Facilitated interactive video versus simulation-based training after a standardized lecture for basic life support in medical students: a randomized trial

Basic life support (BLS) is a core competency for medical students, yet simulation-based training can be resource intensive. Scalable alternatives such as facilitated interactive video may support learning, but evidence on skills retention is mixed. This study aimed to compare facilitated interactive video-based versus simulationbased training, each delivered as an adjunct to the same standardized lecture, on knowledge acquisition and mid-term skills retention in adult BLS education. In this prospective randomized controlled trial, fourth-year medical students at a public university were allocated (1:1) to either simulation-based training (scenario practice plus debriefing) or facilitated interactive video training (interactive animated video with embedded pauses and brief questions, delivered with real-time instructor feedback), after the same standardized 20-min lecture. Knowledge was assessed using a 20-item multiple-choice question test immediately before and after training. Skills were assessed at 3 weeks using a 30-item OSCE checklist. The primary outcome was the between-group difference in 3-week OSCE score; the secondary outcome was the between-group difference in knowledge gain (post-test minus pre-test). A total of 121 students were analyzed (video n = 60; simulation n = 61). Post-test scores increased significantly versus pre-test in both groups (both p < 0.001). Betweengroup differences were small and not statistically significant: post-test 90.00 (85.00–95.00) vs. 90.00(80.00–95.00) (p = 0.748); gain 15.00(10.00–20.00) vs. 10.00(5.00–20.00) (p = 0.058); and OSCE 24.00(22.00–26.00) vs. 24.00(21.00–26.00) (p = 0.385). In this cohort, we found no clear evidence of differences between videobased and simulation-based adjunct training—both delivered after an identical standardized lecture—in short-term knowledge gains or 3-week OSCE performance. Because a substantial portion of the observed knowledge gain is likely attributable to the shared lecture and test–retest exposure, the incremental contribution of each modality cannot be isolated. Nevertheless, facilitated interactive video warrants further investigation as a potential adjunct when simulation capacity is limited. ClinicalTrials.gov (NCT07368452).