# Clinical Clu‐Dr: A Scalable Gamified Tool for Clinical Reasoning Practice

## TL;DR

Clinical Clu-Dr is a gamified tool designed to help preclinical medical students practice clinical reasoning in a scalable and engaging way.

## Contribution

The novel contribution is a low-resource, gamified clinical reasoning tool that can be delivered by both clinical and non-clinical educators.

## Key findings

- Students reported higher engagement and confidence in clinical reasoning after using Clinical Clu-Dr.
- Facilitators noted inclusive engagement but faced initial challenges adapting to a student-led format.
- The tool's success depends on aligning clues with basic science content and collaboration between educators.

## Abstract

Early development of clinical reasoning (CR) is essential but difficult to embed within preclinical medical curricula. Limited clinical exposure can hinder integration of basic and clinical sciences, whereas tutor‐led question‐and‐answer formats may limit engagement, and case‐based approaches often rely on clinical facilitators. Clinical Clu‐Dr (CC) was developed as a low‐resource, gamified approach to support early CR practice in a scalable format deliverable by both clinical and non‐clinical educators.

Adapting the Cluedo concept, CC presents learners with a patient, potential diagnoses and 14–16 mixed‐format ‘clues’ (e.g., lab results, imaging and lifestyle data). In small groups, students analyse and share clues, construct differential diagnoses and confirm a final diagnosis. The design draws on scaffolded learning, cognitive integration and gamification.

Evaluation combined post‐module student surveys (n = 128) with reflective facilitator feedback (n = 6; clinical/non‐clinical) collected across the delivery of 78 sessions. Surveys captured perceptions of engagement, confidence and clinical integration of the foundational biomedical science teaching, whereas facilitator reflections explored feasibility and delivery. Students reported higher perceived engagement and confidence. Facilitators noted initial challenges adapting to a student‐led format but reported strong, inclusive engagement.

CC provides a scalable approach for embedding opportunities for CR practice in preclinical education. Although findings are based on self‐reported perceptions, the approach supports engagement and confidence. Successful implementation depends on careful alignment of clues with the module's basic science content and close collaboration between clinical and non‐clinical educators. Clinical expertise was not required for effective delivery.