Faculty-supervised AI-supported BOPPPS-CBL and performance on a simulated neurological-emergency assessment among junior-college medical interns: a batch-stratified randomized educational study.

Authors

Junhuai Zhang, Zhanqin Xiao, Xiang Gu, Qi Lang, Chanxi Chen, Yaxi Chen

Published in

Frontiers in medicine. Volume 13. Pages 1945397. Epub Oct 14, 2026.

Abstract

County hospitals and township health centers in China provide frontline care for time-sensitive neurological emergencies, and three-year junior-college clinical medicine programs are an important pathway into this workforce. We evaluated a faculty-supervised artificial intelligence (AI)-supported BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory Learning, Post-assessment, and Summary) and case-based learning (CBL) instructional package among junior-college medical interns.
In this prospective, batch-stratified randomized educational study, 118 interns from 12 monthly rotation batches were assigned to AI-supported BOPPPS-CBL (n = 58) or conventional BOPPPS-CBL (n = 60) during a one-month neurology rotation. The intervention used standardized DeepSeek prompts for Socratic questioning, error-focused feedback, and structured reflection under faculty supervision. The primary endpoint was the total score on a locally developed four-station simulated neurological-emergency assessment (0-100). Secondary outcomes included a written examination, while learner-reported questionnaire items were exploratory. Regression models adjusted for rotation batch, baseline academic performance, and digital literacy. The study was not prospectively registered; no public trial registration identifier or registry URL exists, and no publicly time-stamped protocol or statistical analysis plan was available.
All 118 participants completed the primary assessment. Mean total scores were 82.07 in the AI-supported group and 76.43 in the control group, with an adjusted between-group difference of 5.67 points (95% CI, 2.86-8.49; P < 0.001; adjusted Cohen's d = 0.74). In secondary station-specific analyses, only lesion localization met the multiplicity-adjusted threshold (adjusted mean difference, 2.58 points; 95% CI, 1.25-3.91; P < 0.001; adjusted d = 0.71). A Station 2-specific ICC was not estimated. Post hoc sensitivity analyses excluding the station containing reused case contexts yielded standardized estimates of similar magnitude but could not exclude cueing or carry-over. Written-examination estimates were smaller and imprecise. Exploratory learner-reported findings indicated greater perceived preparation-time burden in the AI-supported group.
Assignment to the faculty-supervised AI-supported BOPPPS-CBL package was associated with higher scores on a locally developed simulated neurological-emergency assessment than conventional BOPPPS-CBL. These findings do not establish transfer to workplace clinical performance or patient outcomes. Multicenter studies using independent assessment cases, longer-term follow-up, and workplace-based outcomes are warranted.

PMID:
42952540
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.

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