Integrating Mind Mapping with Virtual Simulation: A Cognitive Scaffolding for Clinical Reasoning in Residency

Objective: To investigate the efficacy of Mind Mapping-Virtual Simulation (MM-VSP) in enhancing clinical reasoning and procedural application competencies among residents. Methods: A retrospective study was conducted with second-year residents (n=80) during their obstetrics and gynecology (OB/GYN) rotations (January 2023 - December 2024). Participants were categorized to either the study group (n=40, receiving MM-VSP training) or the control group (n=40, receiving VSP training), all trained by a unified faculty team using identical clinical cases. Primary outcomes-theoretical knowledge, clinical competency, and learner satisfaction-were extracted from anonymized annual competency assessments. Results: Baseline characteristics were balanced between groups (all p > 0.05). No group difference was found in theoretical knowledge (p = 0.76). The study group demonstrated higher scores in History Taking (p < 0.01, Cohen's d = 0.92), Clinical Reasoning (p < 0.01, r = 0.47), and OB/GYN Specialty Skills (p < 0.01, Cohen's d = 0.88). Most subdomains of clinical reasoning favoured the study group (p < 0.01, r = 0.41-0.53). Additionally, the study group reported higher instructional satisfaction (p < 0.01, r = 0.36) and higher perceived learning outcomes (p < 0.01, r = 0.68). Conclusion: In this retrospective study, MM-VSP was associated with better complex reasoning and procedural skills in OB/GYN residents, without additional cognitive load.