To evaluate the practical effect of short-term training of emergency clinical thinking teaching system based on "situation immersion and case integration".

Trainees of each Teaching Base from 2017 to 2019 participating in the clinical rotation and junior doctors (172 cases) of the Department of Emergency Medicine of the First Affiliated Hospital, College of Medicine, Zhejiang University were selected and divided into two groups according to the convenience sampling method. Trainees in the control group (n = 90) were trained by traditional emergency teaching methods, and those in the experimental group (n = 82) were trained for the emergency clinical thinking system. In short-term courses, the emergency clinical thinking system was gradually integrated into theoretical teaching, practical teaching, and doctor-patient communication training through case integration and situation immersion. After training, trainees were assessed with A2 emergency clinical thinking tests. The general data and test results of trainees were compared between the two groups. Their correct rates of corresponding "dynamic principle", "razor principle", "divergent thinking", "modeling principle", "monist principle", "holistic principle", "suppression theory", and "evidence theory" questions were recorded, as well as those of "easy", "medium", and "difficult" questions.

After the short-term training of emergency clinical thinking teaching system, the test result was significantly higher in the experimental group than in the control group [(81 ± 11) scores vs. (77 ± 10) scores, t = 2.412, P = 0.017]. The correct rate of "evidence theory" questions was also significantly higher in the experimental group than in the control group [89.43% (220 / 246) vs. 80.74% (218 / 270), χ² = 7.576, P = 0.006], while the correct rates of "dynamic principle", "razor principle", "divergent thinking", "modeling principle", "monist principle", "holistic principle", and "suppression theory" questions were not significantly different between the two groups (all P > 0.05). Besides, the correct rate of "difficult" questions was significantly different between the two groups [75.30% (494 / 656) vs. 70.56% (508 / 720), χ² = 3.911, P = 0.048], while the correct rates of "easy" and "medium" questions were not significantly different (both P > 0.05).

The emergency clinical thinking teaching system based on "situation immersion and case integration" can effectively improve trainees' various clinical thinking skills and their ability to solve difficult problems after short-term training, and thus the expected teaching goals were reached.