Real-time Bidirectional Feedback and Multimodal Teaching Boost Clinical Skills in Compressed Infectious Disease Clerkships

Abstract Background Infectious disease (ID) clerkships often struggle to provide comprehensive skills due to time limits, especially in short rotations, and lack real-time feedback, uneven case distribution, and biosafety training. This study assesses a multimodal teaching framework with a Real-Time Bidirectional Feedback System (RTBFS) to improve clinical skills in a 1-week ID clerkship. Methods A prospective study enrolled 474 fourth-year students in clinical medicine major at Sun Yat-sen University. Participants were divided into RTBFS (n = 237) and traditional feedback (n = 237) groups. The curriculum combined problem-based learning (PBL), case-based learning (CBL), simulation, and bedside teaching. RTBFS group utilized a mobile app for daily student-instructor feedback and AI analytics (Kimi) to identify learning gaps. Results The RTBFS group outperformed the traditional group in final exams (90.24 ± 3.08 vs. 86.79 ± 5.02, P < 0.0001), clinical documentation (87.07 ± 7.93 vs. 83.02 ± 8.34, P < 0.0001), and PBL/CBL assessments (PBL: 84.49 ± 9.34 vs. 76.70 ± 12.63; CBL: 85.77 ± 8.04 vs. 78.31 ± 7.88; P < 0.0001). Student satisfaction exceeded 85% across components, with RTBFS rated 94.09% "Very Satisfied." Key challenges included uneven biosafety practice time and exam memorization focus. Curriculum reforms proposed augmented reality (AR), natural language processing (NLP), and flipped classrooms. Conclusions The RTBFS framework enhanced clinical competency in short-term clerkships, addressing gaps in real-time feedback and interdisciplinary integration. Limitations include single-center design and need for longitudinal validation. Future directions emphasize technological inclusivity and scalability in resource-limited settings.