Objective　To explore the effect of flipped classroom combined with scenario simulation in the teaching reform on four basic medical puncture techniques of clinical skills training. Methods A total of 1 275 students majoring in five-year clinical medicine in Guangzhou Medical University were enrolled in the study. The control group (647 cases from Batch 2015) were given the traditional teaching pattern and the experimental group (628 cases from Batch 2016) adopted flipped classroom combined with scenario simulation. At the end of the course

the performance in the tests of four basic medical puncture techniques in the objective structured clinical examination (OSCE) of the two groups were compared. The feedback and evaluation of this teaching mode in the experimental group were investigated by questionnaires. SPSS 19.0 was used for independent samples t test. Results　All the scores of the tests of four basic medical puncture techniques in the experimental group were significantly higher than those in the control group: abdominocentesis [(87.89±7.13) vs. (82.60±10.74) points]

thoracocentesis [(85.20±7.39) vs. (81.96±7.76) points]

bone marrow aspiration [(88.13±6.00) vs. (83.50±9.63) points]

and lumbar puncture [(91.91±7.19) vs. (80.74±12.20) points]

with significant differences (P<0.001). The results about the feedback and evaluation in the experimental group showed that the students gave an average score of 8.4 points to their satisfaction with the new teaching mode. The approval rates of the teaching effect evaluation items such as teaching arrangement

improving learning ability

improving clinical practice ability and school promotion were higher than 90.0%. Conclusion　Flipped classroom combined with scenario simulation

which is worthy to be popularized

can not only improve the students' performance in the tests of four basic medical puncture techniques in the OCSE

but also improve teaching satisfaction and teaching effect.