Clinical reasoning development using case-based direct illness scripts teaching on an online gamified learning platform

Abstract Background The effectiveness of illness scripts in teaching clinical reasoning and the use of case-based illness script worksheets to enhance diagnostic skills in pre-clinical medical students have been previously established. Additionally, online gamified learning has proven effective in increasing student motivation and engagement. This study aimed to determine the effectiveness and satisfaction of case-based direct illness script teaching through an online gamified learning platform among pre-clinical students. Methods A randomized controlled study was conducted among 184 second-year medical students at a university hospital. Over a six-week rotation, participants were randomized into traditional lectures and clinical reasoning group. All students were assigned a pre-test on the first day of the rotation, followed by an initial four weeks of traditional lectures. The control group was assessed post-test at the end of the fourth week. The intervention group received an additional clinical correlation lesson in the fifth week using an online gamified learning platform followed by a post-test. Satisfaction was assessed using a five-point Likert scale. The characteristics of students in the two groups were compared. Wilcoxon’s rank sum test was used to compare pre- and post-test scores and score differences between the groups. Results Of the 184 students, there were no differences in sex, age, or grade point average between the groups. The scores of 174 students (86 and 88 in the control and intervention groups, respectively) indicated low baseline knowledge in all domains. The clinical reasoning group had higher total scores than the control group (16.0 vs. 6.0, p < .001). The satisfaction of 132 students were “strongly agree” and “agree” with the process of online clinical correlation education (Mean, 4.90; SD, 0.34). Conclusions Using case-based direct illness script teaching with a gamified learning platform in pre-clinical education improves knowledge through clinical reasoning skills with high satisfaction.