Simulation-Based Learning on Clinical Reasoning, Knowledge Retention, and Transfer in Undergraduate Medical Education (SIMCORE)

June 29, 2026 updated by: Sibel Zorlu Ozturk, Altinbas University

Does Video-Based Patient Simulation Improve Clinical Reasoning Skills in Medical Students?

This randomized controlled trial evaluates whether a digital, video-based clinical-reasoning simulation improves clinical-reasoning performance compared with conventional lecture-based teaching across multiple clinical disciplines, including orthopedics and ophthalmology.

Within each discipline, participants are randomly allocated 1:1 to an intervention group or a control group. The intervention group learns the assigned topic through an interactive, web-based simulation built on real patient video cases with structured clinical-reasoning steps. The control group receives the same learning objectives and content through a standard didactic lecture, over a comparable duration.

After the learning session, all participants complete the same set of standardized clinical scenarios, scored with a predefined rubric. The primary outcome is the post-intervention clinical-reasoning score. Secondary outcomes include diagnostic accuracy, confidence, and satisfaction.

The trial uses a shared protocol across discipline-specific cohorts to allow consistent, pre-specified comparison of simulation-based versus lecture-based instruction.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background. Clinical reasoning is a core competency across medical disciplines, yet traditional lectures offer limited interactive practice. A digital simulation using authentic patient cases may strengthen reasoning, but comparative evidence is limited.

Objective. To compare a digital, video-based clinical-reasoning simulation with conventional lecture-based teaching on clinical-reasoning performance, using a single shared design applied across discipline-specific cohorts (e.g., orthopedics, ophthalmology, paediatrics).

Design. Single-center, parallel-group, two-arm randomized controlled trial with 1:1 allocation, replicated as pre-specified cohorts by clinical discipline under one common protocol.

Participants. Eligible learners (medical students / residents) within each discipline-specific cohort at primarily Altinbas University.

Randomization. Computer-generated 1:1 randomization performed separately within each cohort; outcome assessors blinded to allocation.

Interventions. Intervention - interactive, web-based clinical-reasoning simulation using real patient video cases with structured reasoning steps. Control - didactic lecture delivering identical learning objectives and content over a comparable duration.

Outcomes. Primary - post-intervention clinical-reasoning score on standardized scenarios rated with a predefined rubric. Secondary - diagnostic accuracy, participant confidence, satisfaction.

Cohorts & analysis. Each discipline-specific cohort is analyzed separately with an independent-samples t-test; inter-rater reliability assessed where applicable. Total target enrollment (n=250) across all cohorts.

Study Type

Interventional

Enrollment (Actual)

250

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 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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Enrolled as a [final-year medical student / resident] in the relevant discipline (orthopedics or ophthalmology) at the participating institution
  • Completed the baseline orientation and agreed to participate
  • Available for the full learning session and the post-session assessment

Exclusion Criteria:

  • Prior completion of the same simulation module or equivalent structured training on the topic
  • Did not complete the assigned learning session
  • Incomplete post-session assessment data

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Simulation
Interactive, web-based clinical-reasoning simulation built on real patient video cases. Learners actively work through structured decision points (history, examination, differential diagnosis, investigation, management) and receive immediate feedback.
Other: Behavioral
Interactive, web-based clinical-reasoning simulation built on real patient video cases. Learners actively work through structured decision points (history, examination, differential diagnosis, investigation, management) and receive immediate feedback.
Other Names:
  • Digital video-based clinical-reasoning simulation
Active Comparator: Lecture
Instructor-led didactic lecture delivering identical learning objectives through expert explanation and slides. Learners receive content passively, without interactive decision steps or video-based case progression.
Behavioral: Lecture
Instructor-led didactic lecture delivering identical learning objectives through expert explanation and slides. Learners receive content passively, without interactive decision steps or video-based case progression.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical-reasoning performance score
Time Frame: Immediately after the learning session (same day)
Performance on a set of standardized clinical scenarios completed after the learning session, rated with a predefined scoring rubric. Higher scores indicate better clinical-reasoning performance. Assessed separately within each discipline-specific cohort. Scored using the five-domain Clinical Reasoning Score System; total range 0-100, with higher scores indicating better clinical-reasoning performance.
Immediately after the learning session (same day)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnostic accuracy
Time Frame: Immediately after the learning session (same day)
Proportion of standardized scenarios in which the participant reached the correct diagnosis, scored against a predefined answer key. Reported as the percentage of scenarios with a correct diagnosis (0-100%); higher values indicate better performance.
Immediately after the learning session (same day)
Participant confidence
Time Frame: Immediately after the learning session (same day)
Self-reported confidence in clinical decision-making, measured on a structured rating scale after the session. Measured on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater confidence.
Immediately after the learning session (same day)
Participant satisfaction
Time Frame: Immediately after the learning session (same day)
Self-reported satisfaction with the learning method, measured on a structured rating scale after the session. Measured on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater satisfaction.
Immediately after the learning session (same day)

Collaborators and Investigators

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

Sponsor

Altinbas University

Investigators

  • Study Chair: Omer Tontus, MD

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)

May 20, 2025

Primary Completion (Actual)

June 1, 2026

Study Completion (Actual)

June 1, 2026

Study Registration Dates

First Submitted

June 23, 2026

First Submitted That Met QC Criteria

June 29, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 1, 2026

Last Update Submitted That Met QC Criteria

June 29, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Altinbas

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

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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