Xiaolong Tang,1,* Amin Li,1,* Lifa Xu,1 Ru Cai,1 Shuping Zhou2 

1Medical College, Anhui University of Science and Technology, Huainan, 232001, People’s Republic of China; 2The First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People’s Hospital), Huainan, 232003, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ru Cai, Email lxhcrlh@aliyun.com Shuping Zhou, Email 710120101@qq.com

Background: Undergraduate medical education in China faces significant gaps in integrating theory with practice, with 32.7% of graduates requiring remedial procedural training.
Objective: To implement and evaluate a competency-based reform targeting problem-solving and practical skills.
Methods: In a single-center RCT (Anhui, China; 2023– 2024), 180 medical undergraduates were randomized to control (traditional pedagogy, n = 90) or intervention groups (reformed curriculum: 40% practice-oriented content, integrated PBL/TBL/CBT). Assessments used OSCE-aligned tools (clinical checklists: Cronbach’s α = 0.89; case analysis rubrics: κ = 0.85).
Results: Intervention group showed significant improvements: theoretical scores (78.7 ± 3.9 vs 68.3 ± 4.8; t = – 17.78, P < 0.01, d = 2.39); clinical skill excellence (80.4% vs 60.2%; χ² = 25.93, P < 0.001, OR = 2.67); PBL adaptability (70.1% vs 42.3%; χ² = 9.0, P < 0.05).
Conclusion: This reform bridges theory-practice gaps and enhances clinical decision-making, requiring institutional support for scalability.

Keywords: medical education reform, clinical problem-solving, competency-based education, curriculum innovation, randomized trial