Evaluating Medical Biochemistry Teaching and Learning Through Simulation: A Mixed-Methods, Quasi-Experimental Study in Medical Students in Ecuador

Biochemistry is fundamental to medical education; however, traditional teaching may limit clinical integration and long-term retention. Although clinical simulation has emerged as a strategy to promote active and contextualized learning, its effectiveness in biochemistry teaching remains limited. This study evaluated the impact of clinical simulation on cognitive knowledge, technical skills, and communication among first-semester medical students compared with traditional practical instruction. A mixed-methods, quasi-experimental design was used with 404 students from the Central University of Ecuador, allocated to a simulation group ( n = 205) or control group ( n = 199). Both groups received identical theoretical instruction. Outcomes were assessed at baseline and post-intervention in four domains: theoretical knowledge, clinical interpretation, technical skills, and communication. Student satisfaction and perceptions were evaluated using surveys and qualitative analysis. Both groups improved after sessions; however, the simulation group demonstrated significantly greater gains across all domains (theoretical knowledge, clinical interpretation, technical skills, and communication). Students in the simulation-based group also achieved higher success rates in blood-sampling procedures, completed tasks in less time, and reported more positive emotions, reduced anxiety, increased confidence, and greater satisfaction. Simulation-based education appears to be an effective and feasible approach to enhance knowledge, technical, communication skills, and student motivation in medical biochemistry teaching.