Objective: To explore the practical application effect of problem‑based learning (PBL) combined with case simulation in the standardized training of geriatric residents and its impact on the trainees’ clinical comprehensive ability. Methods: From January 2020 to December 2024, 80 trainees who completed their training in the Department of Geriatrics of our hospital were enrolled and randomly divided into two groups, with 40 cases in each. The control group received conventional film‑reading teaching, while the observation group received PBL combined with case‑simulation film‑reading teaching; both groups underwent an 18‑month training period. Results: Compared with the control group, the observation group had significantly higher scores in theoretical assessment, practical skills, film‑reading ability, and case analysis (p < 0.05), as well as better performance in clinical reasoning ability, overall coordination, information processing, and interpersonal communication (p < 0.05), and also reported higher teaching satisfaction (p < 0.05). Conclusion: The teaching model of PBL combined with case simulation can effectively improve the theoretical knowledge, clinical thinking ability, and post competence of geriatric residents, and thus deserves wider promotion.