AI-Generated and Rule-Based Individualized Feedback for Medical Students' Nephrology Learning

Medical education increasingly emphasizes individualized learning and formative assessment; however, providing timely and personalized feedback to students remains challenging because of limited faculty resources. Generative artificial intelligence (AI) may provide a scalable approach for generating individualized feedback based on students' learning needs, but its educational effectiveness compared with traditional feedback approaches remains uncertain. This study is a single-center, prospective, three-arm, cluster randomized controlled trial designed to evaluate the effect of pretest-based individualized feedback on medical students' learning outcomes during a nephrology clerkship. Undergraduate medical students participating in a nephrology clerkship at The Second Qilu Hospital of Shandong University will be recruited and assigned by teaching class clusters to one of three groups: an AI-generated feedback group, a rule-based individualized feedback group, or a no-feedback control group. All participants will receive the same nephrology clerkship teaching based on the BOPPPS-CBL instructional model. Before the clerkship, students will complete a diagnostic pretest. Based on the pretest results, individualized feedback will be provided according to group allocation. The primary outcome is immediate knowledge acquisition assessed by the post-test score immediately after the clerkship. Secondary outcomes include four-week knowledge retention, knowledge gap remediation, and clinical reasoning performance. This study aims to determine whether AI-generated individualized feedback provides additional educational benefits compared with traditional rule-based feedback and no feedback, and to provide evidence for the application of artificial intelligence-assisted personalized learning in medical education.

Inclusion Criteria: 1. Undergraduate medical students participating in the nephrology clerkship at The Second Qilu Hospital of Shandong University. 2. Students who voluntarily agree to participate in the study and provide informed consent. 3. Students who complete the baseline assessment and follow the study procedures. Exclusion Criteria: 1. Students who do not complete the required assessments or withdraw from the study. 2. Students who have previously participated in the same nephrology feedback intervention study. 3. Students who are unable to complete the study procedures due to personal reasons.