Evaluation of MicroSage: A Web-Based Clinical Reasoning Support Tool for Microbiology Education in Resource-Limited Settings - A Pilot Observational Study

Background: Clinical microbiology education traditionally presents organisms in isolation, without training students to reason from observable findings — such as gram stain results, infection site, patient age, and symptoms — toward a differential diagnosis. This gap leaves students underprepared for clinical laboratory reasoning. Objective: To evaluate the accuracy, usability, and educational utility of MicroSage, a freely accessible web-based educational clinical reasoning support tool designed to bridge the gap between instructive microbiology education and applied clinical reasoning. Methods: MicroSage was developed using a React frontend and Python FastAPI backend, incorporating a weighted multi-parameter scoring engine across 30 clinically relevant organisms and 6 infection sites. A cross-sectional validation study was conducted among undergraduate students, academic faculty (LifeScience department), and clinical laboratory professionals in Navi Mumbai, Maharashtra, India. Results: A total of 40 participants were included. MicroSage achieved a primary accuracy of 77.5%, with all remaining cases demonstrating partial accuracy within the top three results. Conclusion: MicroSage represents a low-cost, accessible solution for microbiology education that supports clinical reasoning skill development. The tool is freely available at microsage.vercel.app and requires no installation.