Synchronous Remote Teaching for Neurological Examination Training in Fifth-Year Medical Students: Quasi-Experimental Study.

Background: The use of remote teaching in medical education has increased since the COVID-19 pandemic. However, the effectiveness of synchronous remote teaching for specific psychomotor components of the neurological examination, such as tendon reflex assessment, remains underexplored. Objective: This study aimed to evaluate the short-term effectiveness of synchronous remote teaching compared with traditional in-person teaching for training medical students in tendon reflex examination skills and related neurological examination knowledge. Methods: This quasi-experimental study enrolled 110 fifth-year medical students between August 2022 and April 2024, who were assigned to either synchronous remote teaching (n=46) or in-person teaching (n=64). The participants completed pre- and postcourse knowledge tests and an objective structured clinical examination (OSCE) assessing tendon reflex examination skills. Motivational beliefs related to self-regulated learning and technology acceptance were measured at baseline. Group differences were analyzed using t tests, Mann-Whitney U tests, and correlational analyses. Results: Posttest knowledge scores were higher in the synchronous remote teaching group than in the in-person group (mean difference 0.86, 95% CI 0.21-1.51; Cohen d=0.50; P=.01), indicating a modest effect size. Both groups demonstrated substantial improvements in tendon reflex OSCE performance; however, the between-group difference in OSCE score improvement was not statistically significant (mean difference -3.64; 95% CI -9.36 to 2.08; Cohen d=-0.26; P=.21). Within the synchronous remote teaching group, higher motivational beliefs were positively correlated with OSCE score gains (Pearson r=0.34; P=.04; n=46), suggesting a potential role of self-regulated learning-related motivational processes. These exploratory findings should be interpreted with caution. Conclusions: Under the conditions of this study, synchronous remote teaching was associated with modest improvements in knowledge outcomes and with OSCE-assessed tendon reflex examination skill gains that were comparable to those of traditional in-person teaching, without statistically significant between-group differences in psychomotor performance. These findings do not establish durable skill acquisition and should not be interpreted as evidence of equivalence or superiority of synchronous remote teaching over in-person instruction. Unlike many prior remote medical education studies that primarily focused on asynchronous learning or self-reported outcomes, this study incorporated synchronous interactive instruction with objective OSCE-based psychomotor assessment. These findings contribute to the emerging literature on synchronous remote clinical skills education, although future randomized and longitudinal studies are needed to evaluate long-term skill retention and broader applicability.