A randomised cross-over trial assessing the impact of AI-generated individual feedback on written online assignments for medical students

Self-testing has been proven to significantly improve not only simple learning outcomes, but also higher-order skills such as clinical reasoning in medical students. Previous studies have shown that self-testing was especially beneficial when it was presented with feedback, which leaves the question whether an immediate and personalized feedback further encourages this effect. Therefore, we hypothesised that individual feedback has a greater effect on learning outcomes, compared to generic feedback. In a randomised cross-over trial, German medical students were invited to voluntarily answer daily key-feature questions <i>via</i> an App. For half of the items they received a generalised feedback by an expert, while the feedback on the other half was generated immediately through ChatGPT. After the intervention, the students participated in a mandatory exit exam. Those participants who used the app more frequently experienced a better learning outcome compared to those who did not use it frequently, even though this finding was only examined in a correlative nature. The individual ChatGPT generated feedback did not show a greater effect on exit exam scores compared to the expert comment (51.8 ± 22.0% vs. 55.8 ± 22.8%; <i>p</i> = 0.06). This study proves the concept of providing personalised feedback on medical questions. Despite the promising results, improved prompting and further development of the application seems necessary to strengthen the possible impact of the personalised feedback. Our study closes a research gap and holds great potential for further use not only in medicine but also in other academic fields.