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已发表论文
认知学徒制教学模式在重症医学住院医师规范化培训中的应用：一项随机临床试验
Authors Zhang Y, Xia X, Zeng J, Zhang L, Guo C
Received 13 May 2025
Accepted for publication 24 September 2025
Published 4 October 2025 Volume 2025:16 Pages 1825—1833
DOI https://doi.org/10.2147/AMEP.S540031
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Md Anwarul Azim Majumder
Yuxuan Zhang,1 Xun Xia,1 Jing Zeng,2 Limei Zhang,2 Chuan Guo1,3
1Department of Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 2School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 3School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
Correspondence: Chuan Guo, Department of Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China, Email guochu991020@163.com
Objective: This study explores the effectiveness of the cognitive apprenticeship teaching model in fostering critical thinking and clinical reasoning and decision-making skills among medical residents during their rotations in the critical care medicine department.
Methods: We selected medical residents undergoing standardized training during their rotations in the critical care medicine department at the First Affiliated Hospital of Chengdu Medical College as the study participants. We conducted a two-month clinical practice course using the cognitive apprenticeship teaching model and evaluated its outcomes.
Results: Prior to the teaching intervention, there were no significant statistical differences (P > 0.05) in the general information and pre-teaching assessment scores related to critical thinking and clinical reasoning and decision-making skills between the two groups of students. However, after the training, the experimental group demonstrated significant improvements in four dimensions: truth-seeking, systematic skills, confidence in critical thinking, and curiosity, compared to the control group. Furthermore, in the Mini-CEX assessment, the experimental group scored higher in six dimensions: medical history inquiry, humane care, communication skills, clinical judgment, organizational efficiency, and overall clinical competency, with statistically significant differences (P < 0.05) compared to the control group.
Conclusion: The cognitive apprenticeship teaching model enhances the critical thinking and clinical reasoning and decision-making skills of resident physicians, thereby improving the effectiveness of medical education.
Plain Language Summary: Objective: This study tested a teaching method called “cognitive apprenticeship” to see if it helps medical residents improve their critical thinking and decision-making skills during their training in the intensive care unit.
Methods: We worked with medical residents training in the critical care department of a teaching hospital. Half of the residents took part in a two-month program using the cognitive apprenticeship model, while the other half continued with regular training. We compared the two groups before and after the program.
Results: Before the training, both groups had similar skills. After the program, the residents who received the cognitive apprenticeship training showed greater improvement in key areas such as truth-seeking, systematic thinking, confidence, and curiosity. They also scored higher in practical skills like taking patient histories, showing empathy, communicating, making clinical judgments, working efficiently, and overall competence.
Conclusion: The cognitive apprenticeship model helps medical residents develop stronger critical thinking and clinical decision-making skills, making their training more effective.
Keywords: cognitive apprenticeship, critical care medicine, critical thinking, clinical reasoning and decision-making skills
1Department of Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 2School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 3School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
Correspondence: Chuan Guo, Department of Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China, Email guochu991020@163.com
Objective: This study explores the effectiveness of the cognitive apprenticeship teaching model in fostering critical thinking and clinical reasoning and decision-making skills among medical residents during their rotations in the critical care medicine department.
Methods: We selected medical residents undergoing standardized training during their rotations in the critical care medicine department at the First Affiliated Hospital of Chengdu Medical College as the study participants. We conducted a two-month clinical practice course using the cognitive apprenticeship teaching model and evaluated its outcomes.
Results: Prior to the teaching intervention, there were no significant statistical differences (P > 0.05) in the general information and pre-teaching assessment scores related to critical thinking and clinical reasoning and decision-making skills between the two groups of students. However, after the training, the experimental group demonstrated significant improvements in four dimensions: truth-seeking, systematic skills, confidence in critical thinking, and curiosity, compared to the control group. Furthermore, in the Mini-CEX assessment, the experimental group scored higher in six dimensions: medical history inquiry, humane care, communication skills, clinical judgment, organizational efficiency, and overall clinical competency, with statistically significant differences (P < 0.05) compared to the control group.
Conclusion: The cognitive apprenticeship teaching model enhances the critical thinking and clinical reasoning and decision-making skills of resident physicians, thereby improving the effectiveness of medical education.
Plain Language Summary: Objective: This study tested a teaching method called “cognitive apprenticeship” to see if it helps medical residents improve their critical thinking and decision-making skills during their training in the intensive care unit.
Methods: We worked with medical residents training in the critical care department of a teaching hospital. Half of the residents took part in a two-month program using the cognitive apprenticeship model, while the other half continued with regular training. We compared the two groups before and after the program.
Results: Before the training, both groups had similar skills. After the program, the residents who received the cognitive apprenticeship training showed greater improvement in key areas such as truth-seeking, systematic thinking, confidence, and curiosity. They also scored higher in practical skills like taking patient histories, showing empathy, communicating, making clinical judgments, working efficiently, and overall competence.
Conclusion: The cognitive apprenticeship model helps medical residents develop stronger critical thinking and clinical decision-making skills, making their training more effective.
Keywords: cognitive apprenticeship, critical care medicine, critical thinking, clinical reasoning and decision-making skills