Journal Article

Computer-based case simulations enhances clinical reasoning skills of non-dental medical students as measured by mini-CEX

Zeng, Jiahao, Geng, Yuanming, Shen, Xiaoqing, Lv, Xiaozhi, Liu, Xin, Zhou, Xiaolong, Zhang, Jingwen, Liu, Chundong

2026

Overview

Purpose Traditional didactic lecture-based models in stomatology education, which rely on passive learning through lectures and observation, have limitations in fostering clinical reasoning. This study aimed to assess the effectiveness of Computer-based Case Simulations (CCS) in enhancing the clinical reasoning skills of non-dental medical undergraduates, using the Mini-Clinical Evaluation Exercise (Mini-CEX) as an outcome measure. Methods The study involved 328 non-dentistry medical undergraduates enrolled in four different educational programs: Bilingual, Pediatrics, Clinical Medicine I and Clinical Medicine II. Both the control and intervention group completed a Mini-CEX prior to training to establish a baseline. The control group received traditional didactic training (lectures + passive clinical observation), while the intervention group underwent CCS. Educational effectiveness was evaluated via theoretical test scores and Mini-CEX assessments. Results A pre-clerkship survey revealed that non-dentistry undergraduates prioritized learning about various dental diseases and developing clinical diagnostic and therapeutic thinking skills over the technical and procedural skills involved in the delivery of patient care. The intervention group, demonstrated significantly higher theoretical test scores compared with the control group across all classes (Bilingual Class: 98.1 ± 1.22 vs. 97.3 ± 0.97, Cohen’s d = 1.129; Pediatric Class: 97.9 ± 0.85 vs. 96.5 ± 1.35, Cohen’s d = 1.072; Clinical Medicine Class Ⅰ: 98.0 ± 0.91 vs. 97.0 ± 1.08, Cohen’s d = 1.000; Clinical Medicine ClassⅡ: 99.2 ± 1.04 vs. 97.7 ± 1.74, Cohen’s d = 1.432; all P  < 0.05). There was no significant difference in the Mini-CEX score between the groups before the clerkship ( P  > 0.05). Although both groups showed improvements in Mini-CEX scores post-clerkship, the intervention group exhibited a significantly greater increase (Cohen’s d > 0.5, P  < 0.01), indicating superior clinical skill development. Conclusion The results suggest that Computer-based case simulations (CCS) were associated with enhanced clinical knowledge and superior development of clinical reasoning skills in non-dentistry medical undergraduates compared to traditional methods, as measured by theoretical examination and Mini-CEX assessment. Future research should explore the long-term retention of clinical reasoning and the feasibility of scaling CCS in resource-limited settings.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Academic Achievement / Adult / Alignment (Education) / Bilingualism / Clinical clerkship / Clinical Competence / Clinical medicine / Clinical Reasoning / Cognition & reasoning / College students / Communication Skills / Comparative Analysis / Comparative Education / Computer Assisted Instruction / Computer Simulation / Computer-based case simulations / Computer-generated environments / Computers / Content Validity / Control Groups / Critical thinking / Curriculum Evaluation / Data Analysis / Dental education / Dentistry / Departments / Diagnostic equipment (Medical) / Education / Educational aspects / Educational Assessment / Educational evaluation / Educational Measurement / Educational Objectives / Etiology / Evaluation / Evaluative Thinking / Evaluators / Evidence-based medicine / Expectation / Experiential Learning / Feedback / Female / Formative evaluation / Humans / Learner Engagement / Learning / Male / Medical diagnosis / Medical Education / Medical history / Medical students / Medicine / Methods / Mini-CEX / Oral diseases / Patient assessment / Psychological aspects / Reasoning / Simulation / Simulation methods / Social skills / Students, Medical / Teachers / Teaching methods / Textbooks / Theory of Medicine/Bioethics / Undergraduate Students / Young Adult