OMP-based teaching within the past 6 months in the same department.

Not expected to remain on the rotation long enough to be assessed (e.g., planned absence >2 weeks or early withdrawal).

Declines or withdraws informed consent.

Severe communication barrier that precludes valid assessment (e.g., language barrier without support).

- B. Preceptor clusters:

Formal OMP training within the past 12 months (to avoid contamination), or role as an OMP trainer for other faculty during the study period.

Planned cross-coverage that would result in teaching students from both arms during the trial period.

Anticipated extended leave making fidelity and outcome assessments infeasible.