Trial reportBMC medical education2026
The PAPER heuristic: a structured cognitive aid to reduce intrinsic cognitive load in early clinical reasoning training.
Trial report in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Validation of Checklist to Evaluate Emergency Medicine Competencies of Medical Students in Simulation Training.Advances in medical education and practice · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical reasoning is a key competency in undergraduate medical education but is often taught implicitly. Structured approaches such as acronyms may help support students in developing this skill, especially in complex or high-stakes situations. The acronym PAPER (Patient, details of Acute situation, relevant Past medical History, Estimate the situation, Recommendations) was developed to provide a simple and structured framework to support clinical reasoning.
methodsThe acronym was developed through a three-round Delphi process with clinical experts in emergency medicine, anaesthesiology, and trauma surgery. It was piloted in a single-blind, simulation-based study with 290 medical students in either their fourth clinical semester or final year. Students were randomised to either an intervention group, which received a 20-minute introduction to clinical reasoning and the acronym before simulation training, or a control group, which received standard simulation alone. The outcomes included clinical performance, nontechnical skills, and cognitive load, which were assessed via blinded raters and validated self-report questionnaires.
resultsNo significant differences in clinical performance were found between the intervention and control groups. However, among fourth-semester students, the intervention group reported a significantly lower intrinsic cognitive load than did the control group. The final-year students generally reported better scores in teamwork and decision-making but reported lower germane cognitive loads than their junior peers did. The effect of the intervention appeared to be influenced by the students' training stage.
conclusionsWhile the acronym did not improve overall clinical performance, it was associated with a reduced intrinsic cognitive load in less experienced students. Introducing structured clinical reasoning tools earlier in the curriculum may help learners process clinical scenarios more effectively. Timing appears to be an important factor in the success of such interventions and should be considered in curriculum development.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.