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Medical EducationAI-TUINANCT07767916

AI-Assisted Feedback for Learning Standardized Tuina Skills

A study testing AI-Supported Personalized Feedback, Sensor-Based Data Feedback and Traditional Instructor Feedback in people with Medical Education and Clinical Skills, run by Zhejiang University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this educational study is to determine whether personalized feedback generated using sensor data and generative artificial intelligence (AI) can improve the learning of standardized Tuina skills among rehabilitation trainees. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Medical Education, Clinical Skills
What is being tested?
AI-Supported Personalized Feedback, Sensor-Based Data Feedback and Traditional Instructor Feedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
81 participants
Where
No sites listed yet
Study dates
13 Aug 2026to 1 Aug 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Aged 18 years or older.
  • Currently enrolled in or receiving training in rehabilitation medicine, physical therapy, rehabilitation therapy, or a related health profession.
  • Has not previously achieved the predefined competency standard for the standardized Tuina skill evaluated in this study.
  • Able to understand the study instructions and independently complete the training tasks and study questionnaires.
  • Able and willing to attend all scheduled training sessions and the four-week follow-up assessment.
  • Willing to participate voluntarily and provide written informed consent.

Who cannot join

  • Current acute injury, clinically significant pain, or functional limitation involving the hand, wrist, upper limb, shoulder, neck, or lower back that may interfere with repeated manual skill practice.
  • Previous systematic training in the same standardized Tuina technique with performance at or above the predefined competency standard.
  • Any medical, physical, cognitive, or psychological condition that, in the investigator's judgment, may make participation unsafe or prevent valid completion of the study procedures.
  • Unable to understand the study procedures or provide informed consent.
  • Direct involvement in the design, randomization, intervention delivery, outcome assessment, data management, or statistical analysis of this study.
  • Concurrent participation in another training study that may substantially affect performance of the standardized Tuina skill.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Xing-Chen Zhou, Ph.D. contact

+86-18370133761

zhouxingchen0210@163.com

About this study

Official title: Effects of Sensor- and Generative AI-Supported Personalized Feedback on the Acquisition of Standardized Tuina Skills Among Rehabilitation Trainees: A Randomized Controlled Trial

The goal of this educational study is to determine whether personalized feedback generated using sensor data and generative artificial intelligence (AI) can improve the learning of standardized Tuina skills among rehabilitation trainees. Tuina is a form of manual therapy that requires learners to control the location, force, rhythm, and consistency of their hand movements.

A total of 81 rehabilitation trainees will be randomly assigned to one of three training groups: AI-supported personalized feedback, sensor-based data feedback without AI-generated recommendations, or traditional instructor feedback. All groups will receive the same standardized demonstration, training tasks, practice duration, and number of practice sessions.

Read more

The main question is whether trainees receiving AI-supported personalized feedback achieve better retention of standardized Tuina skills four weeks after training. The researchers will also compare immediate skill performance, force and rhythm control, transfer of skills to a related task, learning efficiency, self-efficacy, cognitive load, satisfaction, and the safety and acceptability of AI-generated feedback.

Skill performance will be assessed using a blinded Objective Structured Clinical Examination (OSCE) and objective sensor-based measurements. The study activities will be conducted using a mechanical simulation model and a pressure-sensing system, rather than on patients.

Read the detailed description

Manual rehabilitation skills are complex sensorimotor skills that require learners to integrate anatomical localization, body mechanics, force control, rhythm, consistency, safety, and professional communication. Conventional instruction generally relies on teacher demonstration, observation, and verbal feedback. This approach may be limited by instructor availability and may not provide continuous and objective information about force and rhythm during each practice attempt.

Sensor-based training systems can quantify performance characteristics such as mean force, deviation from the target force, force variability, operating frequency, rhythm variability, and the proportion of time spent within the target range. However, novice learners may have difficulty converting numerical data and performance curves into specific strategies for improvement. Generative AI may help translate objective performance data into immediate, structured, and actionable feedback.

This is a single-center, prospective, assessor-masked, three-arm, parallel-group randomized educational study. Eighty-one rehabilitation trainees will be allocated in a 1:1:1 ratio to an AI-supported personalized feedback group, a sensor-based data feedback group, or a traditional instructor feedback group. All participants will receive the same instructional materials, standardized demonstration, safety instructions, practice tasks, number of practice opportunities, and total training time.

The AI-supported personalized feedback will follow a structured task-gap-action format. The feedback will identify the target skill, describe the difference between the trainee's measured performance and the predefined target, and provide specific recommendations for the next practice attempt. The AI system will receive only coded sensor measurements and predefined task standards. It will not receive participant names, student identification numbers, facial images, voices, patient information, or clinical records. AI-generated feedback will be restricted to educational use and will be subject to instructor oversight and predefined safety rules.

Assessments will be performed at baseline, immediately after the training intervention, and four weeks after training. The primary outcome is the total OSCE score four weeks after training, representing retention of the standardized Tuina skill. OSCE performances will be coded and evaluated independently by assessors who are unaware of group allocation. Objective sensor-based measures will be used to evaluate force accuracy, force variability, rhythm accuracy, rhythm stability, and the proportion of performance within the target range.

Secondary evaluations will include immediate OSCE performance, performance on a related transfer task, the number of practice attempts required to reach a predefined competency standard, learning self-efficacy, cognitive load, learning engagement, satisfaction, trust in AI feedback, instructor feedback time, and the frequency of AI-generated feedback requiring instructor modification or correction.

The study is an educational intervention and will not involve patient treatment, invasive procedures, biological specimen collection, or clinical decision-making. All research-related Tuina practice will be performed on a mechanical simulation model equipped with a pressure-sensing system.

Being tested
AI-Supported Personalized Feedback, Sensor-Based Data Feedback, Traditional Instructor Feedback
Keywords
Artificial Intelligence, Generative Artificial Intelligence, Rehabilitation Education, Health Professions Education, Tuina, Manual Therapy Skills, Sensor-Based Feedback, Personalized Feedback, Deliberate Practice, Objective Structured Clinical Examination

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AI-Supported Personalized FeedbackBehavioural

    Participants will complete four standardized training sessions over two weeks, with each session lasting approximately 45 to 60 minutes. A pressure-sensing system will measure force accuracy, force variability, operating frequency, rhythm stability, and time within the target range. After each practice attempt, a generative AI system will provide feedback using a structured task-gap-action format. The feedback will describe the target task, identify differences between measured performance and the predefined standard, and recommend specific actions for the next practice attempt. AI output will be restricted to educational use and overseen by instructors.

  • Sensor-Based Data FeedbackBehavioural

    Participants will complete four standardized training sessions over two weeks, with each session lasting approximately 45 to 60 minutes. After each practice attempt, participants will view numerical sensor measurements, force-time curves, rhythm information, and predefined target ranges. No generative AI interpretation, personalized action plan, or AI-generated recommendation will be provided.

  • Traditional Instructor FeedbackBehavioural

    Participants will complete four standardized training sessions over two weeks, with each session lasting approximately 45 to 60 minutes. Instructors will observe performance and provide conventional verbal feedback based on the standardized teaching protocol. Participants will not receive sensor-derived performance displays or AI-generated feedback.

Study groups in NCT07767916
Study groupRoleWhat they receive
AI-Supported Personalized FeedbackExperimentalParticipants will receive standardized Tuina instruction and practice using a mechanical simulation model equipped with a pressure-sensing system. After each practice attempt, participants will receive objective sensor measurements and personalized, actionable feedback generated by a generative AI system under instructor supervision.
Receives: Behavioral: AI-Supported Personalized Feedback
Sensor-Based Data FeedbackActive comparatorParticipants will receive the same standardized Tuina instruction, practice tasks, number of practice opportunities, and training duration as the experimental group. After each practice attempt, participants will receive sensor-generated numerical measurements, performance curves, and target ranges, without AI-generated interpretation or personalized recommendations.
Receives: Behavioral: Sensor-Based Data Feedback
Traditional Instructor FeedbackActive comparatorParticipants will receive the same standardized Tuina instruction, practice tasks, number of practice opportunities, and training duration as the other groups. Feedback will be provided through conventional instructor observation and verbal guidance. Participants will not view sensor-generated performance data or AI-generated recommendations.
Receives: Behavioral: Traditional Instructor Feedback

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Standardized Tuina Skill Performance Measured by Total OSCE Score

    Participants will complete a standardized Objective Structured Clinical Examination (OSCE) assessing anatomical localization, body mechanics, force control, rhythm, procedural consistency, safety, communication, and overall performance. Coded performance recordings will be independently scored by two assessors who are unaware of group allocation. The mean of the two assessors' total scores will be used for analysis. Higher scores indicate better standardized Tuina skill performance.

    Measured: Four weeks after completion of the training intervention

Secondary outcomes (8)
  1. Immediate Standardized Tuina Skill Performance Measured by Total OSCE Score

    Standardized Tuina skill performance will be independently evaluated by two masked assessors using the same OSCE scoring rubric as the primary outcome. The mean of the two assessors' total scores will be analyzed. Higher scores indicate better performance.

    Measured: Immediately after completion of the training intervention

  2. Absolute Error From the Target Force

    The pressure-sensing system will calculate the absolute difference, in newtons, between the participant's mean applied force and the predefined target force. A lower absolute error indicates greater force accuracy.

    Measured: Baseline, immediately after the intervention, and four weeks after the intervention

  3. Coefficient of Variation of Applied Force

    Force stability will be calculated as the standard deviation of applied force divided by the mean applied force and expressed as a percentage. A lower coefficient of variation indicates more stable force control.

    Measured: Baseline, immediately after the intervention, and four weeks after the intervention

  4. Absolute Error From the Target Operating Frequency

    The absolute difference, in hertz, between the participant's measured operating frequency and the predefined target frequency will be calculated. A lower value indicates greater rhythm accuracy.

    Measured: Baseline, immediately after the intervention, and four weeks after the intervention

  5. Proportion of Practice Time Within the Target Performance Range

    The pressure-sensing system will calculate the percentage of recorded practice time during which both applied force and operating frequency remain within the predefined acceptable target ranges. Values range from 0% to 100%, with higher percentages indicating better performance.

    Measured: Baseline, immediately after the intervention, and four weeks after the intervention

  6. Performance on a Related Tuina Skill Transfer Task

    Participants will perform a related standardized Tuina task that was not practiced in the same form during training. Performance will be evaluated using a predefined transfer-task rubric by assessors unaware of group allocation. Higher scores indicate better transfer of the learned skill.

    Measured: Immediately after the intervention and four weeks after the intervention

  7. Number of Practice Attempts Required to Reach the Competency Standard

    The number of practice attempts required for a participant to first meet the predefined competency threshold will be recorded. A lower number of attempts indicates greater learning efficiency. Participants who do not reach the threshold will be recorded as not achieving competency during the intervention period.

    Measured: During the four training sessions over two weeks

  8. Proportion of AI-Generated Feedback Requiring Instructor Modification

    For participants in the AI-supported feedback arm, instructors will record whether each AI-generated feedback message is accepted without modification, modified for accuracy or clarity, or blocked because it is potentially inappropriate or unsafe. The outcome will be calculated as the percentage of AI-generated feedback messages requiring modification or blocking.

    Measured: During the four training sessions over two weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Aug 2026
  2. Study start13 Aug 2026 (estimated)
  3. Primary completion1 May 2027 (estimated)
  4. Study completion1 Aug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomly assigned in a 1:1:1 ratio to one of three parallel educational intervention groups: AI-supported personalized feedback, sensor-based data feedback, or traditional instructor feedback. Participants will remain in their assigned group throughout the study, with no crossover between groups.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
81 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07767916
Sponsor's protocol ID
No. 2026JX0812
Acronym
AI-TUINA
Status last verified
Aug 2026
First submitted
12 Aug 2026
Last updated
17 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data underlying the results reported in the primary publication will be considered for sharing. The shared dataset may include participant demographic and educational characteristics, randomized group assignment, assessment time points, OSCE scores, derived sensor-based performance measures, questionnaire scores, and adverse event data. Direct identifiers, the participant identification key, facial images, audio recordings, raw performance videos, identifiable free-text responses, and raw AI interaction logs will not be shared.

Questions about this trial

What is this clinical trial studying?

A study testing AI-Supported Personalized Feedback, Sensor-Based Data Feedback and Traditional Instructor Feedback in people with Medical Education and Clinical Skills, run by Zhejiang University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 17 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Xing-Chen Zhou, Ph.D. (+86-18370133761, zhouxingchen0210@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Standardized Tuina Skill Performance Measured by Total OSCE Score (time frame: Four weeks after completion of the training intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Aug 2026.

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AI-TUINA Clinical Trial NCT07767916 | AzTrials