Gamified Neurology Grand Rounds

NCT07419984 | Active Not Recruiting DMC

• 1 other identifier: WestChinaH-HX-2025-013
• Study Type: interventional
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this research study is to learn if a new, game-based way of teaching neurology grand rounds (called "gamified teaching") works better than the traditional lecture-based format for neurology residents. It will also test whether using wristbands that measure stress and attention can help teachers adjust their pace in real time, and whether earning digital achievement badges motivates residents to keep learning. The main questions it aims to answer are: Does gamified teaching help residents remember key information longer (up to 3 months) compared to traditional teaching? Does it improve how efficiently residents make clinical decisions (for example, ordering the right tests without unnecessary extras)? Do teachers who receive real-time feedback from the wristbands deliver sessions that feel less tiring and more engaging to residents? Do residents find the digital badges useful, and do they encourage more self-study? Researchers will compare the gamified teaching method to the traditional lecture method. Each resident will experience both formats at different times (a "crossover" design). An additional small group will only receive the traditional format to help rule out other factors. Participants will: Take part in eight neurology grand rounds sessions over two 4-week periods (four sessions per period) Wear a research wristband during each session to measure their physiological responses (skin activity and heart rate) Complete short quizzes right after each session and again three months later Fill out brief questionnaires about their learning experience and motivation Use a custom interactive platform during the gamified sessions to work in teams, make clinical decisions, and earn digital badges All information collected will be kept confidential, and participants may leave the study at any time without any impact on their residency evaluations.

Conditions

Education, Medical; Grand Rounds

Keywords

gamification; cognitive load; wearable sensors; clinical reasoning; randomized crossover trial

Outcome Measures

Primary Outcomes (2)

• Immediate Knowledge Acquisition (Post-Session Test Score)

  Standardized 15-item multiple-choice quiz assessing comprehension of case localization, etiology, differential diagnosis, and management. Each item has one correct answer. Score is percentage correct (0-100%). Tests are administered immediately following each grand rounds session. Internal consistency confirmed via pilot testing (Cronbach's α ≥ 0.7).

  Within 30 minutes after each grand rounds session (8 total sessions per participant; measured across both study periods, Weeks 1-2 and Weeks 7-8)

• 3-Month Knowledge Retention (Delayed Retention Test Score and Retention Rate)

  Parallel-form 15-item multiple-choice test matching the immediate post-test in blueprint, difficulty, and internal consistency, but with different question wording and distractor options. Retention rate is calculated as (3-month test score / average immediate post-test score across both periods) × 100%. Higher scores indicate better long-term retention.

  3 months (± 2 weeks) after completion of Period 2 intervention (Week 8)

Secondary Outcomes (8)

• Diagnostic Redundancy Ratio

  During each grand rounds session (8 total sessions; Weeks 1-2 and Weeks 7-8)

• Time to Key Information Extraction

  During each grand rounds session (8 total sessions; Weeks 1-2 and Weeks 7-8)

• Learner Engagement - Interaction Frequency

  During each grand rounds session (8 total sessions; Weeks 1-2 and Weeks 7-8)

• Flow Experience

  Within 10 minutes after each grand rounds session (8 total sessions; Weeks 1-2 and Weeks 7-8)

• Subjective Cognitive Load

  Within 10 minutes after each grand rounds session (8 total sessions; Weeks 1-2 and Weeks 7-8)

Study Arms (3)

Sequence A: Gamified First, Then Traditional

EXPERIMENTAL

Participants in this arm receive gamified neurology grand rounds during Period 1 (Weeks 1-2, four sessions), followed by a 4-week washout period with no neurology grand rounds, then receive traditional lecture-based neurology grand rounds during Period 2 (Weeks 7-8, four sessions). Gamified sessions use a custom web-based platform featuring team-based clinical simulations, real-time decision feedback, points, leaderboards, and blockchain-minted NFT achievement badges. Traditional sessions cover identical case content via instructor-led PowerPoint lecture with intermittent Q\&A. All participants wear Empatica E4 wristbands for cognitive load monitoring during all sessions and complete post-session assessments and 3-month follow-up.

Behavioral: Gamified Neurology Grand Rounds

Sequence B - Traditional First, Then Gamified

EXPERIMENTAL

Participants in this arm receive traditional lecture-based neurology grand rounds during Period 1 (Weeks 1-2, four sessions), followed by a 4-week washout period with no neurology grand rounds, then receive gamified neurology grand rounds during Period 2 (Weeks 7-8, four sessions). Gamified sessions use a custom web-based platform featuring team-based clinical simulations, real-time decision feedback, points, leaderboards, and blockchain-minted NFT achievement badges. Traditional sessions cover identical case content via instructor-led PowerPoint lecture with intermittent Q\&A. All participants wear Empatica E4 wristbands for cognitive load monitoring during all sessions and complete post-session assessments and 3-month follow-up.

Behavioral: Gamified Neurology Grand Rounds; Behavioral: Traditional Component

Parallel Control: Traditional Only

ACTIVE COMPARATOR

Participants in this arm receive traditional lecture-based neurology grand rounds during both Period 1 (Weeks 1-2, four sessions) and Period 2 (Weeks 7-8, four sessions), with a 4-week washout period in between. All sessions cover identical case content used in the experimental arms, delivered via instructor-led PowerPoint lecture with intermittent Q\&A. No gamified elements are introduced at any point. This arm controls for time effects (e.g., knowledge gains from residency progression) and testing effects (e.g., familiarity with assessment formats). All participants wear Empatica E4 wristbands for cognitive load monitoring during all sessions and complete post-session assessments and 3-month follow-up.

Behavioral: Traditional Component

Interventions

Gamified Neurology Grand Rounds BEHAVIORAL

A web-based interactive teaching platform using team-based clinical simulation, real-time decision feedback, points, leaderboards, and blockchain-minted NFT achievement badges. Four 55-minute sessions delivered over 2 weeks. Cases cover stroke, epilepsy, movement disorders, neuroinfectious diseases, neurodegenerative disorders, neuro-ophthalmology, headache, and spinal cord disorders. Participants work in teams of 3-4, make sequential diagnostic/treatment decisions, and receive immediate feedback. Instructor delivers 15-minute expert debrief after 40 minutes of simulation.

Sequence A: Gamified First, Then Traditional; Sequence B - Traditional First, Then Gamified

Traditional Component BEHAVIORAL

Instructor-led PowerPoint lecture covering identical case content as gamified sessions. Linear presentation: history → physical exam → localization → etiology → differential diagnosis → management. Intermittent Q\&A encouraged. No game elements, simulation, points, leaderboards, or blockchain incentives. Four 55-minute sessions delivered over 2 weeks.

Parallel Control: Traditional Only; Sequence B - Traditional First, Then Gamified

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Currently enrolled in postgraduate year 1 (PGY1), PGY2, or PGY3 of an accredited neurology residency program
• No prior formal participation in structured gamified neurology teaching programs focused on clinical reasoning
• Able to attend all eight scheduled grand rounds sessions across both study periods and all assessments (baseline, post-session, washout, and 3-month follow-up)
• Willing to provide written informed consent and comply with all study procedures, including wearing the Empatica E4 wristband during teaching sessions

You may not qualify if:

• Scheduled off-service rotations, vacation, or other commitments that would prevent attendance at any study session or assessment
• Uncorrected severe visual or auditory impairment that would limit participation in multimedia-based gamified sessions or case presentations
• History of skin conditions or allergies that would preclude wearing the Empatica E4 wristband (e.g., contact dermatitis)
• Inability to provide informed consent (e.g., cognitive impairment or language barrier)

Sponsors & Collaborators

• West China Hospital: lead

Study Sites (1)

West China Hospital of Sichuan University

Chengdu, Sichuan, China

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: February 12, 2026
• First Posted: February 19, 2026
• Study Start: January 1, 2026
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): August 30, 2026
• Last Updated: February 23, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)