Medical Education Online最新文献

{"title":"Increasing motivation and well-being among medical students using curricular self-experience group sessions-a randomized controlled trial.","authors":"Philipp Spitzer, Claire Mittmann, Janine Utz, Stefan Mestermann, Teresa Festl-Wietek, Johannes Kornhuber, Anne Herrmann-Werner","doi":"10.1080/10872981.2025.2519386","DOIUrl":"10.1080/10872981.2025.2519386","url":null,"abstract":"<p><strong>Background: </strong>Medical students often face increased stress, reduced well-being, and decreased intrinsic motivation. Deci and Ryan's self-determination theory suggests that intrinsic motivation can be increased through autonomy, relatedness and competence. Intrinsic motivation and relaxation techniques have been shown to reduce stress. Therefore, this pilot study investigates whether promoting relatedness, autonomy and competence through participation in self-experience group therapy increases intrinsic motivation and reduces stress in medical students.</p><p><strong>Methods: </strong>A longitudinal randomized controlled trial was conducted with 139 medical students. The students were participants in a one-week psychiatry internship in the winter semester of 2023-4. They were randomly assigned to either a daily relaxation group or self-experience group therapy based on motivational interviewing. Data were collected from pre- and post-internship groups as well as several weeks later using the Self-Regulation Questionnaire for Learning, the Intrinsic Motivation Inventory, the Perceived Stress Scale, the Visual Analog Scale for Stress, and the WHO-5 Scale for Well-Being. Focus group interviews were conducted with students and therapists and were thematically analyzed. The students' performance was compared and analyzed.</p><p><strong>Results: </strong>The students in both groups exhibited increased autonomous regulation with respect to learning at the end of the internship (<i>p</i> < .001, <i>d</i> = 3.29) and improved well-being (<i>p</i> < .001, <i>d</i> = .275) as evaluated via repeated-measures ANOVA. Cross-sectional testing with at test revealed that participants in the self-experience group sessions presented higher levels of relatedness (<i>p</i> = .005, <i>d</i> = .505) and intrinsic motivation (<i>p</i> = .002, <i>d</i> = .542) than participants in the relaxation group. The self-experience group sessions were well accepted by the students, who preferred these sessions to the relaxation group. No differences were detected at the end of the semester.</p><p><strong>Conclusion: </strong>The integration of self-experience therapy into student teaching is a suitable way of eliciting short-term feelings of relatedness and increasing students' motivation to learn while simultaneously reducing their experiences of stress over a one-week period.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2519386"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cluster randomised crossover trial of single resilience and professionalism tutorials among undergraduate medical students.","authors":"David Byrne, Anne Hickey, Denis Harkin, Aine Ryan, Catherine Moran, Fiona Boland, Jan Illing, Laura Staines, Mohamed Abdelnasser, Lisa Mellon, Caroline Kelleher, Frank Doyle","doi":"10.1080/10872981.2025.2529964","DOIUrl":"10.1080/10872981.2025.2529964","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that targeted interventions can improve medical students' perceptions of professionalism and professional identity formation, resilience and coping skills. However, it is unclear how many educational sessions are required for a meaningful impact. We aimed to determine the impact of single resilience/professionalism tutorials on Year 1 medical students' coping self-efficacy and resilience and perceptions of professionalism and professional identity formation. We also conducted a qualitative process evaluation.</p><p><strong>Methods: </strong>A cluster crossover design was used to evaluate tutorials. Student groups were randomly allocated to 'resilience first' and 'professionalism first' classes, followed immediately by the alternative tutorial. Students (<i>n</i> = 106) completed the Coping Self-Efficacy Scale (CSES) and Penn State Questionnaire on Professionalism (PSCOM) before the first tutorial, between tutorials, and after the second tutorial. Differences in CSES and PSCOM scores between groups were assessed using multivariate analysis of variance. Findings were presented to students (<i>n</i>=6) and focus group data were analysed using reflective thematic analysis.</p><p><strong>Results: </strong>Within-group effects showed significant increases in scores for CSES and PSCOM, but irrespective of original group allocation. Qualitative results suggested three themes: positive aspects, limitations, and improving training. Several logistical issues were identified that may have inhibited tutorial efficacy.</p><p><strong>Conclusion: </strong>While we found increased self-efficacy and professionalism scores, these could not be related to the efficacy of respective single tutorials, suggesting that multiple tutorials are required to impact these outcomes. While cross-over designs are feasible to implement, logistical issues may detract from their efficacy. Tutorials could potentially be improved by introducing more interactive learning methods.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2529964"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International students in United States allopathic medical education: a mixed-methods analysis of institutional policies.","authors":"Akila V Muthukumar, Zhi Ven Fong, Radek Buss, Santiago Rolon, Anai Kothari, Jashodeep Datta, Jed Calata, Gopika SenthilKumar","doi":"10.1080/10872981.2025.2471433","DOIUrl":"10.1080/10872981.2025.2471433","url":null,"abstract":"<p><p>International medical students (IMS; non-U.S. citizens/permanent residents) greatly enhance the diversity of U.S. medical schools and serve in areas of greatest healthcare needs. Despite 15% of the US population being foreign born, international students represent < 2% of US-MD matriculants. Factors that contribute to this underrepresentation of IMS remain unknown. In this study, we analyzed the accessibility, quality, and inclusivity of publicly available admissions and financial aid policies at all US-MD schools, with the goal of evaluating potential institutional and informational barriers faced by IMS. Institutional webpages and American Association of Medical College (AAMC) databases were searched from May-July 2023 to gather IMS-specific admissions and financial aid information from 153 accredited US-MD schools. Two-tailed t-test or chi-square analysis was used to examine differences. An inductive thematic approach was used to qualitatively categorize institutional webpage friendliness. While 45% (69/153) of U.S.-MD schools reported accepting IMS, only 18% (27/153) admitted students without restrictions (e.g., Canadians only, state/religious preference). Further, 38% (26/69) of the schools that accept IMS did not provide financial aid information, while nearly two-thirds of the remaining schools required proof of personal financial ability with no institutional/federal support. International students also entered schools with a higher average Medical College Admission Test (MCAT) score and Grade Point Average (GPA). In the national AAMC databases, 19 additional programs were listed as accepting IMS although the institutional webpages stated otherwise; the databases also lacked details on specific restrictions posed by the majority of institutions. Of all 153 webpages, only 14% were deemed 'international friendly.' Restrictive admissions and financial aid policies as well as the poor quality and access to information are major barriers that affect IMS. Strategies that aim to overcome these challenges can greatly help advance diversity, equity, and inclusion in medical education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2471433"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring gender differences in empathy development among medical students: a qualitative analysis of reflections on juvenile correctional school visits.","authors":"Hsiang-Chin Hsu, Tzu-Ching Sung","doi":"10.1080/10872981.2025.2500556","DOIUrl":"https://doi.org/10.1080/10872981.2025.2500556","url":null,"abstract":"<p><p>Empathy development is a critical component of medical education, shaping future physicians' ability to provide compassionate, patient-centered care. This study investigates the reflections of male and female medical students on their experiences at a juvenile correctional school, focusing on how gender shapes their interpretations, emotional engagement, and learning outcomes. Using a qualitative analysis of reflective journals collected from 28 participants, the study employed thematic analysis to identify gender-based patterns in emotional engagement, interpretive framing, and learning outcomes. Reflexivity measures and rigorous coding processes were implemented to ensure credibility and minimize bias in data interpretation. Male students frequently adopted a practical form of empathy, characterized by task-oriented interactions and a sense of competitive camaraderie. In contrast, female students exhibited relational empathy, emphasizing emotional connections and nurturing behaviors. These findings underscore the value of integrating gender-sensitive empathy training into medical education, encouraging the development of both relational and practical approaches. By incorporating tailored reflection exercises and interactive strategies, medical education programs can better equip students to engage compassionately with diverse patient populations. This approach enriches the learning experience and fosters a more holistic understanding of patient care, ultimately leading to improved healthcare outcomes.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2500556"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-institutional exploration of pediatric residents' perspectives on anti-racism curricula: a qualitative study.","authors":"Jessica Martin, Rebecca Johnson, Lahia Yemane, Ndidi Unaka, Chineze Ebo, Jessica Hippolyte, Margaret Jones, Monique Quinn, Aisha Barber, Baraka Floyd, Rebecca Blankenburg, Sarah L Hilgenberg","doi":"10.1080/10872981.2025.2474134","DOIUrl":"10.1080/10872981.2025.2474134","url":null,"abstract":"<p><strong>Background: </strong>Anti-racism curricula are increasingly being recognized as an integral component of medical education. To our knowledge, there has not yet been a publication exploring resident perspectives from multiple institutions and explicitly representing both underrepresented in medicine (UIM) and non-UIM perspectives.</p><p><strong>Objective: </strong>To explore and compare UIM and non-UIM pediatric residents' perspectives on the content and qualities of meaningful anti-racism curricula.</p><p><strong>Methods: </strong>We performed an IRB-approved multi-institutional, qualitative study that incorporated Sotto-Santiago et al's conceptual framework for anti-racism education. Between February and May 2021, we conducted focus groups of UIM and non-UIM pediatric residents at three large residency programs in the United States. We developed focus group guides using literature review, expert consensus, feedback from study team racial equity experts, and piloting. Focus groups were conducted virtually, audio-recorded, and transcribed verbatim. We employed thematic analysis to code transcripts, create categories, and develop themes until we reached thematic sufficiency. We completed member checking to ensure trustworthiness of themes.</p><p><strong>Results: </strong>Forty residents participated (19 UIM and 21 non-UIM) in a total of six focus groups. We identified 7 themes, summarized as: 1) racism in medicine is pervasive, therefore (2) anti-racism education is critical to the development of competent physicians, and 3) education should extend to all healthcare providers. 4) Residents desired education focused on action-oriented strategies to advance anti-racism, 5) taught by those with both learned and lived experiences with racism, 6) in a psychologically safe space for UIM residents, and 7) with adequate time and financial resources for successful implementation and engagement.</p><p><strong>Conclusion: </strong>Our multi-institutional study affirms the need for pediatric resident anti-racism education, promotes co-creation as a method to affect culture change, and provides practical strategies for curricular design and implementation.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2474134"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating nonverbal cues for assessing physician empathy in telemedicine: a Delphi study.","authors":"Annisa Ristya Rahmanti, Hsuan-Chia Yang, Chih-Wei Huang, Ching-Tzu Huang, Lutfan Lazuardi, Che-Wei Lin, Yu-Chuan Jack Li","doi":"10.1080/10872981.2025.2497328","DOIUrl":"https://doi.org/10.1080/10872981.2025.2497328","url":null,"abstract":"<p><p>Nonverbal communication is essential in physician-patient interaction, especially in telemedicine where verbal cues may be limited. This study aimed to identify and validate key nonverbal cues for assessing physician empathy in telemedicine consultations through a Delphi method. A three-round Delphi study was conducted from June to November 2022, involving various experts, including academics, healthcare professionals, AI/telemedicine researchers, industry professionals, and patients. Experts evaluated the importance, validity, and reliability of potential nonverbal cues. Consensus was determined based on median responses and expert scoring percentages, with statistical agreement and stability assessed using Kendall's coefficient of concordance (Kendall's W) and Wilcoxon signed-rank test. Analyses were conducted using SPSS, version 23.0 with significance set at <i>p</i> < 0.05. Of the 72 experts invited, 37 (51%) agreed to participate, with 35 completing the first round (95% completion rate). Eight significant nonverbal cues were identified in the first round, though one did not reach consensus. The second round obtained an 89% response rate (31/35), with three new cues introduced; one did not reach consensus. Round 3 achieved a 94% response rate (29/31), finalizing nine key cues: facial expression, eye contact, tone of voice, smiling, head nodding, body posture, hand gesture, distance, and environmental cues. Among these, facial expression, eye contact, and tone of voice were identified as the most crucial. Inter-expert agreement was statistically significant across all items with strong agreement on the importance (W = 0.739, <i>p</i> < 0.001), good agreement on their validity (W = 0.689, <i>p</i> < 0.001), and moderate agreement on their reliability (W = 0.452, <i>p</i> < 0.001). This study highlights the importance of specific nonverbal cues in telemedicine, particularly facial expression, eye contact, and tone of voice. It provides a validated foundation for developing tools to enhance physician-patient interactions and potentially improve health outcomes in telemedicine.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2497328"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The medical student's case for TikTok.","authors":"Sahana R Shankar, Forrest Bohler","doi":"10.1080/10872981.2025.2497332","DOIUrl":"https://doi.org/10.1080/10872981.2025.2497332","url":null,"abstract":"<p><p>With the future of TikTok's fate remaining uncertain in the United States, two US medical students, one of whom is a content generator with over 68,000 followers, reflect on the impact of this social media app for medical trainees. In particular, they discuss the benefits on student wellbeing and the how the impact has helped those from disadvantaged backgrounds pursue a career in medicine.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2497332"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical simulation in emergency management and communication improves performance, confidence, and patient safety in medical students.","authors":"Mazlum Baris, Nils von Schaper, Hannah Sofie Weis, Klaus Fröhlich, Christian Rustenbach, Anne Herrmann-Werner, Christian Schlensak, Christoph Salewski","doi":"10.1080/10872981.2025.2486976","DOIUrl":"10.1080/10872981.2025.2486976","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to enhance the confidence and operational safety of 5th-year medical students in the operating room (OR), addressing their corona pandemic gap in surgical training.</p><p><strong>Methods: </strong>We augmented the surgical curriculum focusing on pre-, intra-, and post-operative skills, centered around a phantom operation as a pre-test-retest simulation. We measured confidence to assist in surgery on a 5-level Likert-scale and monitored surgical performance metrics (skin-to-skin time, blood loss, blood and volume transfusion, complications, fatal outcome). Half the cohort was explicitly video trained in hemostasis, while the other half in emergency communication. Factual knowledge gains were assessed with online questionnaires. The groups served as reciprocal controls, as confidence (communication group) and surgical performance (bleeding group) were compared.</p><p><strong>Results: </strong>Initially, the pre-test performance of the 126 participants on the phantom operation was suboptimal, ranging from poor to mediocre. Notably, the retest outcomes demonstrated significant surgical performance improvements following the targeted lessons (e.g. blood loss pre-test 906 ± 468 mL, retest 292 ± 173 mL, <i>p</i> < 0.01, <i>n</i> = 35 teams), with the most pronounced enhancements observed in confidence and emergency communication skills (confidence pre-test 2.42 ± 0.52, retest 3.55 ± 0.64, <i>p</i> < 0.01, <i>n</i> = 35 teams). There is a strong tendency (<i>p</i> = 0.08) that the communication group (1.28 ± 0.53) had higher gains in confidence than the bleeding group (0.997 ± 0.4) with a moderate effect size (Cohen's D = 0.6). Students reported increased confidence in assisting in surgery compared to their initial self-assessments. These results show that the structured exposure to a pre-test-retest phantom operation substantially elevates students' capability to act safely and assertively in the OR.</p><p><strong>Discussion: </strong>This approach appears to foster a justified increase in confidence and surgical performance, potentially elevating patient safety among students and residents in training.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2486976"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambiguous motivations in medical school applicants: a retrospective study from Japan.","authors":"Asuka Kikuchi, Ryuichi Kawamoto, Masanori Abe, Daisuke Ninomiya, Yoshio Tokumoto, Teru Kumagi","doi":"10.1080/10872981.2025.2467487","DOIUrl":"10.1080/10872981.2025.2467487","url":null,"abstract":"<p><p>Aspiring to become a physician is a natural expectation for applicants to medical school. However, choosing a career in medicine is a critical decision, especially in countries where high school students can apply to medical school without an undergraduate degree. Students may select a medical career for various reasons, including parental pressure and academic performance. The question of whether there are students who enroll in medical school without clear intentions of becoming doctors has not been extensively investigated in the literature. We conducted a retrospective study at a national university in Japan. Given the scarcity of research examining medical students who did not have a clear intention to become doctors at the time of admission, we created a survey. The questionnaire asked students whether they had clear intentions to become doctors upon enrollment, and those who responded affirmatively were defined as students with clear intentions to become doctors at admission and assigned to the first group. The second group was composed of students who entered medical school without clear intentions to become doctors. We then compared the differences in sociodemographic characteristics and career determinants between these groups using statistical methods, including Chi-square tests and logistic regression. The collection rate of the questionnaire was 76.2%. We found that 28.8% of students at a national medical school in Japan entered medical school without clear intentions of becoming doctors. For these students, 'parental expectations' and 'peer influence' were identified as significant career determinants. No sociodemographic characteristics showed significant associations with the ambiguity of students' intentions to pursue a medical career at admission. This study confirmed that some students enroll in medical school without clear intentions of becoming doctors. The background factors related to this type of student were parental expectations and the influence of peers on career choice.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2467487"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of providing a customized guideline on virtual medical history taking in two serious games for medical education.","authors":"Alexandra Aster, Arietta Lotz, Matthias Carl Laupichler, Tobias Raupach","doi":"10.1080/10872981.2025.2527175","DOIUrl":"10.1080/10872981.2025.2527175","url":null,"abstract":"<p><strong>Background: </strong>Serious games are known as safe learning environments, allowing medical students to train their skills without endangering patients' safety. By integrating virtual patients via chatbots, serious games provide the opportunity to practice history taking. The study investigated the impact of self-directed learning by means of a customized guideline on history taking in two distinct chatbot systems embedded in serious games.</p><p><strong>Methods: </strong>Fourth-year medical students (<i>N</i> = 159) were randomized to one of two serious games, each representing an emergency department and simulating different clinical scenarios. Students played the serious games at two measurement points and received a guideline between both sessions. The chatbots differed in the manner of query entry, with one requiring students to formulate history taking questions themselves, while the other provided a long menu of selectable questions. The dependent variables analyzed included the history taking data entered into the chatbots, represented as a quantified history score, as well as students' comparative self-assessments of their learning outcomes.</p><p><strong>Results: </strong>Comparing only the first measurement point, students achieved higher scores in the free-entry chatbot (85.2 ± 27.7) compared to the long menu chatbot (78.8 ± 35.7). Students achieved significantly higher scores in the second than in the first session in the long menu chatbot (<i>t</i>(315) = -2.918, <i>p</i> = .004, <i>d</i> = -0.229) but not in the free-entry chatbot after receiving the guideline. In terms of students' self-assessment, no significant difference between both serious games was found.</p><p><strong>Discussion: </strong>The results suggest that history taking benefits from self-directed learning in a long menu format relying on cued recall but not in a free-entry chatbot relying on free recall. Since serious games are partially artificial learning environments for training history taking, future studies should examine the extent to which students can transfer their learning in and out of serious games.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2527175"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}