Objective

2

To explore the application effects of a method combining progressive case study and fishbone diagram in clinical teaching of interns in general surgery

and evaluate its impact on medical students' theoretical knowledge mastery

clinical practice ability development

and systematic thinking cultivation.

Methods

2

Sixty u

ndergraduate clinical medicine students who interned in the Department of General Surgery from July 2022 to December 2023 were selected as the research subjects and randomly divided into a control group (

n

=30) and an observation group (

n

=30). The control group received traditional case-based teaching through centralized lectures

group discussions

and review/Q

&

A sessions. The observation group received an integrated teaching approach combining progressive case study and fishbone diagram through the design of progressive cases and fishbone diagrams. Teaching effectiveness was evaluated through theoretical assessment

practical assessment

and teaching satisfaction survey. SPSS 22.0 was used for

t

-test and

χ

2

test.

Results

2

The total score of theoretical assessments for the observation group interns was higher than that of the control group [(86.97±4.60) vs. (66.06±5.96)

t

=-17.79

P

<

0.001

]

. The differences in scores of diagnosis and treatment standards [(17.03±1.82) vs. (14.07±2.35)

]

and differential diagnosis [(12.85±1.42) vs. (8.92±2.37)

]

were particularly significant. In the practical assessments

the total score of the observation group interns [(90.19±5.04) vs. (68.63±4.30)

t

=-17.82

P

<

0.001

]

and their scores in individual assessments were higher than those of the control group

especially in acute abdomen evaluation [(18.23±1.72) vs. (14.37±2.05)

]

laparoscopic spatial positioning [(8.83±0.95) vs. (5.92±1.38)

]

and intraoperative emergency management [(8.95±0.97) vs. (6.05±1.23)

]

. The satisfaction scores of the observation group interns were higher than those of the control group (

P

<

0.001)

with the greatest improvement in clinical thinking [(4.65±0.61) vs. (3.10±0.71)

]

and teacher-student interaction quality [(4.72±0.53) vs. (3.11±0.63)

]

.

Conclusions

2

The teaching method combining progressive case study and fishbone diagram significantly improved interns' theoretical assessment scores

practical operation ability

and clinical decision-making level through the dynamic presentation of case evolution processes and the application of structured analysis tools

and also enhanced the teaching satisfaction.