Do Leaderboards Improve Self-regulated Training in a Gamified Dermoscopy Training App? A Randomized, Controlled Trial.

Subjects will be recruited through advertisements in online forums for medical students across all four Danish medical schools.

Upon recruitment, subjects will be included via an on-boarding online meeting. They will be introduced to the study and the training platform, and will, if they choose to participate, complete a consent form, a questionnaire of baseline information (age, gender, university semester, dermatological experience) and a 12-case validated diagnostic pre-test.

Participants will be randomized to study groups via sequential block randomization.

The intervention will last for seven days. Depending on group randomization, participants will on day two through seven either receive a group daily message using an internet-based messaging service (see appendix) and view a daily updated leaderboard ranking, only receive the group daily message, or receive neither.

Within the app, participants are able to train dermoscopy diagnosis through sessions of 10 cases. If participants correctly diagnose 8/10 cases, they will progress to the next session with new 10 cases of a higher difficulty, and so on. If participants do not reach a certain diagnostic accuracy, they will repeat their current level with 10 new cases until they are able to progress. There are a total of 6 session levels. Each case is assigned a difficulty level from one to four, calculated based on the percentage of times it has been answered correctly by previous users. In each session, participants are presented with 40% cases at their current level, 20% of an easier difficulty, 20% of a higher difficulty, and 20% cases of an unspecified difficulty.