An RQMN Integrated Teaching Model to Improve Clinical Competence in Undergraduate Internal Medicine Education: A Randomized Controlled Study.

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.