Digital case-based learning for improving clinical decision-making in tuberculosis care

This study compares a digital case-based learning module with standard training for improving guideline-concordant clinical decisions in tuberculosis (TB) care. Evidence on whether digital training improves TB decision accuracy is limited when both groups complete the same scored case assessment. In a two-arm parallel trial, clinicians or trainees were assigned to either the digital module or standard lecture or continuing medical education training, then completed a standardized vignette test within 7 days. Guideline-concordant decision accuracy was higher with the digital module, with an intention-to-treat risk difference of 0.06 [0.02, 0.1]. Because the scoring rules and assessment content were the same in both arms, this comparison indicates the added value of digital cases for standardized decisions on the vignette test, within the reported interval. These findings reflect vignette performance rather than patient outcomes and may inform TB program implementers and medical educators planning scalable decision-making training.