Evaluating TESLA-G, a Gamified, Telegram-delivered, Quizzing Platform for Surgical Education in Medical Students

April 4, 2023 updated by: Lorainne Tudor Car, Nanyang Technological University

Evaluating TESLA-G, a Gamified, Telegram-delivered, Quizzing Platform for Surgical Education in Medical Students: a Protocol for a Pilot Randomised Controlled Trial

Telegram Education for Surgical Learning and Application Gamified (TESLA-G) is an online, gamified quizzing platform for surgical education in medical students.The main objective of this pilot study is to assess the feasibility and acceptability of carrying out a full randomised control trial involving TESLA-G.

A pilot randomised controlled trial involving 50 undergraduate medical students will be conducted. They will be randomised into an intervention group and an active control group.

Feasibility will be determined by participant enrollment, retention rate, and quiz completion. Acceptability will be measured quantitatively via a post-intervention learner satisfaction survey and qualitatively via semi-structured interviews. Additionally, participants' scores for pre- and post-intervention knowledge tests will be compared.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Online multiple-choice question (MCQ) quizzes are a well-established summative assessment tool in medical education. However, they suffer from high drop-out rates, attributed to waning user motivation over time. Various studies have shown that incorporation of gamified elements into learning can promote engagement and motivation.

In this pilot study, we will assess the feasibility and acceptability of a novel gamified quizzing platform, Telegram Education for Surgical Learning and Application Gamified (TESLA-G), to determine the possibility of a future larger-scale randomised controlled trial.

This study entails a randomised controlled trial with two arms, an intervention group (TESLA-G) and an active control group (conventional quizzing platform). 50 first to fifth year medical students from Lee Kong Chian School of Medicine, Nanyang Technological University will be randomised into the two arms with a 1:1 allocation ratio, stratified by year of study. Participants will use the assigned quizzing platform to attempt questions on a specific topic (endocrine surgery) over a period of two weeks.

At the end of the study period, several outcomes will be assessed. Feasibility will be determined by participant enrollment, retention rate, and quiz completion. Acceptability will be measured quantitatively via a post-intervention learner satisfaction survey and qualitatively via semi-structured interviews. Additionally, participants' scores for pre- and post-intervention knowledge tests will be compared.

Study Type

Interventional

Enrollment (Anticipated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 100 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Currently enrolled in a full-time 5-year undergraduate programme in the medical school that leads to the Bachelor of Medicine and Bachelor of Surgery (MBBS)
  • Willing and able to provide consent for participating in the entire duration of the study including all pre- and post-study assessments

Exclusion Criteria:

  • NIL

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: TESLA-G
Participants will be randomised into the two arms with a 1:1 allocation ratio stratified by year of study. There will be 25 participants in this arm.
Other: Gamified online quizzing platform

TESLA-G is a novel gamified quizzing platform designed based on Bloom's taxonomy of learning domains. Questions will be created in blocks, where each block will test a specific topic within a specialty (endocrine surgery has been selected for this study). Each block has 5 questions, and each question corresponds to each level of Bloom's taxonomy and each level in game.

For this study, we aim to create 56 blocks of 5 questions, totalling 280 questions. All questions will be created by two board-certified general surgeons and one endocrinologist, and validated by the research team.

The aim of the game is for players to get as many points as they can before the timer runs out. Gamification elements include levels, countdown timer, lives, a point multiplier system, leaderboard rankings and a personalised dashboard.

Participants in the intervention group will be provided with a link to access TESLA-G, sent from an automated Telegram bot; this access will be provided for 14 days.
Active Comparator: Control
Participants will be randomised into the two arms with a 1:1 allocation ratio stratified by year of study. There will be 25 participants in this arm.
Other: Conventional quizzing platform

The conventional quizzing platform will be a modified version of TESLA-G with all gamification elements removed. The same set of questions as the gamified version will be used. Upon entering the quiz, a question stem and five choices will be shown. When an option is selected, the right answer along with its explanation will be indicated. The next question will then be sent, and this process repeats until the participant leaves the platform or has answered every question.

Questions will be queued in blocks, with each block corresponding to a particular topic in endocrine surgery. Unlike the gamified version, questions within each block will be randomised, regardless of their level on the Bloom's taxonomy. Participants will also not be informed of the level of Bloom's taxonomy for individual questions. The access link to the platform will be sent to participants from an automated Telegram bot, and this access will last for 14 days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility of intervention
Time Frame: 14 days

The feasibility of the intervention will be evaluated quantitatively. These are the objectives:

  1. Enrollment of 50 participants
  2. Retention of at least 75% of the enrolled participants
  3. Individual quiz completion rate of 80%

Achieving all of these goals will prove that it is feasible to conduct a full-scale randomised controlled trial (RCT), while achieving two out of three goals will indicate that it is probably feasible. Achieving less than two goals will suggest that a full-scale RCT is not feasible with the current procedure.
14 days
Acceptability of intervention
Time Frame: Post-intervention (14 days)
Acceptability of the intervention is measured quantitatively via a post-intervention learner satisfaction survey and qualitatively via semi-structured interviews.
Post-intervention (14 days)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Improvement of surgical knowledge
Time Frame: Pre and post-intervention (14 days)
Scores of pre- and post-intervention quizzes will be compared. The quizzes, which are on endocrine surgery, will be drafted by two board-certified general surgeons and one endocrinologist. All questions will also be validated by the research team. It should be noted however, that the power of study will be inadequate in identifying the comparative effectiveness between the control and intervention groups in terms of improvement of surgical knowledge. Hence the analysis will be primarily conducted to identify any potential adverse effects and increase in the surgical knowledge within each group, and secondarily between groups. This will be done using a confidence interval of 95% using a small effect size of 0.2.
Pre and post-intervention (14 days)
Participant satisfaction
Time Frame: Post-intervention (14 days)
All participants will also complete a post-intervention learner satisfaction survey, in the form of a Likert scale adapted from the System Usability Survey (SUS) (Brooke et al., 1996) and the Student Evaluation of Educational Quality (SEEQ) Questionnaire. The survey will assess if students in the intervention group are more satisfied with their experience than students in the control group.
Post-intervention (14 days)
Retention of surgical knowledge
Time Frame: 14 days after intervention
After another 14 days, participants will sit for a follow-up knowledge test, which once again consists of 20 MCQs on endocrine surgery conducted over 30 minutes. At this point, participants in both control and intervention groups will no longer be able to access the learning platforms. The difficulty level of the follow-up test will be similar to that of the post-intervention test as described earlier. The difference in test scores (post-intervention and follow-up) will indicate participant retention of surgical knowledge.
14 days after intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Nanyang Technological University

Investigators

  • Principal Investigator: Clement, Luck Khng Chia, MBBS, MS, Department of General Surgery, Khoo Teck Puat Hospital, Singapore
  • Principal Investigator: Lorainne Tudor Car, MBBS, PhD, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

May 1, 2023

Primary Completion (Anticipated)

June 30, 2023

Study Completion (Anticipated)

June 30, 2023

Study Registration Dates

First Submitted

August 24, 2022

First Submitted That Met QC Criteria

August 29, 2022

First Posted (Actual)

August 30, 2022

Study Record Updates

Last Update Posted (Actual)

April 5, 2023

Last Update Submitted That Met QC Criteria

April 4, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • SGG20/SN02

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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