Effect of a Clinical Decision Support System on Team-Based Clinical Quiz Performance Among Japanese Medical Students:...

Educational impact of point-of-care clinical decision support system (CDSS) on medical students remains insufficiently studied. Our aim was to evaluate the effect of a CDSS on team-based clinical quiz performance and confidence in using medical information resources.

We conducted a nationwide, online, pre-post quasi-experimental pilot study on November 24, 2024. Eighteen teams of Japanese medical students (team size ranging from one to three members) completed ten multiple-choice questions based on two clinical cases. Teams first answered questions using any resources except UpToDate (Pre phase), then re-answered the same questions using UpToDate only (Post phase) under stricter time constraints. The primary outcome was team-based quiz score. Secondary outcomes were team-based confidence in using UpToDate and other resources. Paired t-tests and Wilcoxon signed-rank tests were performed. Sensitivity analyses addressed missing post-intervention confidence data.

Seventeen teams (43 individuals) were included in the analysis. Mean quiz scores increased from 4.00 (SD 1.70) to 4.76 (SD 2.17) (paired t-test p = 0.01; Wilcoxon p = 0.026). Confidence in using UpToDate improved from 1.38 (SD 0.77) to 2.54 (SD 0.97) (paired t-test p = 0.0021), while confidence in other resources showed no significant change. Sensitivity analyses supported the confidence improvement under neutral and best-case assumptions but not under the extreme worst-case scenario.

CDSS use may be associated with modest improvements in team-based quiz performance and confidence among medical students in this volunteer-based sample; generalizability to broader populations requires further investigation. Future studies should examine learning outcomes, clinical applicability, and curricular integration.