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This randomized controlled trial evaluates whether a digital, video-based clinical-reasoning simulation improves clinical-reasoning performance compared with conventional lecture-based teaching across multiple clinical disciplines, including orthopedics and ophthalmology.
Within each discipline, participants are randomly allocated 1:1 to an intervention group or a control group. The intervention group learns the assigned topic through an interactive, web-based simulation built on real patient video cases with structured clinical-reasoning steps. The control group receives the same learning objectives and content through a standard didactic lecture, over a comparable duration.
After the learning session, all participants complete the same set of standardized clinical scenarios, scored with a predefined rubric. The primary outcome is the post-intervention clinical-reasoning score. Secondary outcomes include diagnostic accuracy, confidence, and satisfaction.
The trial uses a shared protocol across discipline-specific cohorts to allow consistent, pre-specified comparison of simulation-based versus lecture-based instruction.
Background. Clinical reasoning is a core competency across medical disciplines, yet traditional lectures offer limited interactive practice. A digital simulation using authentic patient cases may strengthen reasoning, but comparative evidence is limited.
Objective. To compare a digital, video-based clinical-reasoning simulation with conventional lecture-based teaching on clinical-reasoning performance, using a single shared design applied across discipline-specific cohorts (e.g., orthopedics, ophthalmology, paediatrics).
Design. Single-center, parallel-group, two-arm randomized controlled trial with 1:1 allocation, replicated as pre-specified cohorts by clinical discipline under one common protocol.
Participants. Eligible learners (medical students / residents) within each discipline-specific cohort at primarily Altinbas University.
Randomization. Computer-generated 1:1 randomization performed separately within each cohort; outcome assessors blinded to allocation.
Interventions. Intervention - interactive, web-based clinical-reasoning simulation using real patient video cases with structured reasoning steps. Control - didactic lecture delivering identical learning objectives and content over a comparable duration.
Outcomes. Primary - post-intervention clinical-reasoning score on standardized scenarios rated with a predefined rubric. Secondary - diagnostic accuracy, participant confidence, satisfaction.
Cohorts & analysis. Each discipline-specific cohort is analyzed separately with an independent-samples t-test; inter-rater reliability assessed where applicable. Total target enrollment (n=250) across all cohorts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Simulation | Experimental | Interactive, web-based clinical-reasoning simulation built on real patient video cases. Learners actively work through structured decision points (history, examination, differential diagnosis, investigation, management) and receive immediate feedback. |
|
| Lecture | Active Comparator | Instructor-led didactic lecture delivering identical learning objectives through expert explanation and slides. Learners receive content passively, without interactive decision steps or video-based case progression. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Behavioral | Other | Interactive, web-based clinical-reasoning simulation built on real patient video cases. Learners actively work through structured decision points (history, examination, differential diagnosis, investigation, management) and receive immediate feedback. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical-reasoning performance score | Performance on a set of standardized clinical scenarios completed after the learning session, rated with a predefined scoring rubric. Higher scores indicate better clinical-reasoning performance. Assessed separately within each discipline-specific cohort. Scored using the five-domain Clinical Reasoning Score System; total range 0-100, with higher scores indicating better clinical-reasoning performance. | Immediately after the learning session (same day) |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic accuracy | Proportion of standardized scenarios in which the participant reached the correct diagnosis, scored against a predefined answer key. Reported as the percentage of scenarios with a correct diagnosis (0-100%); higher values indicate better performance. | Immediately after the learning session (same day) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Omer Tontus, MD | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Altinbas University MP Hospital | Istanbul | Turkey (Türkiye) |
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|
| Lecture | Behavioral | Instructor-led didactic lecture delivering identical learning objectives through expert explanation and slides. Learners receive content passively, without interactive decision steps or video-based case progression. |
|
| Participant confidence |
Self-reported confidence in clinical decision-making, measured on a structured rating scale after the session. Measured on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater confidence. |
| Immediately after the learning session (same day) |
| Participant satisfaction | Self-reported satisfaction with the learning method, measured on a structured rating scale after the session. Measured on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater satisfaction. | Immediately after the learning session (same day) |