Smartboard for PowerPoint-based lectures in undergraduate paediatric education: A randomised controlled trial

Background and objectives Interactive digital tools such as smartboards are increasingly being used in education, yet robust evidence from low- and middle-income countries (LMICs) is limited. This study compared Smartboard- and PowerPoint-based teaching in undergraduate paediatrics and assessed their impact on knowledge retention and learner engagement. Methods A single-centre, open-label, parallel-group randomised controlled trial was conducted among 360 MBBS students (second, third, and final years). Participants were stratified by academic year and baseline test scores, then randomly assigned to Smartboard or PowerPoint groups. Identical paediatric topics were taught using standardised lesson plans. The primary outcome was knowledge retention, assessed through objective structured clinical examinations (OSCEs) immediately, and at 1- and 2-month follow up. Secondary outcomes included student and faculty feedback. The trial was prospectively registered with the Clinical Trials Registry-India (CTRI/2025/04/083965). Results Immediate pooled OSCE performance was comparable (Smartboard: 47.2% Grade A vs. PowerPoint: 41.1%, P=0.29). At 1-month follow-up (primary outcome), Smartboard students achieved higher Grade A scores across all years combined (46.1% vs. 40.3%, P=0.028). Smartboard participants also showed superior retention at 2 months in third- (P=0.002) and final-year (P=0.049) cohorts. Students reported greater engagement (66.1% vs. 51.9%; absolute difference 14.2% points), attention (68.1% vs. 33.9%; difference 34.2% points), and recall (46.1% vs. 22.8%; difference 23.3% points). Faculty rated Smartboards higher for engagement (100% vs. 33.3%; difference 66.7% points), but preferred PowerPoint for ease of preparation (83.3% vs. 33.3%; difference 50.0% points). Interpretation and conclusions Smartboard-based teaching improved long-term knowledge retention, engagement, and attention compared with PowerPoint, particularly at 1 month and among senior students. Interactive digital tools may enhance learning outcomes in LMIC settings.