AI-Assisted Adaptive Simulation in Physiology Education (PBL)
20. mai 2026 oppdatert av: Jeevarathinam Thirumalai, Saveetha University
Effect of Adaptive AI-Supported Simulation on Physiology Learning Outcomes Among Medical Students: A Randomized Controlled Trial
This randomized controlled trial evaluated whether an AI-assisted, rule-based adaptive screen-based simulation module could improve physiology learning outcomes among undergraduate health science students compared with conventional instruction.
A total of 672 students from Physiotherapy, Occupational Therapy, Nursing, and Allied Health Sciences were randomly assigned in a 1:1 ratio to either the adaptive simulation group or the conventional teaching group.
The intervention used web-based clinical physiology cases with algorithm-supported case sequencing, automated formative feedback, and structured faculty-led debriefing, while the control group received standard lectures, textbook reading, tutorial sessions, and laboratory practicals.
The primary outcomes were physiological knowledge and reasoning ability, and the secondary outcomes were conceptual understanding, engagement, cognitive load, and academic self-efficacy.
Assessments were performed at baseline, immediately after the 12-week intervention, and again at four-week follow-up.
Studieoversikt
Status
Fullført
Forhold
Detaljert beskrivelse
This study was designed as a prospective, two-arm, parallel-group randomized controlled trial with repeated-measures assessment at three time points: baseline, immediately post-intervention, and four weeks after the intervention. It was conducted at Saveetha Institute of Basic Medical Sciences, India, between August 2025 and January 2026, and received institutional ethical approval before enrollment. Participants were undergraduate health science students aged 18 to 25 years who were enrolled in a Human Physiology course and had access to an internet-enabled personal device. Students with prior formal exposure to simulation-based physiology instruction or adaptive digital learning platforms were excluded. After baseline assessment, participants were randomized in a 1:1 ratio to the intervention or control group, with allocation concealment and blinded outcome assessment.
The intervention group received physiology instruction through a screen-based adaptive simulation environment over 12 weeks. The module was intentionally designed as a bundled educational strategy integrating adaptive case sequencing, automated formative feedback, and faculty-led debriefing. The adaptive component used predefined rule-based logic to personalize learning by adjusting case difficulty and feedback pathways according to learner performance; it did not use autonomous generative artificial intelligence or clinical decision-making. Participants completed structured simulation sessions for two hours per week, including pre-briefing, individual case-based simulation, and facilitated debriefing. The control group received conventional curriculum-based physiology instruction over the same 12-week period, including didactic lectures, prescribed textbook readings, tutorial sessions, and laboratory practicals.
The study prioritized objective learning outcomes. Physiological knowledge was measured using a 40-item multiple-choice test, physiological reasoning ability using a scenario-based rubric-scored assessment, and conceptual understanding using a physiology concept inventory. Secondary outcomes included student engagement measured with the USEI, cognitive load measured with NASA-TLX, and academic self-efficacy measured with an adapted CASES scale. Outcomes were collected at baseline, post-intervention, and follow-up using the same instruments across all time points.
Studietype
Intervensjonell
Registrering (Faktiske)
672
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Tamil Nadu
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Chennai, Tamil Nadu, India, 602105
- Saveetha Institute of Basic Medical Sciences (SIBMS), Saveetha Institute of Medical and Technical Sciences (SIMATS)
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
Tar imot friske frivillige
Ja
Beskrivelse
Inclusion Criteria:
- Undergraduate students enrolled in Health Science programs including Physiotherapy, Occupational Therapy, Nursing, and Allied Health Sciences
- Registered for a Human Physiology course during the study period
- Age between 18 and 25 years
- Proficiency in English language
- Access to an internet-enabled personal device capable of supporting web-based educational applications
- Willingness to provide written informed consent for participation
Exclusion Criteria:
- Prior formal exposure to structured simulation-based physiology instruction
- Prior exposure to adaptive digital learning platforms related to physiology education
- Inability to access or use internet-enabled educational applications required for the intervention
- Declined or withdrew informed consent for participation
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Grunnvitenskap
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Eksperimentell: I-Assisted Adaptive Simulation Group
Participants received AI-assisted algorithm-supported adaptive screen-based physiology simulation over a 12-week period.
The intervention included adaptive case sequencing, automated formative feedback, interactive clinical reasoning activities, animated physiological visualization, and structured faculty-led debriefing sessions aligned with physiology curriculum objectives.
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The intervention consisted of an AI-assisted algorithm-supported adaptive screen-based physiology simulation delivered over 12 weeks.
Participants engaged in structured web-based simulation sessions involving interactive clinical case scenarios, animated physiological visualizations, adaptive case sequencing, automated formative feedback, and faculty-led debriefing.
The adaptive instructional system operated through predefined rule-based educational algorithms that adjusted case difficulty, feedback pathways, and learning progression according to participant performance within faculty-defined parameters.
Sessions included pre-briefing, individual simulation-based clinical reasoning activities, adaptive feedback, and reflective debriefing.
The intervention was implemented in alignment with the INACSL Healthcare Simulation Standards of Best Practice and focused on improving physiological knowledge, conceptual understanding, and clinical reasoning skills.
Andre navn:
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Aktiv komparator: Conventional Instruction Group
Participants received standard curriculum-based physiology instruction over a 12-week period, including didactic lectures, prescribed textbook readings, faculty-guided tutorial sessions, and scheduled laboratory practicals covering core physiological systems.
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Participants received standard curriculum-based physiology instruction over a 12-week period according to institutional teaching guidelines.
Conventional instruction included didactic lectures, prescribed textbook readings, faculty-guided tutorial sessions, and scheduled laboratory practicals covering cardiovascular, respiratory, renal, neurological, endocrine, gastrointestinal, musculoskeletal, and integumentary physiology.
Tutorial sessions focused on instructor-led clarification of physiological concepts, small-group discussion, and question-and-answer interactions.
Laboratory practicals included supervised physiological measurements, observation of physiological demonstrations, interpretation of experimental findings, and guided analysis of physiological responses.
The control condition did not include adaptive simulation, automated formative feedback, algorithm-supported instructional adaptation, or structured simulation-based clinical reasoning activities.
Andre navn:
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Physiological Reasoning Ability
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Physiological reasoning ability was assessed using a scenario-based assessment requiring hypothesis generation, interpretation of physiological data, and application of physiological mechanisms to management decisions.
Responses were scored using a standardized four-point analytic rubric assessing reasoning and clinical interpretation skills.
Higher scores indicate better physiological reasoning ability.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Physiological Knowledge
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Physiological knowledge was assessed using a faculty-developed 40-item multiple-choice assessment designed to evaluate conceptual understanding and applied physiological reasoning across eight core physiological systems, including cardiovascular, respiratory, renal, neurological, endocrine, gastrointestinal, musculoskeletal, and integumentary physiology.
Higher scores indicate better physiology knowledge performance.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Conceptual Understanding
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Conceptual understanding was assessed using a faculty-developed Physiology Concept Inventory designed to evaluate deep conceptual understanding, integration of physiological mechanisms across systems, and identification of common physiological misconceptions.
Higher scores indicate better conceptual understanding of physiology concepts.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Student Engagement
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Student engagement was assessed using the University Student Engagement Inventory (USEI), which evaluates behavioral, emotional, and cognitive dimensions of learner engagement.
Higher scores indicate greater learner engagement during physiology learning activities.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Cognitive Load
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Cognitive load was assessed using the NASA Task Load Index (NASA-TLX), a multidimensional measure evaluating perceived cognitive workload and task demand during learning activities.
Higher scores indicate greater perceived cognitive workload.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Academic Self-Efficacy
Tidsramme: Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Academic self-efficacy was measured using an adapted version of the College Academic Self-Efficacy Scale (CASES) to evaluate learner confidence in physiology-related academic tasks and simulation-based learning activities.
Higher scores indicate greater academic self-efficacy.
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Baseline (Week 1), post-intervention (Week 13), and follow-up (Week 17)
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Sim JJM, Rusli KDB, Seah B, Levett-Jones T, Lau Y, Liaw SY. Virtual Simulation to Enhance Clinical Reasoning in Nursing: A Systematic Review and Meta-analysis. Clin Simul Nurs. 2022 Aug;69:26-39. doi: 10.1016/j.ecns.2022.05.006. Epub 2022 Jun 15.
- Elven M, Welin E, Wiegleb Edstrom D, Petreski T, Szopa M, Durning SJ, Edelbring S. Clinical Reasoning Curricula in Health Professions Education: A Scoping Review. J Med Educ Curric Dev. 2023 Oct 25;10:23821205231209093. doi: 10.1177/23821205231209093. eCollection 2023 Jan-Dec.
- Parodis I, Andersson L, Durning SJ, Hege I, Knez J, Kononowicz AA, Lidskog M, Petreski T, Szopa M, Edelbring S. Clinical Reasoning Needs to Be Explicitly Addressed in Health Professions Curricula: Recommendations from a European Consortium. Int J Environ Res Public Health. 2021 Oct 25;18(21):11202. doi: 10.3390/ijerph182111202.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
1. august 2025
Primær fullføring (Faktiske)
31. januar 2026
Studiet fullført (Faktiske)
31. januar 2026
Datoer for studieregistrering
Først innsendt
15. mai 2026
Først innsendt som oppfylte QC-kriteriene
20. mai 2026
Først lagt ut (Faktiske)
27. mai 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
27. mai 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
20. mai 2026
Sist bekreftet
1. mai 2026
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Andre studie-ID-numre
- 24/032/2025/SR/SIBMS
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
NEI
IPD-planbeskrivelse
Individual participant data (IPD) will not be publicly shared because the dataset contains institution-linked educational performance information and participant-level academic assessment data.
De-identified data may be considered for academic collaboration upon reasonable request to the corresponding author, subject to institutional ethical approval and data-sharing regulations.
Legemiddel- og utstyrsinformasjon, studiedokumenter
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Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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