{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:54:21Z","timestamp":1789437261848,"version":"build-2803163510"},"reference-count":56,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Competency-based medical education (CBME) in India emphasizes early competency formation, higher-order cognitive processing, and self-directed learning. Although e-learning is widely adopted, there is limited evidence on structured e-modules explicitly designed using Bloom taxonomy and the Miller pyramid for Indian MBBS students.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to design, validate, implement, and evaluate CBME-aligned e-modules for first-year MBBS foundational subjects (anatomy, physiology, and biochemistry) and to compare their effectiveness with traditional teaching on cognitive, psychomotor, and affective learning outcomes using Kirkpatrick levels 1 and 2.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A randomized controlled study was conducted among 690 first-year medical undergraduates (control: n=370; intervention: n=320). The intervention group received Sharable Content Object Reference Model\u2013based interactive e-modules through Moodle (Modular Object-Oriented Dynamic Learning Environment) in addition to standard lectures, while the control group received lectures only. e-Modules were designed using Bloom taxonomy and the Miller pyramid, validated by internal and external experts, and implemented following Kern 6-step approach. Learning outcomes were assessed using structured feedback (Kirkpatrick level 1) and end-of-block internal assessments comprising multiple choice questions, short notes, and objective structured clinical examinations (Kirkpatrick level 2).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Students in the intervention group performed significantly better across all cognitive levels compared with the control group: remember (mean 6.52, SD 2.24 vs mean 5.26, SD 2.89;\n P<\/jats:italic>\n <.001), understand (mean 2.92, SD 1.45 vs mean 2.55, SD 1.13;\n P<\/jats:italic>\n <.001), apply (mean 3.43, SD 1.06 vs mean 2.56, SD 1.08;\n P<\/jats:italic>\n <.001), and analyze (mean 3.01, SD 0.83 vs mean 2.53, SD 1.11;\n P<\/jats:italic>\n <.001). Psychomotor scores (objective structured clinical examination manipulation: mean 4.55, SD 1.12 vs mean 4.10, SD 1.42;\n P<\/jats:italic>\n <.001) and affective domain scores (mean 3.02, SD 0.81 vs mean 2.03, SD 0.81;\n P<\/jats:italic>\n <.001) were also significantly higher in the intervention group. Subgroup analysis showed the largest gains among medium achievers across domains.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CBME-aligned e-modules significantly enhanced student performance in cognitive, psychomotor, and affective domains compared with traditional teaching alone, with particularly pronounced benefits for medium achievers. Well-designed e-modules represent a scalable, adaptable strategy to support CBME implementation across diverse medical education settings in India.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/84339","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T18:01:00Z","timestamp":1775584860000},"page":"e84339-e84339","source":"Crossref","is-referenced-by-count":2,"title":["E-Learning Modules Based on Bloom Taxonomy and the Miller Pyramid for First-Year Indian Medical Students: Randomized Controlled Study in Medical Education"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1536-8433","authenticated-orcid":false,"given":"Archana","family":"Prabu 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