Effectiveness of a Theatre-Infused Script-to-Skills Teaching Model in Undergraduate Otorhinolaryngology Education: A Randomized Two-Period Crossover Trial.

Background: Otorhinolaryngology teaching in undergraduate medicine is often compressed, and lecture-based delivery does not consistently sustain engagement or durable retention. Objectives: To evaluate whether a theatre-infused script-to-skills teaching model improves immediate knowledge acquisition, short-term retention, communication-related competencies, and learner satisfaction compared with conventional didactic lectures among final-year MBBS students. Methods: This randomized, controlled, two-period, two-sequence crossover trial included 60 final-year undergraduate medical students. Two otorhinolaryngology topics, chronic suppurative otitis media and deviated nasal septum, were taught sequentially. The intervention combined pre-session script preparation, doctor-patient role-play, facilitator-guided collaborative problem-solving, take-home reinforcement tasks, and structured feedback, while the control arm received conventional didactic lectures. Pre-test, immediate post-test, and two-week retention scores were analyzed, together with facilitator-rated communication, empathy, clinical reasoning, professionalism, collaborative rubric scores, and student satisfaction. Knowledge was measured using topic-specific 20-item single-best-answer multiple-choice tests scored from 0 to 20 at baseline, immediately after teaching, and after two weeks. Communication, empathy, clinical reasoning, and professionalism were rated with a four-domain analytic grid using 1-5 anchors; collaborative performance was scored with a 20-point rubric, and satisfaction was assessed on a five-point Likert scale. Results: Baseline pre-test scores were comparable between the groups in both study periods. The intervention produced higher immediate post-test gains for both chronic suppurative otitis media and deviated nasal septum. Retention scores at two weeks also remained significantly higher after the theatre-infused model. Communication, empathy, clinical reasoning, and professionalism scores in the intervention arm were consistently high, and learner satisfaction clearly favored the interactive strategy. Mixed-effects analysis confirmed the intervention as an independent predictor of improved post-test and retention performance. Conclusion: The theatre-infused script-to-skills teaching model was superior to didactic lecture for promoting knowledge gain, retention, communication-oriented performance, and student satisfaction in undergraduate otorhinolaryngology teaching. This model offers a feasible, learner-centered approach for strengthening clinically relevant undergraduate ENT education.