Journal of medical education and curricular development · 2026
An RQMN Integrated Teaching Model to Improve Clinical Competence in Undergraduate Internal Medicine Education: A Randomized Controlled Study.
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Zhang Haoruo, Liao Liqi, Cao Rui, Gong Chunlin, Zhong Jiaoyue, Zhang Xindan, Hong Siting
Аннотация
PURPOSE: Integrating theoretical instruction with the development of clinical reasoning and practical competence remains a challenge in internal medicine education. This study evaluated an integrated teaching model designed to facilitate the transfer of classroom learning to clinical practice in undergraduate medical education.
METHODS: Eighty undergraduate medical students were randomly assigned to an RQMN group receiving the RQMN integrated teaching model-a structured sequence of role playing, question raising, making diagnostic and therapeutic plans, and novice clinical apprenticeship through supervised clerkship-or a control group receiving conventional instruction. Outcomes were assessed immediately after completion of the course and clinical clerkship using a comprehensive clinical competence evaluation and a structured questionnaire on learning experience and teaching quality.
RESULTS: No significant difference was observed in theoretical examination scores between the groups. However, the RQMN group performed significantly better in several practice-oriented domains, including medical history taking, physical examination, communication skills, clinical judgment, and medical record writing (all P < 0.05). Questionnaire results also showed greater improvements in learning interest, self-directed learning, teamwork, clinical reasoning, and practical skills among students in the RQMN group (all P < 0.05), without a marked increase in perceived learning-related stress. Overall satisfaction with teaching quality and learning experience was also higher in the RQMN group.
CONCLUSION: The RQMN integrated teaching model was associated with short-term improvements in selected clinical skills and self-reported learning experiences immediately after course completion, while theoretical examination performance was maintained. Further studies with delayed follow-up are needed to determine whether these gains are retained and transferred to later clinical performance.
METHODS: Eighty undergraduate medical students were randomly assigned to an RQMN group receiving the RQMN integrated teaching model-a structured sequence of role playing, question raising, making diagnostic and therapeutic plans, and novice clinical apprenticeship through supervised clerkship-or a control group receiving conventional instruction. Outcomes were assessed immediately after completion of the course and clinical clerkship using a comprehensive clinical competence evaluation and a structured questionnaire on learning experience and teaching quality.
RESULTS: No significant difference was observed in theoretical examination scores between the groups. However, the RQMN group performed significantly better in several practice-oriented domains, including medical history taking, physical examination, communication skills, clinical judgment, and medical record writing (all P < 0.05). Questionnaire results also showed greater improvements in learning interest, self-directed learning, teamwork, clinical reasoning, and practical skills among students in the RQMN group (all P < 0.05), without a marked increase in perceived learning-related stress. Overall satisfaction with teaching quality and learning experience was also higher in the RQMN group.
CONCLUSION: The RQMN integrated teaching model was associated with short-term improvements in selected clinical skills and self-reported learning experiences immediately after course completion, while theoretical examination performance was maintained. Further studies with delayed follow-up are needed to determine whether these gains are retained and transferred to later clinical performance.