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IRCT20260213068845N3 IRCT 2026-09-12 Kerman University of Medical Sciences The Effect of Metaphorical Storytelling and Multimedia Education on Diagnostic Reasoning and Learning Retention in General Practitioners Comparing the Effectiveness of the MNV Educational Model (Metaphor–Narrative–Visualization) with the Traditional Teaching Method on Diagnostic Reasoning, Cognitive Load, Learning Retention, and Satisfaction in General Practitioners 2026-09-12 anticipated 60 Recruiting https://irct.ir/trial/93201 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Randomization description: Randomization is performed using simple randomization at the individual level. Stratified randomization based on demographic variables is not applied. The unit of randomization is the individual (each general practitioner). The random sequence is generated using Random Allocation software by a person independent of the principal investigator. Allocation concealment is ensured using sequentially numbered, opaque, sealed envelopes or central allocation by an independent person. The outcome assessor is blinded to group allocation. Participants are not blinded due to the nature of the educational intervention, Blinding description: The study is single-blind; only the outcome assessor is blinded to group allocation. Participants and the principal investigator are not blinded due to the educational intervention. The assessor does not attend sessions and scores tests using only ID codes without group labels. If possible, the data analyst remains blinded using A/B codes. No Data Safety and Monitoring Committee is formed. N/A Myocardial Infarction. Intervention 1: Intervention group: 30 general practitioners. Training on 4 clinical topics (myocardial infarction, lobar pneumonia, acute kidney injury, liver cirrhosis) using the MNV educational model with three layers: (1) persistent visual metaphors, (2) structured storytelling, (3) interactive visualization (static image, 30-second animation, scientific ID, targeted scenario). Four 60-minute sessions over 2 weeks (2 sessions per week). Each session includes a quick pre-test, animation with audio narrative, interactive teaching, targeted scenario solving, structured review, and post-test/Q&A. Intervention 2: Control group:30 general practitioners. Training on the same 4 clinical topics via conventional lecture with text-image PowerPoint slides and a text handout, without coherent metaphor, storytelling, or interactive content. Four 60-minute sessions over 2 weeks (2 sessions per week). Each session includes a quick pre-test, a 30-minute lecture, two simple clinical cases without immediate feedback, review and summary, and post-test/Q&A. Yes - There is a plan to make this available What will be shared: De-identified individual participant data (IPD), including demographic data, diagnostic reasoning scores, free recall scores, cognitive load questionnaire, and user satisfaction questionnaire. Also, the study protocol, informed consent form, and statistical analysis plan. When: From 6 months after publication of the main results until 5 years after publication. To whom: Academic researchers and reputable research institutions, after approval of the request by the principal investigator and the ethics committe Conditions: For non-commercial research, meta-analysis, secondary analysis, and educational purposes only. Use is conditional upon signing a data use agreement, maintaining confidentiality, not attempting to identify participants, and citing the original source. Where to obtain: Principal Investigator: Samaneh Movahedi Nia, Kerman University of Medical Sciences, How to obtain: A written request including the research purpose, analysis plan, ethics committee approval, and data use agreement is sent to the principal investigator. The request is reviewed by the principal investigator and the ethics committee. If approved, de-identified data are securely provided to the applicant. Comments:
public samaneh movahedinia
Kerman, beginning of Haft Bagh Alavi Road, Kerman University of Medical Sciences Campus
kerman Iran (Islamic Republic of) 7616910002 +98 913 399 0170 movahedinia.s84@gmail.com Kerman University of Medical Sciences scientific samaneh movahedinia
Kerman, beginning of Haft Bagh Alavi Road, Kerman University of Medical Sciences Campus
kerman Iceland 7616910002 09133990170 movahedinia.s84@gmail.com Kerman University of Medical Sciences Iran (Islamic Republic of) Holding a Doctor of Medicine (MD) degree. Working as a physician in comprehensive health service centers affiliated with Kerman University of Medical Sciences Having at least 1 year of clinical work experience after graduation. Willingness to participate in the study and signing the informed consent form. No concurrent participation in similar educational courses. 30 years 60 years Both Not holding a Doctor of Medicine (MD) degree (or being a student). Not working as a physician in comprehensive health service centers affiliated with Kerman University of Medical Sciences. Having less than 1 year of clinical work experience after graduation. Unwillingness to participate in the study or not signing the informed consent form. Concurrent participation in other educational courses similar to this study’s educational model. Physical or time-related inability to attend the four training sessions. Other Other Intervention group: 30 general practitioners. Training on 4 clinical topics (myocardial infarction, lobar pneumonia, acute kidney injury, liver cirrhosis) using the MNV educational model with three layers: (1) persistent visual metaphors, (2) structured storytelling, (3) interactive visualization (static image, 30-second animation, scientific ID, targeted scenario). Four 60-minute sessions over 2 weeks (2 sessions per week). Each session includes a quick pre-test, animation with audio narrative, interactive teaching, targeted scenario solving, structured review, and post-test/Q&A. Control group:30 general practitioners. Training on the same 4 clinical topics via conventional lecture with text-image PowerPoint slides and a text handout, without coherent metaphor, storytelling, or interactive content. Four 60-minute sessions over 2 weeks (2 sessions per week). Each session includes a quick pre-test, a 30-minute lecture, two simple clinical cases without immediate feedback, review and summary, and post-test/Q&A. Primary outcome 1: Diagnostic reasoning score measured by a researcher-made 20-item multiple-choice test (score range 0–20). Timepoint: Before the intervention (pre-test) and immediately after the intervention (post-test). Method of measurement: Diagnostic reasoning score is measured using a researcher-made 20-item multiple-choice test (each item has 4 options with one correct answer). The score range is 0–20, and a higher score indicates better diagnostic reasoning. Learning retention score measured by a 10-item free recall test (each item with 4 keywords; score range 0–40) at three-month follow-up. Timepoint: two months after the intervention (2-month follow-up). Method of measurement: Learning retention score is measured using a 10-item free recall test. Each item has 4 keywords, and the score range is 0–40. A higher score indicates greater retention of information. Cognitive load score measured using the Cognitive Load Questionnaire (Klepsch et al., 2017), consisting of 8 items on a 7-point Likert scale. It covers three subscales: intrinsic load, extraneous load, and germane load. A higher extraneous load score indicates greater unnecessary cognitive load. Timepoint: Immediately after each training session. Method of measurement: The Cognitive Load Questionnaire (Klepsch et al., 2017) with 8 items rated on a 7-point Likert scale (1 = very low to 7 = very high) is administered to participants. Each subscale score is calculated as the mean of its corresponding items. User satisfaction score measured by a researcher-made 15-item questionnaire covering 4 domains: quality of educational content, presentation method, interaction with instructor and content, and clinical applicability. It uses a 5-point Likert scale, with a total score range of 15–75; higher scores indicate greater satisfaction. Timepoint: Immediately after the intervention. Method of measurement: The user satisfaction questionnaire contains 15 items across 4 domains. Responses are scored on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), and the total score ranges from 15 to 75. Kerman University of Medical Sciences Approved 2026-08-16 Ethics Committee of Kerman University of Medical Sciences Kerman, at the beginning of Haft Bagh-e Alavi Axis, University of Medical Sciences Campus kerman Kerman Iran (Islamic Republic of)