Abstract
Simulation in medical education improves clinical competence. The Diagnostic Clinical Reasoning Program (DxR), a web-based simulated patient cases software, augments students’ clinical skills in a virtual hospital setting. In the Arabian Gulf University, Bahrain it is used to train the medical students before they begin the clinical clerkship. This study aims to assess the impact of using the DxR software during pediatric clerkship on the clinical skills of year-5 medical students. 186 fifth-year medical students attending the pediatric clerkship during the academic year 2018–2019 were enrolled in the study. The students were randomized into two equal groups with similar gender ratios. Both groups attend all the regular educational activities of the pediatric clerkship. The study group used the DxR software to study five simulated patients’ scenarios and the control group examined five hospitalized patients and wrote their case write-ups. The scores obtained by the two groups in the written and clinical components of the pediatric end-of-clerkship examination were compared. The students in the study group obtained higher scores than the students in the control group in the objective structured clinical examination (OSCE) and the long case. The difference was statistically significant (p<0.001). There was no significant difference between the two groups in the scores of the written exam. Training using the DxR software has a positive impact on the clinical skills of medical students in their pediatric clerkship. Using the software as an integral part of clerkship training would be useful.

Key words: Web-based simulation, medical education, clinical skills, DxR software, OSCE.