Abstract
BACKGROUND: Clinical reasoning (CR) is a critical competency in medical education, essential for effective decision-making in clinical practice. This study aimed to enhance CR skills among undergraduate medical students by comparing two instructional strategies: the E-learning by Concordance (e-LbC) approach and an interactive lecture-based method. METHODS: A quasi-experimental comparative study was conducted at the Faculty of Medicine, Suez Canal University, Egypt, during the 2021-2022 academic year. The study involved 60 fifth-year medical students through comprehensive sampling and was implemented over one academic term. It consisted of three phases. In the first phase, an online Script Concordance Test (SCT) was used via the Wooclap platform to assess students' baseline CR skills. The second phase included the educational intervention, in which the e-LbC method was used to teach the topic of painless vision loss, while the interactive lecture method was used for painful vision loss. In the final phase, a researcher-developed questionnaire assessed students' perceptions regarding the impact of each instructional method on CR development, difficulty level, and satisfaction. The questionnaire's validity was established by medical education experts, and reliability was confirmed using Cronbach's alpha. RESULTS: Statistical analysis using paired t-tests revealed no significant difference in the pre-SCT scores between groups. However, post-SCT scores showed a statistically significant improvement in both groups, with the e-LbC, painless vision loss theme, demonstrating a greater effect size (Cohen's d) and overall higher performance (p < 0.001). Additionally, 62% of students expressed satisfaction with the e-LbC method. CONCLUSION: the e-LbC approach positively influenced students' clinical reasoning skills and engagement. Its integration with real-time assessment tools like Wooclap, combined with its cost-effectiveness, flexibility, and user-friendliness, positions it as a valuable tool for enhancing medical education in diverse learning environments.