Elaboration and Feedback for Clinical Reasoning Training

NCT05585892 | Completed

• 1 other identifier: 17/9/18
• Study Type: interventional
• Target: 143
• Locations: 1 country
• Sites: 1

Brief Summary

Clinical reasoning abilities can be enhanced by repeated formative testing with key feature questions. An analysis of wrong answers to key feature questions facilitates the identification of common misconceptions. This prospective, randomised, cross-over study assessed whether an elaboration task and individualised mailed feedback further improve student performance on clinical reasoning.

Conditions

Medical Education

Keywords

medical education; clinical reasoning; test-enhanced learning

Outcome Measures

Primary Outcomes (1)

• Clinical reasoning performance

  Within-subject difference in percent scores in intervention versus control items in the retention test six months after the last e-seminar

  Nine months after the start of the study

Secondary Outcomes (1)

• Predictors of exam performance

  Three (exit exam) and nine (retention test) months after the start of the study

Study Arms (2)

Intervention items 1-15

OTHER

Students in this arm were exposed to intervention and control items in the 10 weekly e-seminars. Assignment of item types was the exact opposite of that in group B.

Other: Elaboration and individual mailed feedback

Intervention items 16-30

OTHER

Students in this arm were exposed to intervention and control items in the 10 weekly e-seminars. Assignment of item types was the exact opposite of that in group A.

Other: Elaboration and individual mailed feedback

Interventions

Elaboration and individual mailed feedback OTHER

see above

Intervention items 1-15; Intervention items 16-30

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Enrolment to three consecutive undergraduate teaching modules in Year 4 at Goettingen Medical School in winter term 2018/19

You may not qualify if:

• no informed consent

Sponsors & Collaborators

• University Medical Center Goettingen: lead

Study Sites (1)

University Medical Centre Göttingen

Göttingen, D-37075, Germany

Location

Related Publications (16)

• Raupach T, Andresen JC, Meyer K, Strobel L, Koziolek M, Jung W, Brown J, Anders S. Test-enhanced learning of clinical reasoning: a crossover randomised trial. Med Educ. 2016 Jul;50(7):711-20. doi: 10.1111/medu.13069.

  PMID: 27295475 BACKGROUND

• Raupach T, Schuelper N. Reconsidering the role of assessments in undergraduate medical education. Med Educ. 2018 May;52(5):464-466. doi: 10.1111/medu.13543. No abstract available.

  PMID: 29672946 BACKGROUND

• Ludwig S, Schuelper N, Brown J, Anders S, Raupach T. How can we teach medical students to choose wisely? A randomised controlled cross-over study of video- versus text-based case scenarios. BMC Med. 2018 Jul 6;16(1):107. doi: 10.1186/s12916-018-1090-y.

  PMID: 29976211 BACKGROUND

• Wing EA, Marsh EJ, Cabeza R. Neural correlates of retrieval-based memory enhancement: an fMRI study of the testing effect. Neuropsychologia. 2013 Oct;51(12):2360-70. doi: 10.1016/j.neuropsychologia.2013.04.004. Epub 2013 Apr 19.

  PMID: 23607935 BACKGROUND

• Roediger HL 3rd, Karpicke JD. The Power of Testing Memory: Basic Research and Implications for Educational Practice. Perspect Psychol Sci. 2006 Sep;1(3):181-210. doi: 10.1111/j.1745-6916.2006.00012.x.

  PMID: 26151629 BACKGROUND

• Dobson JL, Linderholm T. Self-testing promotes superior retention of anatomy and physiology information. Adv Health Sci Educ Theory Pract. 2015 Mar;20(1):149-61. doi: 10.1007/s10459-014-9514-8. Epub 2014 May 17.

  PMID: 24838598 BACKGROUND

• Kromann CB, Jensen ML, Ringsted C. The effect of testing on skills learning. Med Educ. 2009 Jan;43(1):21-7. doi: 10.1111/j.1365-2923.2008.03245.x.

  PMID: 19140995 BACKGROUND

• Kromann CB, Bohnstedt C, Jensen ML, Ringsted C. The testing effect on skills learning might last 6 months. Adv Health Sci Educ Theory Pract. 2010 Aug;15(3):395-401. doi: 10.1007/s10459-009-9207-x. Epub 2009 Oct 17.

  PMID: 19838814 BACKGROUND

• Logan JM, Thompson AJ, Marshak DW. Testing to enhance retention in human anatomy. Anat Sci Educ. 2011 Sep-Oct;4(5):243-8. doi: 10.1002/ase.250. Epub 2011 Jul 29.

  PMID: 21805688 BACKGROUND

• Baghdady M, Carnahan H, Lam EW, Woods NN. Test-enhanced learning and its effect on comprehension and diagnostic accuracy. Med Educ. 2014 Feb;48(2):181-8. doi: 10.1111/medu.12302.

  PMID: 24528400 BACKGROUND

• Larsen DP, Butler AC, Roediger HL 3rd. Test-enhanced learning in medical education. Med Educ. 2008 Oct;42(10):959-66. doi: 10.1111/j.1365-2923.2008.03124.x.

  PMID: 18823514 BACKGROUND

• Page G, Bordage G, Allen T. Developing key-feature problems and examinations to assess clinical decision-making skills. Acad Med. 1995 Mar;70(3):194-201. doi: 10.1097/00001888-199503000-00009.

  PMID: 7873006 BACKGROUND

• Norman GR, Eva KW. Diagnostic error and clinical reasoning. Med Educ. 2010 Jan;44(1):94-100. doi: 10.1111/j.1365-2923.2009.03507.x.

  PMID: 20078760 BACKGROUND

• Goldmann M, Middeke AC, Schuelper N, Dehl T, Raupach T. [Choosing Wisely in medical education]. Z Evid Fortbild Qual Gesundhwes. 2017 Dec;129:22-26. doi: 10.1016/j.zefq.2017.10.014. Epub 2017 Nov 16. German.

  PMID: 29153352 BACKGROUND

• Watling C, Driessen E, van der Vleuten CP, Lingard L. Learning from clinical work: the roles of learning cues and credibility judgements. Med Educ. 2012 Feb;46(2):192-200. doi: 10.1111/j.1365-2923.2011.04126.x.

  PMID: 22239333 BACKGROUND

• Berens M, Becker T, Anders S, Sam AH, Raupach T. Effects of Elaboration and Instructor Feedback on Retention of Clinical Reasoning Competence Among Undergraduate Medical Students: A Randomized Crossover Trial. JAMA Netw Open. 2022 Dec 1;5(12):e2245491. doi: 10.1001/jamanetworkopen.2022.45491.

  PMID: 36472876 DERIVED

Study Officials

• Tobias Raupach, MD

  University Medical Centre Göttingen

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants could not be masked to the intervention as it was clear to them whether they had received an email (for intervention items) or not (for control items). Investigator and Outcomes Assessor knew that each participant was exposed to both item types but they were masked to the group a student was assigned to.
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: This was an educational study with a cross-over design in which every undergraduate medical student served as their own control as both groups were exposed to control and intervention items in non-graded key feature examinations.

Study Record Dates

• First Submitted: October 11, 2022
• First Posted: October 19, 2022
• Study Start: October 1, 2018
• Primary Completion: June 14, 2019
• Study Completion: June 14, 2019
• Last Updated: October 19, 2022

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will not share

Locations

DE (1)