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Cited by 1Innovations in Medical EducationProblem and Project Based LearningSimulation-Based Education in Healthcare

Reforming hospital management education with the P-MASE pedagogy: a randomized controlled trial

Open access
Zhang, Yongshuo, Li, Wenbo, Zhang, Chuchen, Wang, Yawei, Feng, Shuo·2026·BMC Medical Education
DOI 10.1186/s12909-026-08948-8PMC PMC13078037
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Abstract

BACKGROUND: To address persistent gaps in hospital management education—including outdated theoretical instruction, insufficient competency assessment, and limited interdisciplinary training—we developed and evaluated the P-MASE pedagogy (Problem-based, Mobile, Authentic, Social, Experiential) to narrow the knowing–doing gap. METHODS: In a prospective, parallel-group randomized controlled trial, 120 undergraduates from a medical university were allocated 1:1 to the P-MASE pedagogy or traditional instruction a 16-week teaching period followed by a 4-week evaluation. The primary outcome was the closed-book examination score. Secondary outcomes included skills—Diagnosis-Related Groups (DRG) grouping accuracy, empathy in crisis statements, and departmental budgeting satisfaction; learning process—weekly platform logins, valid discussion posts, and modeled Emergency Department (ED) waiting-time reduction rate; and teaching satisfaction. A combined evaluation framework integrating data-driven metrics, simulation modeling, and Natural Language Processing (NLP) was applied. Outcome assessors were blinded to group allocation. A two-sided α of 0.05 was used. RESULTS: In this educational RCT, the P-MASE group had higher closed-book examination scores than the control group (88.3 ± 3.2 vs. 73.6 ± 5.8, P < 0.001). The P-MASE group also demonstrated better performance on standardized simulation/task-based assessments and showed higher learning engagement and teaching satisfaction than the control group (all P < 0.05). CONCLUSIONS: P-MASE was associated with higher short-term educational outcomes in this course-based setting. Findings should be interpreted within the educational context of this course. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2400082568. Registered on 01 April 2024.

AI snapshot

Written from the paper’s full text.

TL;DR

In a single-center randomized controlled trial of 120 undergraduates, the P-MASE pedagogy produced higher closed-book examination scores and better simulation/task-based performance, engagement, and teaching satisfaction than traditional instruction. These are short-term, course-based educational effects, not evidence of real-world hospital operational improvement.

Key findings

  • Primary outcome: closed-book examination score was higher in the P-MASE group than the control group (88.3 ± 3.2 vs. 73.6 ± 5.8, P < 0.001); case analysis scores were also higher (90.1 ± 4.5 vs. 65.4 ± 7.2, P < 0.001).
  • Skills-based assessments favored P-MASE: simulated departmental satisfaction 82.5 ± 3.4% vs. 74.3 ± 5.1% (P < 0.001); empathy markers in standardized crisis statements 5.3 ± 0.8 vs. 2.1 ± 0.4 per 100 words (P < 0.001); DRG grouping error rate 6.3 ± 2.1% vs. 21.7 ± 4.3% (narrative reports P < 0.01; table lists P < 0.001).
  • Learning-process indicators were higher in the P-MASE group: weekly platform logins 18.3 ± 2.1 vs. 9.7 ± 3.4 (P < 0.001); valid discussion posts 24.5 ± 5.2 vs. 8.3 ± 3.7 (P < 0.001); simulated ED waiting-time reduction 33.3 ± 4.7% vs. 11.2 ± 3.6% (P < 0.001).
  • Teaching satisfaction was higher for course practicality (4.7 ± 0.3 vs. 3.1 ± 0.6), resource support (4.5 ± 0.4 vs. 3.4 ± 0.5), and confidence in job competence (4.6 ± 0.2 vs. 3.0 ± 0.7), all P < 0.001; over 91% agreed simulation-based training was closely connected to real hospital management scenarios.

Methods

  • Prospective, parallel-group RCT with 120 undergraduates majoring in Health Administration and Information Resource Management at one medical university; participants were stratified by major and allocated 1:1 to P-MASE (n = 60) or traditional instruction (n = 60), with a 16-week teaching period and 4-week evaluation (September 2024–January 2025); registered as ChiCTR2400082568.
  • P-MASE was delivered as an integrated five-component package (problem-based, mobile, authentic, social, experiential learning) versus traditional lectures and case discussions covering identical content; allocation concealment used sequentially numbered opaque sealed envelopes, outcome assessors were blinded, and instructors were trained and matched.
  • Outcomes included a closed-book examination (primary), skills tasks (DRG grouping accuracy, NLP-assisted empathy markers in crisis statements, budgeting/resource-allocation satisfaction), learning-process indicators (platform logins, valid discussion posts, simulated ED waiting-time reduction), and teaching satisfaction; analysis used SPSS v25.0, Welch’s t-tests, chi-square/Fisher’s exact tests, two-sided α = 0.05, and Benjamini–Hochberg FDR for multiple secondary outcomes.

Limitations

  • The paper states: single medical university in China limits generalizability; P-MASE is multi-component so specific active elements cannot be identified; students and instructors could not be blinded, raising performance bias/Hawthorne concerns; satisfaction and perceived job competence were self-reported; contamination between groups cannot be fully ruled out; NLP and simulation tools were locally developed and not extensively externally validated; outcomes were assessed immediately after the course, so only short-term effects are shown.
  • The paper also states that formal attendance was not systematically recorded, so session-level attendance/adherence rates could not be computed; platform logs and task completion were used as engagement proxies.
  • The paper repeatedly notes that management-derived indicators (e.g., DRG grouping accuracy, simulated departmental satisfaction, simulated ED waiting-time reduction) are educational performance measures within standardized tasks/simulations, not real-world hospital operational or policy outcomes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12909-026-08948-8

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

18 of 21 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Hospital administrators' core competency lies in dynamically balancing complex systems.

    “This study confirms that hospital administrators’ core competency lies in dynamically balancing complex systems [18].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [18] Terzic-Supic Z, Bjegovic-Mikanovic V, Vukovic D, Santric-Milicevic M, Marinkovic J, Vasic V, et al. Training hospital managers for strategic planning and management: a prospective study. BMC Med Educ. 2015;15:25. source

      The Background and Discussion (page unavailable) describe managers responding to changing conditions and using strategic analysis to address competing demands. The study does not establish that dynamically balancing complex systems is hospital administrators’ core competency; it evaluates training in strategic planning and management. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    The experimental group's low negative sentiment scores in crisis responses stemmed from integrating the tripartite communication strategy-empathic engagement, factual clarification, and institutional accountability.

    “the experimental group’s low negative sentiment scores in crisis responses stemmed from integrating the tripartite communication strategy—empathic engagement, factual clarification, and institutional accountability—requiring managers to simultaneously interpret public emotion metrics and design compassionate communication frameworks [19].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [19] Lighterness A, Adcock M, Scanlon LA, Price G. Data Quality-Driven Improvement in Health Care: Systematic Literature Review. J Med Internet Res. 2024;26:e57615. source

      The Discussion (Outcomes; page unavailable) addresses interventions to improve health-care data quality, and the Results (Reported Outcomes; page unavailable) reports changes in data-quality measures. Searches for negative sentiment in crisis responses and for public emotion metrics and compassionate communication found no passage addressing the claimed communication strategy or its effect. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    Such pedagogical logic restructuring provides a theoretical pathway to resolve the persistent "knowing-doing gap" in hospital management education.

    “Such pedagogical logic restructuring provides a theoretical pathway to resolve the persistent “knowing-doing gap” in hospital management education [16, 17].”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [16] Choshi M. Addressing Challenges in Undergraduate Community Health Nursing Clinical: Kolb’s Experiential Learning Theory. J Nurs Educ. 2025;64(6):e31–4. source

      The abstract and Conclusion report that Kolb-guided reflection helped undergraduate community health nursing students connect clinical experience with concepts and envision applying their learning in practice. This supports the proposed pedagogical pathway, but the paper does not establish that it resolves a persistent knowing-doing gap in hospital management education. The Conclusion explicitly says its usefulness was not examined in acute care clinical settings. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [17] Nagel DA, Penner JL, Halas G, Philip MT, Cooke CA. Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review. BMC Med Educ. 2024;24(1):139. source

      The Conclusion (page not provided) says that theory-informed experiential learning can strengthen interprofessional practice education for pre-licensure healthcare students. That supports the general idea of a pedagogical pathway from learning to practice, but the paper does not address a persistent “knowing-doing gap” in hospital management education or claim to resolve it. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    The P-MASE model achieves a shift from "knowledge transmission" to "decision-wisdom cultivation" by embedding authentic managerial conflicts and leveraging digital analytics technologies.

    “The P-MASE model achieves a shift from “knowledge transmission” to “decision-wisdom cultivation” by embedding authentic managerial conflicts (e.g., interest negotiations in DRG cost containment) and leveraging digital analytics technologies (e.g., RoBERTa-based sentiment analysis) [15].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] Semary NA, Ahmed W, Amin K, Pławiak P, Hammad M. Improving sentiment classification using a RoBERTa-based hybrid model. Front Hum Neurosci. 2023;17:1292010. source

      The Introduction describes a RoBERTa-based sentiment-analysis model, supporting the sentence’s example of a digital analytics technology. It does not discuss P-MASE, managerial conflicts, DRG cost containment, or a shift from knowledge transmission to decision-wisdom cultivation. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Premisecitation

    Traditional written exams fail to measure complex, context-dependent decision-making and communication.

    “traditional written exams fail to measure complex, context dependent decision‑making and communication [5, 6]”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [5] Song X, Cleaves E, Gluzman E, Kotlyar B, Russo RA, Schilling DC, et al. A Scoping Review of Assessments in Undergraduate Medical Education: Implications for Residency Programs and Medical Schools. Acad Psychiatry. 2025;49(3):263–73. source

      The Discussion (page unavailable) distinguishes traditional MCQs from simulated and workplace assessments that assess communication and decision-making in context. But it does not say written exams fail to measure those abilities; the Results, “Types of Assessments” (page unavailable), describes a written Script Concordance Test used to assess clinical reasoning and multiple judgments. The categorical claim overstates the review. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [6] Chang O, Holbrook AM, Lohit S, Deng J, Xu J, Lee M, et al. Comparability of Objective Structured Clinical Examinations (OSCEs) and Written Tests for Assessing Medical School Students’ Competencies: A Scoping Review. Eval Health Prof. 2023;46(3):213–24. source

      The Introduction describes limitations of multiple-choice questions, and the Results report low correlations between written tests and OSCEs for the Communicator competency. But the Discussion > Implications says written exams are limited for some competencies, not that they fail to measure communication or complex, context-dependent decision-making; it also finds insufficient evidence that OSCEs are superior. Page numbers are unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • May combine two claims. 26
  • Classified as probably not a substantial claim. 23

  • May combine two claims.

    Premisecitation

    Current hospital management curricula overemphasize legacy theories and underrepresent emerging competencies such as DRG/DIP.

    “curricula overemphasize legacy theories and underrepresent emerging competencies such as Diagnosis-Related Groups (DRG) / Diagnosis-Intervention Packet (DIP) [2–4]”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [2] Cooper D, Holmboe ES. Competency-Based Medical Education at the Front Lines of Patient Care. N Engl J Med. 2025;393(4):376–88. source
    • cites [3] Wu Z, Huang Y, Lyu L, Huang Y, Ping F. The efficacy of simulation-based learning versus non-simulation-based learning in endocrinology education: a systematic review and meta-analysis. BMC Med Educ. 2024;24(1):1069. source

      The Background (page not available) discusses limitations of conventional teaching in endocrinology, not hospital management curricula. Searches for DRG/DIP and for the claimed emphasis on legacy theories found no passage in our copy addressing those points. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [4] Patel H, Perry S, Badu E, Mwangi F, Onifade O, Mazurskyy A, et al. A scoping review of interprofessional education in healthcare: evaluating competency development, educational outcomes and challenges. BMC Med Educ. 2025;25(1):409. source

      The Discussion’s ‘Implications for practice’ section recommends developing curricula that include interprofessional education competencies. It does not assess hospital management curricula or say they overemphasize legacy theories or underrepresent DRG/DIP. Searches for the claim’s wording and for DRG/DIP found no passage addressing those points; page numbers were unavailable in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Systematic evidence indicates that competency-based assessment and interdisciplinary training remain insufficient in medical and health management education.

    “Systematic evidence indicates that competency‑based assessment and interdisciplinary training remain insufficient in medical and health management education [8, 9].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [8] Alharbi NS. Evaluating competency-based medical education: a systematized review of current practices. BMC Med Educ. 2024;24(1):612. source

      The Results (Findings of the included studies; page unavailable) report that 63% of included studies did not state the standards used to evaluate competency-based curricula, and the Discussion identifies gaps in reported evaluation practices. This supports a concern about competency-based curriculum evaluation, but the paper does not establish that interdisciplinary training is insufficient or specifically assess health management education. Its finding about evaluation reporting is also narrower than a claim that competency-based assessment itself is insufficient. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [9] Tulshian P, Montgomery L, McCrory K, Theobald M, Matosich S, Wright O, et al. National Recommendations for Implementation of Competency-Based Medical Education in Family Medicine. Fam Med. 2025;57(4):253–60. source

      The section on residency administrators and coordinators (page unavailable) says the transition to competency-based medical education requires more frequent resident assessments and support for assessment systems. This supports a need to strengthen assessment in family medicine residency, but the paper does not establish a systematic finding that competency-based assessment remains insufficient across medical and health management education. The passages also do not address insufficiency in interdisciplinary training. (LLM, conf=0.80)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Technological dependency risks must be mitigated-when students overemphasize quantitative metrics (e.g., CMI values), individualized patient needs may be overlooked, necessitating strengthened medical humanities modules in future curricula.

    “Paradoxically, technological dependency risks must be mitigated—when students overemphasize quantitative metrics (e.g., CMI values), individualized patient needs may be overlooked, necessitating strengthened medical humanities modules in future curricula [24, 25].”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [24] Chen L, Zhang J, Zhu Y, Shan J, Zeng L. Exploration and practice of humanistic education for medical students based on volunteerism. Med Educ Online. 2023;28(1):2182691. source

      In “Problems of humanistic education” (page not provided), the paper says a “medical technology comes first” mentality neglects humanism in practice. In “The importance of humanistic education in teaching medical students” (page not provided), it calls for medical humanities in the curriculum. It does not address students’ reliance on quantitative metrics or CMI values as the mechanism by which individual patient needs are overlooked. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [25] Ambalavanan R, Snead RS, Marczika J, Towett G, Malioukis A, Mbogori-Kairichi M. Challenges and strategies in building a foundational digital health data integration ecosystem: a systematic review and thematic synthesis. Front health Serv. 2025;5:1600689. source

      The Discussion section on patient-centered care says that current EHR systems can lack tools for personalized care and patient-specific recommendations. It does not discuss students, overreliance on CMI or other quantitative metrics, or strengthening medical humanities curricula; its proposed response is better patient-centered digital tools. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    This randomized controlled trial was reported in accordance with the CONSORT 2010 statement.

    “This randomized controlled trial was reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement [14].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152(11):726–32. source

  • May combine two claims.

    Premisecitation

    Systematic interdisciplinary training is limited, weakening graduates' coordination across information, clinical, and administrative interfaces.

    “systematic interdisciplinary training is limited, weakening graduates’ coordination across information, clinical, and administrative interfaces [7].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [7] Oudbier J, Verheijck E, van Diermen D, Tams J, Bramer J, Spaai G. Enhancing the effectiveness of interprofessional education in health science education: a state-of-the-art review. BMC Med Educ. 2024;24(1):1492. source

      The Results (Guidance and reflection; page unavailable) identify scheduling and program sustainability as barriers to interprofessional education, while the Background links that education to collaborative skills. The review does not establish that systematic training is generally limited or that its absence weakens graduates’ coordination across information, clinical, and administrative interfaces. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    RoBERTa-driven sentiment analysis of crisis statements shifted communication training from post hoc scoring to in-process calibration-mirroring real-time monitoring paradigms in clinical diagnostics.

    “RoBERTa-driven sentiment analysis of crisis statements shifted communication training from post hoc scoring to in-process calibration—mirroring real-time monitoring paradigms in clinical diagnostics [22].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [22] Fuller K, Lupton-Smith C, Hubal R, McLaughlin JE. Automated Analysis of Preceptor Comments: A Pilot Study Using Sentiment Analysis to Identify Potential Student Issues in Experiential Education. Am J Pharm Educ. 2023;87(9):100005. source

      The Discussion (page unavailable) says the sentiment-analysis tool was used in real time to flag potential student progression issues, supporting the general idea of monitoring during training. But the Methods and Discussion describe analysis of pharmacy preceptor comments at midpoint evaluations using an R-based program and the sentimentr package—not RoBERTa analysis of crisis statements, a shift in communication training from post hoc scoring to in-process calibration, or a comparison with clinical diagnostics. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    Through departmental satisfaction modeling in budgetary simulations, students observed direct trade-offs (e.g., "a 10% increase in equipment investment raised surgical satisfaction by 6.2% but reduced medical department satisfaction by 3.8%"), thereby internalizing marginal utility principles and resource allocation compromises.

    “Through departmental satisfaction modeling in budgetary simulations, students observed direct trade-offs (e.g., “a 10% increase in equipment investment raised surgical satisfaction by 6.2% but reduced medical department satisfaction by 3.8%”), thereby internalizing marginal utility principles and resource allocation compromises [21].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [21] Feng X, Qu Y, Sun K, Luo T, Meng K. Identifying strategic human resource management ability in the clinical departments of public hospitals in China: a modified Delphi study. BMJ open. 2023;13(3):e066599. source

      Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • Rests on an assumption: The RoBERTa-based sentiment analysis provides an objective indicator of empathic risk-communication strategies.

  • May combine two claims.

    Study design and conductreasoning

    Several outcomes (teaching satisfaction, perceived job competence) relied on self-reported data, which are susceptible to social desirability and recall bias and may not fully reflect objectively measured competence.

    “several outcomes (teaching satisfaction, perceived job competence) relied on self-reported data, which are susceptible to social desirability and recall bias and may not fully reflect objectively measured competence.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The between-group differences in closed-book examination performance indicate stronger consolidation of core management knowledge and improved ability to apply this knowledge to practice-relevant scenarios.

    “These between-group differences were statistically significant (P < 0.001 for both domains), indicating stronger consolidation of core management knowledge and improved ability to apply this knowledge to practice-relevant scenarios”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The closed-book examination score is a valid measure of core management knowledge.

  • May combine two claims.

    Study design and conductreasoning

    P-MASE is a multi-component intervention; therefore, we cannot determine which specific elements (or their combinations) drove the observed improvements.

    “P-MASE is a multi-component intervention; therefore, we cannot determine which specific elements (or their combinations) drove the observed improvements.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The findings should be interpreted within the educational context of this course.

    “Findings should be interpreted within the educational context of this course.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    To mitigate instructor-related bias, instructors from both groups received standardized training before the trial, and teaching experience and academic rank were matched between groups.

    “To mitigate instructor-related bias, instructors from both groups received standardized training before the trial, and teaching experience and academic rank were matched between groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study was a prospective, randomized controlled educational trial conducted in accordance with the CONSORT-Edu guidelines.

    “This study was a prospective, randomized controlled educational trial conducted in accordance with the CONSORT-Edu guidelines to ensure methodological transparency and reproducibility.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The NLP (RoBERTa) model for empathy detection and the simulation platforms were locally developed and have not yet undergone extensive external validation across diverse datasets or institutions nor calibrated against widely used benchmark corpora or commercial platforms.

    “The NLP (RoBERTa) model for empathy detection and the simulation platforms were locally developed and have not yet undergone extensive external validation across diverse datasets or institutions nor calibrated against widely used benchmark corpora or commercial platforms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Outcomes were assessed immediately after the course and therefore represent short-term, course-based effects without evidence of long-term retention.

    “outcomes were assessed immediately after the course and therefore represent short-term, course-based effects without evidence of long-term retention.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Allocation concealment was achieved through sequentially numbered, opaque, sealed envelopes prepared by an independent administrator.

    “Allocation concealment was achieved through sequentially numbered, opaque, sealed envelopes prepared by an independent administrator.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Although allocation concealment and outcome assessor blinding were implemented, blinding of students and instructors was not feasible due to the nature of the educational intervention.

    “although allocation concealment and outcome assessor blinding were implemented, blinding of students and instructors was not feasible due to the nature of the educational intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The management-derived indicators used in this study are operationalized within standardized simulations or practice-proximal learning tasks and are interpreted as educational performance measures rather than real-world hospital operational outcomes.

    “are interpreted as educational performance measures rather than real-world hospital operational outcomes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The interdisciplinary team's emergency resource scheduling model demonstrated how synchronizing patient flow optimization with algorithmic rostering could overcome traditional management's "efficiency ceiling".

    “the interdisciplinary team’s emergency resource scheduling model demonstrated how synchronizing patient flow optimization with algorithmic rostering could overcome traditional management’s “efficiency ceiling“ [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] El-Rifai O, Garaix T, Augusto V, Xie X. A stochastic optimization model for shift scheduling in emergency departments. Health Care Manag Sci. 2015;18(3):289–302. source

  • May combine two claims.

    Study design and conductown data

    A baseline comparison was performed to ensure initial equivalence between groups; no significant differences were observed in age, sex, GPA, or prior management-related coursework.

    “A baseline comparison was performed to ensure initial equivalence between groups. No significant differences were observed in age, sex, GPA, or prior management-related coursework.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The broader implementation of the P-MASE model faces significant challenges, particularly regarding the integration of pedagogical tools with hospital management information systems.

    “Despite the demonstrated efficacy of the P-MASE model, its broader implementation faces significant challenges, particularly regarding the integration of pedagogical tools (e.g., DRG groupers, performance algorithms) with hospital management information systems.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    To control for type I error inflation due to multiple secondary outcomes, the Benjamini-Hochberg false discovery rate (FDR) procedure was applied.

    “To control for type I error inflation due to multiple secondary outcomes, the Benjamini–Hochberg false discovery rate (FDR) procedure was applied.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    This "management-as-pedagogy" technological translation establishes a replicable methodological framework for hospital management education.

    “This “management-as-pedagogy” technological translation establishes a replicable methodological framework for hospital management education [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Cahn A, Akirov A, Raz I. Digital health technology and diabetes management. J Diabetes. 2018;10(1):10–7. source

  • May combine two claims.

    Study design and conductown data

    Formal attendance was not systematically recorded for all sessions in either group; therefore, session-level attendance rates could not be computed as a measure of adherence.

    “Formal attendance was not systematically recorded for all sessions (e.g., no standardized roll-call or electronic sign-in across teaching activities) in either group. Therefore, we could not compute session-level attendance rates as a measure of adherence.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Outcome assessors in the trial were blinded to group allocation.

    “Outcome assessors were blinded to group allocation.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Educational equipoise remained regarding the magnitude and generalizability of benefit, supporting the use of a parallel-group randomized design.

    “Therefore, educational equipoise remained regarding the magnitude and generalizability of benefit, supporting the use of a parallel-group randomized design.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study evaluated P-MASE as an integrated, multicomponent intervention delivered as a single package; the effects of individual components were not tested separately.

    “This study evaluates P-MASE as an integrated, multicomponent intervention delivered as a single package; the effects of individual components were not tested separately.”
    • Also stated in: § Teaching Interventions · plain
      “This trial evaluated P-MASE as an integrated, multi-component pedagogy; it was not designed to isolate the independent effects of individual components.”
    • Also stated in: § Teaching Interventions · plain
      “P-MASE is a descriptive acronym for a bundled, five-component pedagogy (PBL, ML, AL, SL, EL); the study was not designed to estimate component-specific effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    A cross-over design was considered but deemed inappropriate because educational exposure is not readily reversible, substantial carry-over would be expected across periods, and interaction within a single cohort would increase contamination risk.

    “A cross-over design was considered but deemed inappropriate because educational exposure is not readily reversible, substantial carry-over would be expected across periods, and interaction within a single cohort would increase contamination risk.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Missing data were minimal (< 5%) and handled by complete-case analysis.

    “Missing data were minimal (< 5%) and handled by complete-case analysis.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Participants were stratified by major and randomly assigned in a 1:1 ratio to either the experimental group (P-MASE pedagogy, n = 60) or the control group (traditional instruction, n = 60) using computer-generated permuted blocks.

    “Participants were stratified by major and randomly assigned in a 1:1 ratio to either the experimental group (P-MASE pedagogy, n = 60) or the control group (traditional instruction, n = 60) using computer-generated permuted blocks.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The innovation of this study lies in transforming hospital management tools-such as the Analytic Hierarchy Process (AHP)-into pedagogical enablers.

    “The innovation of this study lies in transforming hospital management tools—such as the Analytic Hierarchy Process (AHP)—into pedagogical enablers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Cultivating such competencies necessitates authentic conflict scenarios where students experience the complete decision-making continuum-from data insight generation to stakeholder interest harmonization.

    “Cultivating such competencies necessitates authentic conflict scenarios where students experience the complete decision-making continuum—from data insight generation to stakeholder interest harmonization.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Outside of the intervention, students followed the standard curriculum of the program; because randomization occurred within the same cohort, exposure to other learning activities beyond this course was expected to be comparable between groups.

    “Outside of the intervention, students followed the standard curriculum of the program; because randomization occurred within the same cohort, exposure to other learning activities beyond this course was expected to be comparable between groups.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The results should be interpreted as educational effects observed within a course-based and simulation-supported learning environment, and should not be taken as evidence of improved real-world hospital management effectiveness or policy execution.

    “Importantly, these results should be interpreted as educational effects observed within a course-based and simulation-supported learning environment, and should not be taken as evidence of improved real-world hospital management effectiveness or policy execution.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The simulation-based tasks and NLP-assisted analysis validly measure applied reasoning and decision-making.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    To minimize contamination between groups, separate teaching assistants were assigned, classes were scheduled at different times and locations, and LMS access was restricted to group-specific materials and forums.

    “To minimize contamination between groups, separate teaching assistants were assigned, classes were scheduled at different times and locations, and learning management system (LMS) access was restricted to group-specific materials and forums.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The teaching satisfaction questionnaire was developed for this study based on prior hospital management education literature and expert consultation.

    “The teaching satisfaction questionnaire (Table 3) was developed for this study based on prior hospital management education literature and expert consultation.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    To minimize expectancy effects, students were informed that two teaching formats were being compared as part of routine course delivery, but they were not informed of the study hypothesis or any pilot findings suggesting superiority of either format.

    “To minimize expectancy effects, students were informed that two teaching formats were being compared as part of routine course delivery, but they were not informed of the study hypothesis or any pilot findings suggesting superiority of either format.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was prospectively registered in the Chinese Clinical Trial Registry (ChiCTR2400082568).

    “The study was prospectively registered in the Chinese Clinical Trial Registry (ChiCTR2400082568).”
    Quote in the paperNot a substantial claim
38 of 38

  • The paper relies on this without support.

    The closed-book examination score is a valid measure of core management knowledge.

    “Primary outcome: Closed-book examination score.”

  • The paper relies on this without support.

    The teaching satisfaction questionnaire items validly measure course practicality, resource support, and confidence in job competence.

    “It included three items—course practicality, resource support, and confidence in job competence—rated on a 5-point Likert scale.”

  • The paper relies on this without support.

    The simulation-based tasks and NLP-assisted analysis validly measure applied reasoning and decision-making.

    “Several management-derived outcomes (e.g., DRG grouping accuracy, simulated departmental satisfaction, and simulated ED waiting-time reduction) were generated within standardized simulations or practice-proximal learning tasks and are reported as educational performance indicators rather than real-world operational metrics.”

  • The paper relies on this without support.

    The control group received standard instruction that is a valid comparator for traditional pedagogy.

    “compared with standard instruction”

  • The paper relies on this without support.

    The AHP-enabled multi-criteria structuring of trade-offs is a valid method for evaluating learners’ prioritization rationale.

    “In the budgeting/resource-allocation simulations, the use of AHP-enabled multi-criteria structuring of trade-offs, allowing evaluation of learners’ prioritization rationale and consistency of judgments under constraints.”

  • The paper relies on this without support.

    The RoBERTa-based sentiment analysis provides an objective indicator of empathic risk-communication strategies.

    “For crisis communication, NLP-assisted analysis of standardized written statements provided an objective indicator of empathic risk-communication strategies, complementing other competency assessments.”
6 of 6

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Evaluation dimension has two different names

    Minor

    The text names Learning Process as one of the four evaluation dimensions, but Table 2 labels the corresponding dimension Teaching Process.

1 of 1

Cites

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Related

Authors
Zhang, Y., Li, W., Zhang, C., Wang, Y., & Feng, S.
Affiliations
  • Xuzhou Medical College (CN)
  • China University of Mining and Technology (CN)
  • Affiliated Hospital of Xuzhou Medical College (CN)
Corresponding author
  • Wang, Yawei
  • Feng, Shuo
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2026-03-06
Volume
26
Issue
1
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-026-08948-8
PMC
PMC13078037
OpenAlex
W7133667134
Cited by
0
References
25
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • The Construction Project of High Level Hospital of Jiangsu Province ((GSPJS202515))
  • Paired Assistance Scientific Research Project by The Affiliated Hospital of Xuzhou Medical University ((FXJDBF2024204))
  • The Major Program in Philosophy and Social Sciences of Jiangsu Provincial Colleges and Universities ((2021SJZDA1350))
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Education › Problem and Project Based Learning
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
Keywords
hospital management education, problem-based learning, mobile learning, authentic learning, experiential learning, social learning, knowledge-practice gap, medical students, simulation-based assessment, diagnosis-related groups, departmental budgeting, emergency department waiting times, student engagement, teaching satisfaction
MeSH terms
Educational Measurement, Female, Humans, Male, Prospective Studies, Problem-Based Learning

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-29.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-29.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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