Randomized comparison of gamified mobile app-based training versus conventional learning for pneumothorax detection in chest radiographs.

BACKGROUND: Medical education could benefit from the introduction of novel teaching techniques. The present study aimed to assess the effect of a gamified mobile app (LuluRad) to improve pneumothorax detection on chest radiographs (CXRs). METHODS: In this prospective, single-center randomized trial, third-year medical students were individually randomized using a coin toss to app-based learning (n = 60) or script-based learning (n = 66). Participants completed pre- and post-learning intervention CXR pneumothorax tests. The primary study outcome was pre/post diagnostic accuracy change between the app-based and script-based group. Secondary endpoints were changes in sensitivity and specificity. RESULTS: In the app group, accuracy increased from 50.8% to 65.0% (p = 0.015) and sensitivity from 53.3% to 67.2% (p = 0.022), while specificity did not change significantly (p = 0.068). In the script group, accuracy did not significantly change (p = 0.132), sensitivity decreased from 64.1% to 41.9% (p < 0.001), and specificity increased from 39.4% to 51.0% (p = 0.006). Between-group change scores demonstrated greater increases in accuracy (Δ + 14.2 vs. − 5.3% points (pp); p < 0.001) and sensitivity (Δ + 13.9 vs. − 22.2 pp; p < 0.001) in the app group, while specificity did not change significantly between groups (p = 0.378). CONCLUSION: App-based learning was associated with greater increases in pneumothorax detection accuracy compared with conventional self-study among third-year medical students. Given the study design, these findings should be considered exploratory. While confirmation in larger studies is required, this approach appears promising and may represent a valuable adjunct to traditional teaching. TRIAL REGISTRATION: This trial was not prospectively registered due to its educational study design and the absence of any potential harm or disadvantage for participants.