关键词: 案例教学法, 虚拟仿真, 问题导向教学法, 临床实习, 脑血管病, 教学应用, 医学教育改革

Abstract: Objective　To evaluate the practical effectiveness of a teaching model that integrates case-based learning (CBL) and problem-based learning (PBL) with virtual simulation technology in the teaching of complex cerebrovascular intervention cases. The study assessed its impact on clinical reasoning skills, learning satisfaction, teamwork abilities, and long-term knowledge retention.Methods　A randomized controlled trial was conducted with 120 resident physicians and standardized training medical students who received training at the First Affiliated Hospital of Zhengzhou University from December 2023 to March 2025. Participants were randomly assigned to either the control group (n=60) or the intervention group (n=60) in a 1∶1 ratio. The control group received traditional lecture-based instruction, while the intervention group engaged in a CBL-PBL integrated teaching model enhanced with a virtual reality cerebrovascular intervention simulation system and an interactive online case-based learning platform to create immersive clinical learning scenarios. At the end of the teaching period, both groups were evaluated on clinical reasoning ability, learning satisfaction, teamwork and communication skills, and knowledge retention and transfer one month later.Results　After the teaching intervention, the intervention group showed significantly higher clinical reasoning scores than the control group (P＜0.001). Overall satisfaction and scores across all satisfaction dimensions were significantly higher in the intervention group (P＜0.05). Peer-assessed teamwork scores were also significantly higher (P＜0.001), although instructor-assessed scores showed no significant difference (P＞0.05). Follow-up testing revealed that knowledge retention in the intervention group remained significantly higher than in the control group (P＜0.001), though the rate of score decline over time did not differ significantly between groups (P＞0.05).Conclusion　The virtual simulation-assisted CBL-PBL integrated teaching model significantly enhances the instructional effectiveness for complex cerebrovascular intervention cases. It contributes to the development of clinical reasoning, collaboration, and knowledge transfer skills among trainees and demonstrates strong potential for broader implementation in clinical education.

Key words: case-based learning, virtual simulation, problem-based learning, clinical internship, cerebrovascular diseases, teaching application, medical education reform