Leaderboard Influence on Self-Regulated Training in a Gamified Dermoscopy Training App

February 3, 2024 updated by: Sigrid I. P. Kristensen, Herlev Hospital

Do Leaderboards Improve Self-regulated Training in a Gamified Dermoscopy Training App? A Randomized, Controlled Trial.

This study aims to examine the isolated effect of leaderboards (scoreboards) and daily training motivation on dermatology skill acquisition and training engagement within a gamified dermoscopy training platform.

Research Questions:

What is the effect of leaderboards and/or daily motivation on diagnostic accuracy? What is the effect of leaderboards and/or daily motivation on self-regulated learning: time spent training and case amount? What is the effect of leaderboards and/or daily motivation on training distribution?

Method:

150 danish medical students will upon inclusion and end of trial answer a Multiple Choice Questionnaire (MCQ).

Participants will be asked to download the gamified training platform onto their mobile devices. Within the app participants can access quizzes on a library of 10,000+ skin lesions combined with written educational modules on histopathological skin diagnosis. Participants receive instant feedback on quiz answered. Points are awarded for correct answers and removed for incorrect answers.

Participants will be randomized to one of three groups; either receiving no communication from the principal investigator, receiving a daily motivational message, or receiving a once daily updated leaderboard ranking participant's scores.

The intervention will last for seven days, followed by a 14-day washout period.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Subjects will be recruited through advertisements in online forums for medical students across all four Danish medical schools.

Upon recruitment, subjects will be included via an on-boarding online meeting. They will be introduced to the study and the training platform, and will, if they choose to participate, complete a consent form, a questionnaire of baseline information (age, gender, university semester, dermatological experience) and a 12-case validated diagnostic pre-test.

Participants will be randomized to study groups via sequential block randomization.

The intervention will last for seven days. Depending on group randomization, participants will on day two through seven either receive a group daily message using an internet-based messaging service (see appendix) and view a daily updated leaderboard ranking, only receive the group daily message, or receive neither.

Within the app, participants are able to train dermoscopy diagnosis through sessions of 10 cases. If participants correctly diagnose 8/10 cases, they will progress to the next session with new 10 cases of a higher difficulty, and so on. If participants do not reach a certain diagnostic accuracy, they will repeat their current level with 10 new cases until they are able to progress. There are a total of 6 session levels. Each case is assigned a difficulty level from one to four, calculated based on the percentage of times it has been answered correctly by previous users. In each session, participants are presented with 40% cases at their current level, 20% of an easier difficulty, 20% of a higher difficulty, and 20% cases of an unspecified difficulty.

Participants will be awarded 2 points multiplied by case difficulty for each correct answer. 2 points, multiplied by case difficulty, will be taken away if participants assign a benign diagnosis to a malignant case, and 1 point, multiplied by case difficulty, if a malignant diagnosis is assigned to a benign case. Participants will receive 0 points if a case is correctly classified as benign or malignant, but the precise histological diagnosis is incorrectly guessed (For example guessing melanoma on a basal cell carcinoma case, or nevus on a case of dermatofibroma). Participants will be able to view points earned following each training session, as well as a cumulative total.

After the seven-day interventional period, participants will start a 14-day washout period, in which participants can train freely, but no group will receive either daily messages or have access to the leaderboard. After the washout period, participants will be asked to complete a validated 12-case retention test, supervised by a member of the research group in a virtual meeting.

As this project is an educational study comprising medical students, it does not fulfill the criteria described in the Danish Scientific Ethical Committees Act § 2, and does not require approval by the The Regional Ethical Committee of the Copenhagen Capital Region of Denmark. A waiver has been obtained by The Regional Ethical Committee of the Copenhagen Capital Region of Denmark (case nr. F-23075872) The research group considers this project ethically responsible.

Study Type

Interventional

Enrollment (Estimated)

150

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 Locations

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Medical student at a Danish university

Exclusion Criteria:

  • Have not completed a university-level course on histology
  • Have completed or are currently enrolled in a clinical university course in dermatology
  • Prior experience with the app Dermloop Learn or equivalent experience via. courses or by using other training platforms for skin diagnosis.

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: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Motivational messages and leaderboard
This group will receive daily reminders/motivational messages. They will be able to view their personal score and will be ranked on a daily updated leaderboard.
Other: Daily updated ranking on leaderboard

The intervention will last for seven days. Participants will on day two through seven receive a group daily message using an internet-based messaging service and view a daily updated leaderboard ranking.

Leaderboards will demonstrate participant's ranking in their respective group, participant's (anonymized) name, cumulative point total, total case amount, and current level. Participant ranking will be based on the cumulative point total. All groups will have continual access to their personal score.

Participants will not receive further training encouragement to train in the app or interact with the research group beyond this, aside from technological aid.
Experimental: Only motivational messages
This group will receive daily reminders/motivational messages. They will be able to view their personal score, but they will not be ranked on a leaderboard.
Other: Daily motivational message

The intervention will last for seven days. Participants will on day two through seven receive a group daily message using an internet-based messaging service encouraging training.

Participants will not receive further training encouragement to train in the app or interact with the research group beyond this, aside from technological aid.
No Intervention: Control
This group will be able to view their personal score, but will not be ranked on a leaderboard or receive daily reminders/motivational messages.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time spent training
Time Frame: Three weeks
The participant's time spent with the platform, measured by the platform
Three weeks
Amount of cases
Time Frame: Three weeks
The number of cases participants assign a diagnosis to, measured by the platform
Three weeks
Change in diagnostic accuracy
Time Frame: Three weeks
Measured as a percentage of correctly diagnoses skin lesions in validated multiple choice questionnaire
Three weeks

Collaborators and Investigators

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

Sponsor

Herlev Hospital

Investigators

  • Study Director: Martin Frendø, MD, PhD, Copenhagen Academy for Medical Education and Simulation

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 (Actual)

January 27, 2024

Primary Completion (Estimated)

February 25, 2024

Study Completion (Estimated)

March 3, 2024

Study Registration Dates

First Submitted

January 26, 2024

First Submitted That Met QC Criteria

February 3, 2024

First Posted (Actual)

February 12, 2024

Study Record Updates

Last Update Posted (Actual)

February 12, 2024

Last Update Submitted That Met QC Criteria

February 3, 2024

Last Verified

February 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DL_Leaderboard_MS_01

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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