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Enhancing Clinical Reasoning in Surgical Education: A Randomized Crossover Trial on AI-Generated Individual Feedback
Johanna Flora Rother1, Leon Nissen2, Matthias Carl Laupichler1
1Institute of Medical Education, University of Bonn, University Hospital Bonn, Bonn, Germany.
Journal of Surgical Education
|July 7, 2026
Summary
Self-testing with an app improved surgical learning outcomes, particularly with intensive usage. Personalized feedback did not outperform general feedback, suggesting app engagement is key.
Area of Science:
- Medical Education
- Surgical Training
- Educational Technology
Background:
- Self-testing enhances learning, with feedback potentially improving outcomes.
- Investigating the impact of different feedback types and app usage on clinical reasoning in surgery.
Purpose of the Study:
- To compare the effectiveness of personalized versus general feedback in a surgical education app.
- To assess the impact of general and intensive app usage on learning outcomes.
Main Methods:
- Fourth-year medical students used a self-developed app with daily questions aligned to lectures.
- A crossover design was employed, with students receiving either personalized or general feedback.
- Learning outcomes were measured via an exit exam.
Main Results:
- No significant difference in exit exam scores between personalized and general feedback groups.
- General app usage alone did not significantly improve scores, but interactions with time were observed.
- Higher intensity of app usage was significantly associated with higher scores and greater learning benefits over time.
Conclusions:
- The study supports the testing effect and the utility of key feature questions in surgical education.
- Feedback type effectiveness was inconclusive, indicating a complex relationship.
- Further research is needed to clarify the nuanced effects of feedback and app usage.
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