This prospective randomized study aims to compare the impact of three Case-Based Learning (CBL) approaches on knowledge acquisition, knowledge retention, and clinical reasoning development among third-year medical students during their obstetrics and gynecology rotation.

Participants are randomly assigned to one of three groups: CBL without concept mapping, CBL with a teacher-constructed concept map, or CBL with a concept map co-constructed by students during the learning session. Knowledge acquisition and retention are assessed using pre-tests, immediate post-tests, and delayed post-tests. Clinical reasoning and knowledge organization are evaluated using a synthesis exercise.

The study seeks to determine whether concept mapping and the modality of its integration into CBL enhance learning outcomes and clinical reasoning skills in undergraduate medical education.

Case-Based Learning (CBL) is a learner-centered educational approach that promotes active learning and clinical reasoning through the discussion of authentic clinical cases. Concept maps are educational tools that help learners organize, integrate, and connect knowledge.

This prospective randomized study was conducted among third-year medical students during their obstetrics and gynecology rotation at the Maternity and Neonatology Center of Tunis. Eligible students who had reviewed the official preeclampsia learning module were randomly allocated to one of three educational interventions:

1. Case-Based Learning without concept mapping.
2. Case-Based Learning with a concept map designed by the instructor and presented at the end of the session.
3. Case-Based Learning with a concept map progressively developed by students under instructor supervision.

All groups were exposed to the same clinical case, learning objectives, instructor, and teaching duration. Learning outcomes were assessed using a pre-test, an immediate post-test, a delayed post-test administered two weeks later, and a synthesis exercise evaluating knowledge organization and clinical reasoning.

The primary outcome is the effect of concept mapping and its integration modality on clinical reasoning and knowledge organization, assessed through the synthesis exercise score. Secondary outcomes include knowledge acquisition and knowledge retention assessed through test scores and score variations over time.

The findings of this study may contribute to identifying effective educational strategies for improving learning and clinical reasoning in undergraduate medical education.

Inclusion Criteria:

• Third-year medical students enrolled in the Obstetrics and Gynecology rotation.
• Completion of the preeclampsia learning module before the educational session.
• Provision of informed consent.

Exclusion Criteria:

• Refusal to participate.
• Failure to complete the pre-test, post-test, synthesis assessment, or delayed -post-test.
• Absence from the educational session.
• Incomplete study data.