Observation on the Application Effect of Clinical Thinking-Oriented Case Discussion Teaching in the Standardized Residency Training of Internal Medicine
Objective: To observe the application value of a clinical thinking‑oriented case discussion teaching model in the standardized residency training of internal medicine, and to provide practical evidence for optimizing the teaching program and enhancing residents’ comprehensive clinical competency. Methods: A total of 106 residents who rotated through the internal medicine department in a tertiary hospital from July 2023 to June 2025 were selected and randomly divided into an observation group (n = 53) and a control group (n = 53) using a random number table. The control group received conventional teaching, consisting mainly of theoretical lectures and routine teaching ward rounds; the observation group additionally received clinical thinking‑oriented case discussion teaching over a 6‑month period. The two groups were compared in terms of multi‑dimensional clinical thinking scores (evidence‑based retrieval ability, differential diagnosis construction, treatment plan weighing, risk prediction and adverse event identification, and total clinical thinking score), post competency assessment scores (sub‑scores for clinical practice, doctor‑patient communication, multidisciplinary collaborative management, and quality of medical documentation, as well as total competency score), self‑directed learning behaviors (proactive guideline and literature searching, proactive case‑thinking note‑taking, and proactive diagnostic questioning), and teaching satisfaction. Results: All scores in the observation group were significantly higher than those in the control group (all P < 0.05), including overall teaching satisfaction. Conclusion: The implementation of clinical thinking‑oriented case discussion teaching in internal medicine residency training can strengthen residents’ evidence‑based reasoning and risk prediction abilities, enhance comprehensive post competency, and improve self‑directed learning status, with positive teaching feedback. This approach is suitable for broader application in internal medicine residency training bases.
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